RCC Reimbursement, RBRVS & Revenue Cycle Management

Question 1

What does RBRVS stand for in physician fee schedule calculations?

Accepted Answer

Resource-Based Relative Value Scale

Answer

RBRVS stands for Resource-Based Relative Value Scale, the foundation of the Medicare Physician Fee Schedule.

Question 2

Which three components make up a Relative Value Unit (RVU)?

Accepted Answer

Physician work, practice expense, malpractice expense

Answer

RVUs consist of three components: physician work RVU, practice expense RVU, and malpractice (PLI) RVU.

Question 3

What is the role of the Geographic Practice Cost Index (GPCI) in MPFS calculations?

Accepted Answer

Adjusts RVUs to reflect regional cost differences

Answer

GPCIs adjust each RVU component for geographic variation in physician work, practice costs, and malpractice premiums.

Question 4

In revenue cycle management, what does 'clean claim' mean?

Accepted Answer

A claim submitted without errors that can be processed immediately

Answer

A clean claim contains all required information and no errors, allowing immediate adjudication by the payer.

Question 5

Which metric measures the percentage of submitted claims that are paid on the first submission?

Accepted Answer

First-pass resolution rate

Answer

First-pass resolution rate measures the percentage of claims paid without rework on initial submission.

RCC - Radiology Certified Coder Practice Test