Why would a payer use edits as a tool to review claims for inaccuracies?
What will be an ideal response?
Claims not passing through the edits are not paid. This allows the payer to earn interest on the money that would have been paid out for those claims.
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November data:Admissions: A&C = 285, NB = 30Deaths:Medical = 21Surgical = 3Pediatric = 1OB = 1NB = 1Fetal-early = 3Fetal-intermediate = 1Fetal-late = 1Discharges (including deaths):Adult = 280Children = 18NB = 24Determine the gross death rate for November correct to two decimal places.
A. 8.39% B. 8.65% C. 8.00% D. 8.25%
Signs of fraud or abuse by a workers' compensation patient include
a. repeated injuries from work-related conditions b. difficulty recalling details and the details of the injury keep changing c. preexisting conditions that are exacerbated by work d. None of the above
Under OBRA-90, pharmacists in every state must offer to __________ all patients and review medications that they are taking
Fill in the blank(s) with correct word
One of the goals of public health is to protect people from diseases and conditions that are preventable and to alert officials of an emerging problem that needs to be addressed.
Answer the following statement true (T) or false (F)