CHAA Examination Preparation. Pre-Encounter - Session IV Pages 52-61 University of Mississippi Medical Center. What to Expect…. This module covers various aspects of Patient Access knowledge found in pages 52-61 of the Pre-Encounter section of the 2010 CHAA Study Guide.
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Pre-Encounter - Session IV
University of Mississippi Medical Center
PROs have two main functions in serving CMS beneficiaries:
1.) They conduct COOPERATIVE QUALITY IMPROVEMENT PROJECTS to increase the quality of care by examining and improving health-care delivery processes.
2.) They provide BENEFICIARY PROTECTION AND EDUCATION thorough mandatory case review of beneficiary complaints and outreach activities.
In an effort to limit the increasing costs of healthcare, CMS proposed a “Prospective Payment System” which lists the amounts CMS will reimburse for each procedure.
Fiscal Intermediaries are also responsible for:
Medicare is a federal health insurance program for:
A patient’s Medicare card will identify:
Medicare Beneficiaries are automatically eligible and must apply 3 months before their 65th birthday.
This is Hospital Insurance and helps pay for:
This helps pay for:
This is known also as the “Medicare Advantage Plan.”
This helps cover PRESCRIPTION DRUGS and MAY lower prescription drug costs.
This form is given to ALL MEDICARE BENEFICIARIES in INPATIENT HOSPITALS and it explains:
The ABN should be given to the beneficiary to sign if:
- BECAUSE -
These are Private Insurance plans that pay some or all of healthcare costs not covered by Medicare: