Health maintenance organizations (HMOs) often do not require participants to pay deductibles.
Answer the following statement true (T) or false (F)
True
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The most likely outcome of an insurance claim submitted with a diagnosis code of a sore throat and a treatment code indicating a cast for a broken leg would be
A. coverage at 100 percent. B. the fee for service would be applied toward the patient's deductible. C. denied as a billing error because the treatment was not medically necessary based on the diagnosis. D. the patient may have to pay a coinsurance after the deductible is met.
ECRM legislation controls _____
A) All forms of data and the tools used to generate and store it B) Just the contents of electronic tools, such as computers C) Only business and financial records maintained on patients D) Privacy and confidentiality of healthcare information
Polypharmacy is defined as the:
A. prescription of medications by two physicians. B. intentional use of five or more medications. C. simultaneous use of multiple medications
The abbreviation NEC represents a code
A. that is used when a disease or condition cannot be found in any other category. B. that is used for unspecified reasons. C. that has a manifestation code also. D. that is used when no other information is available.