HSA 525 Midterm exam/HSA 525 Midterm exam/HSA 525 Midterm exam
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Question 1 What are the two types of forms used for health services billing? CMS 1501 and CMS 1450 UB 04 CMS 1100 and CMS 1450 UB-05 and UB-1450 Question 2 Describe how Medicaid payments to pro... viders are limited by the federal government. The payments to providers are not limited by the federal government but rather by state agencies that have predetermind estimates. The law requires that Medicaid payments to qualified hospitals, nursing facilities, ICF/MRs, and clinics not exceed a reasonable estimate of the amount that Medicare would pay for equivalent services in the aggregate within state-owned or operated, non-state-owned or operated, and private facilities. CMS reviews state payment methodologies and supporting documentation to ensure that the state plan methodology may be audited and is comprehensively described and that payment rates are economic, efficient, and sufficient to attract willing and qualified providers. All of the statements are correct. None of the statements are correct Question 3 What is charge explosion? [Show More]
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