RHIT Revenue Cycle Management 2

Question 1

Which term describes the process of verifying a patient's insurance coverage before providing services?

Accepted Answer

Eligibility verification

Answer

Eligibility verification confirms a patient's active insurance coverage and benefits before services are rendered.

Question 2

A claim is denied because the procedure code does not match the diagnosis code. This is an example of which type of edit?

Accepted Answer

National Correct Coding Initiative (NCCI) edit

Answer

NCCI edits prevent improper payment of procedures that should not be billed together or when a procedure is incompatible with the diagnosis.

Question 3

What is the purpose of a charge description master (CDM)?

Accepted Answer

To list all billable services with corresponding codes and prices

Answer

The CDM (chargemaster) is a comprehensive list of services, procedures, and supplies with associated billing codes and prices used for claim generation.

Question 4

Which federal program uses the Inpatient Prospective Payment System (IPPS) for hospital reimbursement?

Accepted Answer

Medicare

Answer

Medicare uses IPPS to reimburse acute care hospitals a predetermined rate based on the patient's MS-DRG assignment.

Question 5

A hospital receives payment less than the billed amount with an explanation listing contractual adjustments. What should the HIM professional do with the difference?

Accepted Answer

Write it off as a contractual adjustment

Answer

Contractual adjustments represent the difference between billed charges and the negotiated rate and must be written off per the payer contract.

RHIT - Registered Health Information Technician Practice Test

RHIT - Registered Health Information Technician Practice Test

RHIT Revenue Cycle Management 2