Cic Chapter 13 |14 Questions| With Correct Answers.

Balanced Budget Act of 1997 (BBA) {Ans: the Balanced Budget Act of 1997 included the CMS requirement to move from a cost-based reimbursement for hospital outpatient services to the implementation of an outpatient prospective payment system (OPPS). The OPPS went into effect August 2000 for hospital facilities}Composite rate {Ans: an average rate weighted to account for resources utilized in the facility for grouping of procedures using similar resources}Bill Type {Ans: a code indicating the specific type of bill}Outpatient Prospective Payment System (OPPS) {Ans: A reimbursement method in which payment is a pre-determined, fixed amount based on a classification system of that service. Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999-known as the Balanced Budget Refinement Act (BBRA), included provisions for a transitional pass-through payment for innovative and generally expensive medical devices, drugs, and biologicals in OPPS}Medicare Severity-Diagnostic Related Group (MS-DRG) {Ans: the prospective payment system used by Medicare and many other payers for inpatient payments}Cost-to-Charge Ratio (CCR) {Ans: a ratio of the cost divided by the charges. the CCR is used to determine outlier payments and payments for pass-through devices}