Admin & Finance Section 2: Internal Controls, Provider Enrollment and Fee Schedule Development Flashcards
True or False: RHCs should have one fee schedule for all patients.
True
What is the most common method for setting fees?
Medicare Fee Schedule
True or False: By establishing recommended standard internal controls, the practice reduces the ability and opportunity for employees to commit crimes.
True
True or False: It is recommended that RHCs use their encounter rate as their fee.
False
True or False: Participation with state Managed Medicaid Plans is automatic.
False
True or False: Internal Controls are processes to minimize and better control risk to the practice.
True
RBRVS is an acronym for:
Resource-Based Relative Value System
True or False: Fee schedules should be the same for all payer types.
True
True or False: Medicare Administrative Contractors (MACs) determine RHC Medicaid Payment rules:
True
List three examples of potential cover up when cash is being taken.
- Charge and applicable payment are not posted
- Charge is posted with payment adjusted to reduce balance
- Fee ticket is destroyed
Crime usually has three factors that intersect. Those being:
Opportunity, motive, ability (means)
True or False: Policy and Procedure development is a foundation in setting up Internal Controls.
True
True or False: Internal Controls guarantee a financially healthy organization.
False. They help mitigate risk.
True or False: Using vacation time yearly with reasonable accrual allows not only for cross coverage, but also for other staff to recognize potential suspicious circumstances for cash handling, write-offs, payroll or accounts payable.
True
RHCs are recommended to set their fee schedule:
Based on their reasonable and customary fees
