Question

33. Patient care approached from a holistic approach defines a. Health Maintenance Organizations b. Patient-Centered Medical Home. c. precertification. d. medical necessity. 34. Abuse is knowingly and willfully executing or attempting to execute a scheme to defraud any healthcare benefit program. Fraud is an unintended action that results in an overpayment to the healthcare provider. Both statements are true. b. Both statements are false. c. The first statement is true and the second statement is false. d. The first statement is false and the second statement is true. 35. If the ICD-10-CM codes and the CPT/HCPCS codes do not match the claim will not show a. eligibility b. precertification

Answer 1

33)option b - Patient care approached from a holistic approach defines patient centered medical home. In a patient centered home, complete care is provided to the patient ,it is just not assisting the ailing person but also being there for them supporting, understanding. It helps to heal body and mind.

34)option c - First statement is true and second statement is false.( Abuse and fraud, both are the acts done intentionally).

35) option A - eligibilty ( one of the reasons for claims being rejected).