100%(2)2 out of 2 people found this document helpful
This preview shows page 5 - 8 out of 8 pages.
The payers that reimburse the facility the most would be Medicaid and BC/BS. The least would be TRICARE* with .04 percent.d.Based on the percentages calculated in the adjustments column, identify the payers that proportionately reimburse the facility the most and the least. The payers that reimbursed the most would be Medicare and Medicare. The least would be Commercial, BC/BS, and TRICARE*.4. Managing the Revenue cycle process: Explain why revenue cycle management is important and what the role for HIM professionals is in the process.
1.What is the term used by the insurance industry that refers to the process of paying, denying, and adjusting claims based on patients’ health insurance coverage benefits?2.True or false: Clinical data is used to identify an individual. a.Falseb.True3.________ protects a person from having to pay the full cost of healthcare.4.The ______ is the process of patient financial and health information moving into,through, and out of the healthcare facility.a.Revenue streamb.Revenue spinc.Revenue cycled.Revenue circle5.What is the term that is used to identify an insurance company that pays for the healthcare of covered individuals? 6.True or false: If a patient is covered by more than one insurance plan, the process of coordination of benefits (COB) takes place.7.True or false: A Chargemaster is a financial management list that contains information about the organization’s charges for healthcare services it provides to patients.6
Health Information Management Technology: An Applied Approach, 5eWorkbook8.______ is a type of incentive to improve clinical performance using the electronichealth record resulting in additional reimbursement or eligibility for grants or other subsidies to support further HIT efforts.a.Fee-for-serviceb.Fee-for performancec.Pay-for-serviced.Pay-for-performance