Reimbursement Methodologies Review
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Topics of this game:
- What is Prospective Reimbursement?
- What is Medicare Advantage?
- When does open enrollment periods begin?
- What is the foundation of the social insurance model?
- What is the amount paid to a healthcare provider for services provided to a patient?
- How many components are there in the revenue cycle?
- What is the contract that describes the conditions of the insurance policy?
- How many categories are required by the ACA for essential benefits?
- What is a healthcare service benefit that the health insurance company will cover or reimburse?
- What do evidence-based clinical practice guidelines outline?
- What is utilization management?
- What is a point-of-service (POS) health insurance plan?
- When was the Social Security Act established?
- Which portion of Medicare covers outpatient services?
- Can a person, who is qualified for Medicaid, receive services in a different state, other than where they are qualified in?
- What did the Balanced Budget Act of 1997 authorize to be created?
- What healthcare program did TRICARE replace?
- How many Priority Groups are in the Veterans Health Administration (VHA)
- What does bundled payment mean?
- What does accountable care organization (ACO) mean?
- What is a type of institutional provider is required to submit cost reports?
- What is case-mix index (CMI)
- How many steps are there in assigning MS-DRGs for hospital inpatient admissions?
- What is a total performance score (TPS)
- What is a skilled nursing facility?
- By what percentage is nursing staff time wage-weighted for AIDS residents?
- How many components are used to determine the per diem rate for SNF resident stays in the PDPM model?
- How many SI reimbursement methods are currently used in the OPPS?
- Which SI in the APC payment reimbursement method is used to describe "Significant procedures for which multiple procedure reduction does not apply"?
- What is an example of packaged services with the SI N in OPPS?
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