RCC Reimbursement, RBRVS & Revenue Cycle Management 2

Question 1

What is the 'conversion factor' in the Medicare Physician Fee Schedule?

Accepted Answer

A dollar amount multiplied by total RVUs to determine payment

Answer

The conversion factor is a dollar multiplier applied to total adjusted RVUs to calculate Medicare payment amounts.

Question 2

Which KPI measures the average number of days it takes to collect payment after a service is provided?

Accepted Answer

Days in Accounts Receivable (AR)

Answer

Days in AR measures the average time from service date to payment receipt, indicating billing efficiency.

Question 3

What is 'upcoding' in the context of radiology billing compliance?

Accepted Answer

Reporting a more complex or higher-paying code than the service actually performed

Answer

Upcoding is a fraudulent practice of reporting higher-paying codes than the documentation supports.

Question 4

Which federal law imposes liability for knowingly submitting false or fraudulent claims to Medicare?

Accepted Answer

False Claims Act (FCA)

Answer

The False Claims Act imposes civil monetary penalties and treble damages for knowingly submitting false claims to federal health programs.

Question 5

What does the term 'write-off' mean in a radiology practice's revenue cycle?

Accepted Answer

Amounts contractually adjusted off the billed charge per payer agreement

Answer

Write-offs are contractual adjustments reducing the billed charge to the payer-contracted rate.

RCC - Radiology Certified Coder Practice Test