Medical Practices and Health Care Facilities Should Routinely Participate in an Auditing

question 15

Multiple Choice

Medical practices and health care facilities should routinely participate in an auditing process, which involves reviewing patient records and CMS-1500 or UB-04 claims to __________.

• A) assess coding accuracy and completeness of documentation
• B) calculate the amount of money that must be sent to the payer
• C) determine whether procedures and services were covered
• D) follow up on payer reimbursement of the submitted claims

---

Definitions:

Performance Orientation

An aspect of organizational culture focusing on outcomes and results, emphasizing the achievement of goals and standards of excellence.

External Locus

A belief system where individuals perceive their successes or failures to be the result of external forces or the environment.

Control

The ability to direct, manage, or govern over oneself, other people, or situations to achieve a desired outcome.

Social Intelligence

The skill of comprehending and handling the nuances and interactions within personal connections efficiently.