A ________occurs when a procedure and a diagnosis are not correctly linked, in the opinion of the payer.

A. development
B. redetermination
C. determination
D. medical necessity denial


Answer: D

Health Professions

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Why are fractures across the femoral neck common, especially among elderly women? How does the blood supply of the femoral head play a role in the critical nature of the injury?

What will be an ideal response?

Health Professions

Which of the following statements is NOT true about the effect of / imbalances on O2 and carbon dioxide exchange?

a. Blood leaving high units has a high PO2 and a low PCO2. b. Blood leaving low units has a low PO2 and a high PCO2. c. High units can compensate for high PCO2 levels from low units. d. High units can compensate for low PO2 levels from low units.

Health Professions

On the patient aging report, ____________________ owed after the payment from the patient insurance may appear

Fill in the blank(s) with correct word

Health Professions

A jury in a medical malpractice lawsuit against a hospital determines that the patient is responsible for two-thirds of the injury and the hospital is responsible for one-third. The jury determined that the compensation for the injury will be $900,000. The hospital had to pay the entire amount. This is due to ____.

A. punitive damages B. joint and several liability C. the statute of limitations D. clerical error

Health Professions