2024 Spring Leadership: Train for Successful Reimbursements from Managed Care Payors (Post-Test)

Question Title

* 1. Full Name

Question Title

* 2. Email Address

Question Title

* 3. Please provide your registrant ID or reference number from your registration in Swoogo. This can be found by viewing your invoice, logging into your profile, or checking your email announcing post-tests are available to find the correct ID.

Question Title

* 4. As of February 2024, a majority of Medicare eligible people in Michigan are enrolled in Medicare Advantage plans.

True

False

Question Title

* 5. The reimbursement process for Managed Care Organizations’ (MCO) Medicare Advantage plans work differently than traditional Fee for Service reimbursement.

True

False

Question Title

* 6. Because of the way MCO contracts and reimbursement work, at which stage can you incur a loss of revenue?

Pre-admission

Admission

Managing the Patient

Billing

All of the above

Question Title

* 7. Tailoring operational processes to succeed with managed care requirements can help a facility get accurate reimbursements for serving a patient insured by managed care.

True

False

Question Title

* 8. Managed care contracts should be:

Accessible to both clinical and business office personnel to ensure services are accurately captured and billed

Visible only for administrators and kept in a locked file cabinet somewhere in the basement

Question Title

* 9. Managed care contract terms differ, depending on the MCO.

True

False

Question Title

* 10. A “cheat sheet” can help a facility’s team understand a patient’s specific contract requirements and maximize the chances of successful reimbursement.

True

False

Question Title

* 11. A case manager, or a designated staff member, can serve as the single point of contact with MCOs and help the facility get accurate reimbursement.

True

False

Question Title

* 12. To succeed with complicated MCO contracts, a facility’s business office should:

Openly communicate with other staff members to ensure claims are accurate and clean

Trust that things will work themselves out and the money will be there

Question Title

* 13. In the Grandma Alice example, a facility can lose thousands of dollars on a case if the facility does not accurately capture a patient’s contract terms and submit a clean claim.

True

False