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MODULE 2 REVIEW

Horizontales
A federal law to prevent Medicare fraud
A report that indicates which claims are outstanding
Equipment that might include walkers, oxygen, and wheelchairs
The exchange of data through computer systems
A percentage limit on nonPAR fees
Medicare does not have primary responsibility for beneficiary's medical expenses
Pre-established rate for hospital services
Verticales
Waiver signed by the patient, accepting payment responsibility, when medical necessity cannot be established
A request for payment by asking for review of the claim
Program implemented by CMS in attempt to eliminate unbundling and other inappropriate reporting of CPT codes
Provides reimbursement for out of pocket costs not covered by Medicare
The first step to resolve a denied claim