How did the retrospective reasonable cost system work

Question

Question 1: How did the retrospective reasonable cost system work?

Question 2: How is the prospective payment system different from retrospective reasonable cost system?

Question 3: What is the difference between prospective cost-based rates and prospective price-based rates?

Question 4: List 6 federal healthcare programs.

Question 5: Describe the ambulance fee schedule.

Question 6: Why are ambulatory surgical centers considered suppliers rather than providers?

Question 7: What are APC groups?

Question 8: How does Medicare determine reimbursement for laboratory services?

Question 9: How much does Medicare reimburse for DMEPOS?

Question 10: What items does Medicare cover for ESRD?

Question 11: What facilities are considered FQHCs?

Question 12: Under home health PPS, how long is an episode?

Question 13: Is there a limit to home health services if the patient needs it?

Question 14: What system is used to reimburse services provided by home health, rehab facilities and skill nursing facilities?

Question 15: How does Medicare reimburse hospital inpatient services?

Question 16: How is hospital discharges categorized?

Question 17: What is included in a DRG?

Question 18: Each DRG has a payment weight assigned to it but the payment can be adjusted according to certain guidelines. What are these guidelines?

Question 19: What is the difference between MS-DRGs and APR-DRGs?

Question 20: What are the subdivisions of the two subclasses of APR-DRGs? Need Assignment Help?

Question 21: What changes were made from DRGs to MS-DRGs?

Question 22: What is the difference between POA (present on admission) indicators and hospital and hospital acquired conditions and how do they affect reimbursement?

Question 23: Explain the role of MACs in hospital submission of the UB-04 claim for IPPS payments.

Question 24: When is a hospital outpatient treatment received as an inpatient DRG payment?

Question 25: What are hospital-acquired infections and how are they categorized?

Question 26: List 3 reasons/occasions that CMS will not pay of surgical or insurance procedures.

Question 27: List a few hospital-acquired conditions (HACs) that Medicare and Medicaid will not pay for.

Question 28: What is the purpose of the hospital value-based purchasing effort?

Question 29: What is the purpose of the hospital readmission reduction program (SRRP)?

Question 30: What claim form is used to report hospital outpatient encounter and what coding manuals are used to code diagnoses and procedures?

Question 31: What are wage index adjustment?

Question 32: What coding manuals are used to code for inpatient diagnoses and procedures?

Question 33: How are rehab facilities paid for inpatient services?

Question 34: How does Medicare define long-term (acute) care hospitals?

Question 35: What are the diagnostic groups for LTC facilities called?

Question 36: What reimbursement system is used by Medicare to pay skilled nursing facilities for services provided?

Question 37: Describe the physician fee schedule.

Question 38: What are the components that make up the relative value units for physicians fee schedule?

Question 39: What are geographic cost practice indices?

Question 40: How are anesthesia, radiology and pathology fee/payments determine?