(02.06 LC)Which of the following documents argued for the po…
Questions
(02.06 LC)Which оf the fоllоwing documents аrgued for the power of judiciаl review?
Fill in the blаnks belоw by using this Wоrd Bаnk (sоme words will not be used): ABN аmbulatory care back-end claims production clinic CMI commercial correct setting cost sharing covered entity deductible demographic dependent front-end government-sponsored government official hospital may not medically necessary middle paid patient engagement percent of charges PHI POA refuses resident resource tracking time understands will will not written off 1. Which component of the revenue cycle is responsible for determining the type of insurance coverage and current insurance company for a patient? [BLANK-1] processes of the revenue cycle—[BLANK-2] 2. Many states and the federal government have price transparency regulations. How does price transparency help patients and guarantors? Price transparency is the first step in helping patients understand the amount of [BLANK-3] required for a service. 3. What is the purpose of a prior authorization? Prior authorization is a cost containment concept of managed care. Therefore, its purpose is to ensure that services are [BLANK-4] and delivered in the [BLANK-5]. 4. What type of information is collected from the patient during scheduling? Basic [BLANK-6] data, required services to be scheduled, and insurance coverage information are collected during scheduling. 5. What is the purpose of a patient financial responsibility agreement? The patient financial responsibility agreement outlines what items the patient is financially responsible for and when that amount should be [BLANK-7]. 6. How is an ABN different from a patient financial responsibility agreement? The ABN is a Medicare-specific patient financial responsibility agreement. An ABN informs the Medicare beneficiary that an item or service [BLANK-8] be covered by Medicare. 7. What is the role of a financial counselor in the revenue cycle? To ensure that the patient [BLANK-9] their coverage and financial responsibility and to help the patient find means to cover that cost. 8. Search for an example of a manufacturer drug cost sharing card. Use the search term “drug copay card.” What are the eligibility criteria? Criteria typically include patient must have [BLANK-10] insurance, patient must have an approved condition to be treated with the drug, and the patient must be a [BLANK-11] of the U.S. 9. Why is knowledge regarding the charge or price of a healthcare service not enough information to determine the cost sharing amount? Other coverage information is required to know the full cost sharing amount. The patient must know if the physician or facility is in or out of network, the differences in cost sharing for in or out of network, and whether or not they have satisfied their [BLANK-12]. 10. Why is a HIPAA authorization form required by a provider prior to treating a patient? The provider must submit HIPAA protected [BLANK-13] to the insurance company for billing purposes, so a HIPAA waiver is required.