If Medicare fails to notify a provider that a procedure is considered medically unnecessary, Medicare:

a. is in the wrong.
b. made a communication error.
c. is responsible for the payment.
d. is not responsible for the payment.

Answer: c

Health Professions

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The outpatient prospective payment system reimburses services according to ambulatory payment classifications (APCs), which group services according to similar __________ and in terms of resources required

a. clinical characteristics b. intensity of resources c. risk of mortality d. severity of illness

Health Professions

Form locator 22 indicates:

A) Patient's relationship to insured. B) Medicaid Resubmission Code. C) EPSDT Family Plan. D) Accept Assignment Code.

Health Professions