List and describe the three components of UCR that provider fees are based on.
What will be an ideal response?
-Usual fee: The fee the provider usually charges for a given service
-Customary fee: The fee that other providers, in the same geographic area, with similar training, charge for the same service. The customary fee is an average of the fees charged by other providers OR the fee that falls in the 90th percentile of the fees charged by other providers.
-Reasonable fee: A fee that is higher than the usual and/or customary fee AND can be justified by the patient's condition. The insurance carrier determines whether or not there is sufficient justification for the higher fee.
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The family members of a 72-year-old female state that the patient complained of a sudden, severe headache; had slurred speech; then became unresponsive. She responds to painful stimuli with decorticate posturing and has snoring respirations at a rate of 10 per minute. Her radial pulse is palpable but grossly irregular. According to her son, she also suffers from congestive heart failure,
hypertension, and diabetes. Which of the following should you do first? A) Attach the cardiac monitor. B) Manage the airway with a modified jaw-thrust maneuver. C) Check her blood sugar. D) Insert an endotracheal tube.
________ energy balance is necessary for weight loss
Fill in the blank(s) with correct word
When a provider bills separately for procedures that are a part of the major procedure, this is
called A. fraud. C. unbundling. B. packaging. D. discounting.
When you check the patient's phlebotomy site before applying a bandage, you notice the site is still bleeding. Why may this be and what, if anything, should you do? (Choose all that apply)A) The patient has held his/her arm above heart level; lower the patient's arm.B) Enough pressure may not have been applied to the site; apply additional pressure.C) The patient may be on anticoagulant therapy; apply additional pressure.D) This is normal; apply extra gauze under the bandage, and thank and dismiss the patient.
What will be an ideal response?