Reimbursement Methodologies Crossword

Fee schedules are updated by third-party payers.
Performance of Internal - facility based staff (HIM P.) & External - consultants hired for purpose ( corporates that specialize), Scope, Frequency & size of sample depends: size of organ, available resources, number of code profess., history of noncompliance, risk factors, case complexity, results of initial assessments
Per person premiums, provide all contracted hc services that the covered individuals needs over a specific period of time, calculated on project cost - per patient per month or per member per month
A Healthcare program for dependent and survivors of permanently and totally disabled veterans
A medical condition that coexists with the primary cause for hospitalization and affects the patient's treatment and length of stay
A medical condition that arises during an inpatient hospitalization (for example, a postoperative wound infection)
The amount of money that the patient is responsible for before the insurance kicks in is called the
The computer software program that assigns appropriate MS-DRGS according to information provided for each episode of care is called a
Which of the following is not a place where PACE services can be provided?
Which of the following plans reimburses patients up to a specified amount?
Title XIX of the Social Security Act Amendment of 1965 is also known as
In this model, healthcare services are contracted with two or more multispecialty group practices instead of just one
What data set is used for patient assesments by the home health prospective payment system?
A payment under the medicare outpatient prospective payment system that includes items such as anesthesia, supplies, certain drugs, and the use of recovers and observation rooms
Which of the following terms is used for the amount charged for a medical
The MS DRG prospected payment system rate is based on what type of diagnosis?
The type of payment system where the amount of payment is determined before the service is delivered is called
What is the name of the federally funded program that pays the medical bills of
Uses multiple codes that Describe individual components of a procedure rather than an appropriate single code that describes all steps of procedure preformed.
Assigning a diagnosis/procedure code specifically for purpose to obtain higher payment
Upon which criterion is Medicaid eligibility-based?