When Records Are Reviewed by Third-Party Payers, If a Procedure

question 30

Multiple Choice

When records are reviewed by third-party payers, if a procedure is not documented, it:

• A) will be reimbursed at only 50% of the standard rate
• B) will be reimbursed at only 10% of the standard rate
• C) is considered to never have been performed
• D) must be resubmitted with a statement of explanation from the provider

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Definitions:

Existing Liabilities

Financial obligations or debts that a company or individual currently owes and is responsible for repaying.

Submission

in legal terms means the act of presenting a document, proposal, or application to a person or authority for consideration or judgment.

Arbitration

A method of dispute resolution where an impartial third party, the arbitrator, makes a decision to resolve a conflict outside of court.

UPA

Uniform Partnership Act; a law in the United States that provides a basic framework for the operation of partnerships in the absence of an express agreement.