1996 HIPAA laws mandate that insurance companies cannot require precertification for:
a. maternity hospitalizations.
b. psychiatric hospitalizations.
c. substance abuse treatment hospitalizations.
d. detoxification treatment hospitalizations.
Answer: a
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When an internal monitor is used to track the fetal heart rate (FHR), the following must have occurred:
A. The cervix is dilated 1 cm and the amniotic sac is intact. B. There are no parameters for the use of the internal FHR monitor. C. Contractions must be <5 minutes apart, and the cervix must be dilated >4cm. D. The amniotic sac must be ruptured and the cervix must be dilated 2-3 cm.
The term ________ during claim adjudication means that the payer needs more information to process the claim.
A. determination B. redetermination C. suspended D. development
Karen works 40 hours a week at a popular tourist attraction and earns a weekly salary of $400. This week, due to Fourth of July crowds, she was asked to work another 10 hours. Having worked 50 hours this week, how much can Karen expect to earn for the week?
A. $700 B. $800 C. $600 D. $400 E. $500