RHIT - Registered Health Information Technician Revenue Cycle Management 3

Question 1

What is the difference between Medicare Part A and Medicare Part B?

Accepted Answer

Part A covers inpatient/hospital services while Part B covers physician/outpatient services

Answer

Part A covers inpatient hospital, skilled nursing, hospice, and some home health. Part B covers physician services, outpatient care, and medical equipment.

Question 2

How does the MS-DRG system affect hospital reimbursement?

Accepted Answer

It classifies inpatient cases to determine a fixed payment amount under the Inpatient Prospective Payment System

Answer

Each DRG has a relative weight that determines the payment amount under Medicare's IPPS.

Question 3

What is the purpose of chargemaster (CDM) maintenance?

Accepted Answer

To regularly review and update all billable services to ensure accurate pricing, current codes, and compliance

Answer

CDM maintenance involves regular review of all billable items for accurate descriptions, current codes, and appropriate prices.

Question 4

What is the difference between 'assignment' and 'non-assignment' in Medicare billing?

Accepted Answer

Assignment means accepting Medicare's allowed amount as full payment; non-assignment allows billing up to 115% of the fee schedule

Answer

Participating providers accept the allowed amount; non-participating providers can charge up to the limiting charge.

Question 5

What is a prior authorization?

Accepted Answer

A requirement to obtain health plan approval before providing certain services

Answer

Prior authorization requires health plan approval before specific services are provided, verifying medical necessity.

RHIT - Registered Health Information Technician Practice Test

RHIT - Registered Health Information Technician Practice Test

RHIT - Registered Health Information Technician Revenue Cycle Management 3