IMG_3781

.jpeg

School

South University, Savannah *

*We aren’t endorsed by this school

Course

1

Subject

Accounting

Date

Jan 9, 2024

Type

jpeg

Pages

1

Uploaded by ElderDangerSeahorse1016

Report
3. What tool might be helpful in defining which services to audit for a focused review? A. RAT-STATS B. Numerical sampling C. Random sampling D. Utlization reports Hide Answer Answer: D. Utilization reports Rationale: Utilization review and data mining provide insight into billing patterns and can help uncover areas of risk. Utilization review is a technique that provides data about how frequently certain services are billed. A utilization pattern can be found from looking at the utilization review to evaluate coding patterns. When performing a government audit, the NCCI edits manual can serve what purpose? A. Provide medical necessity support B. Support the use of modifiers C. Determine evaluation and management levels D. Determine MAC coverage decisions Hide Answer Answer: B. Support the use of modifiers Rationale: The NCCI manual can help support the use of modifiers (e.g., modifier 25, 59), and can help to point out bundling errors when performing the audit. 5. Which resource is valuable when performing an evaluation and management audit? A. MDM Risk Table B. NCCI Manual C. Surgical Audit Tool D. Advance Beneficiary Notice (ABN) LIM(,‘\”\“ er Answer: A. MDM Risk Table Rationale: Any audit of Evaluation and Management services would require that the auditor have access to the Medical Decision Making Risk Table.
Discover more documents: Sign up today!
Unlock a world of knowledge! Explore tailored content for a richer learning experience. Here's what you'll get:
  • Access to all documents
  • Unlimited textbook solutions
  • 24/7 expert homework help