CMS Emergency Definition Quiz
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Questions and Answers

Health plans base reimbursement on the final diagnosis rather than a patient's presenting symptoms.

False

If a patient's severe chest pain turns out to be heartburn rather than a heart attack, the health plan must cover the emergency department care.

True

Urgent and Emergent claims are considered at the Out of Network (OON) benefit level.

False

Severe and/or persistent vomiting is commonly identified as an Urgent / Emergent condition.

<p>True</p> Signup and view all the answers

If the provider is in-network and the claim is denied, it is the provider's responsibility.

<p>True</p> Signup and view all the answers

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