Month End Close
Managed Care & ALTCS
Medicare
Abbr.
Anything Goes
100

What day must you close PCC?

The 4th business day

100

What type of bill is a 217?

An adjustment claim

100

What condition code is used to indicate a private room when a semi-private room is not available?

38

100

What does DSO stand for?

Days Sales Outstanding

100

What amount for a write off requires an asset search?

$3500

200

What day must triple check meeting be?

The 3rd business day

200

Name one insurance company where a pharmacy exclusion is already included in our contract and an additional authorization is not needed?

Cigna and Banner Health Network

200

What is the Medicare part B deductible amount for 2023?

$226

200

What is an IPA?

Interim Payment Assessment

200

What is the maximum asset limit to be eligible for the Medicaid program?

$2000.00

300

What day are internal controls due?

The 5th business day

300

What value code is required for a Mercy Care LTC bariatric claim?

A8 - along with the weight of the patient in kilos

300

If someone is under 65 and eligible for Social Security Disability Insurance, how long must they be considered disabled before they are entitled to Medicare?

24 months 

300

What does NDC stand for?

National Drug Code

300

What is the annual cap for PT/SLP part B services?

$2010.00

400
Do you enter ancillary charges before or after triple check?

Before

400

What is the difference between a MAOLP-pdpm and MAOPDPM payer

MAOLP-pdpm requires a HIPPS on the claim, but pays at a level. MAOPDPM requires a HIPPS and pays the HIPPS rate.

400

What revenue code is required on a Medicare claim to indicate a LOA?

0180

400
What does CO stand for?

Contractual Obligation

400

Can an allowable write off go on the under $500 log?

No

500

You must run these three reports to verify days by payer, and grand total days match?

1. Detailed Census 2. Revenue Reconciliation 3. Electronic Manual Census
500

Who is the payer of last resort?

Medicaid

500

What occurrence span code is used with the qualifying hospital stay dates?

70

500

What does CARC mean?

Claim Adjustment Reason Code

500

All write offs require these 4 reports

1. Facesheet 2. Transaction History 3. Aging 4. Collection Notes