HFMA Exam Questions with Complete
Solutions7
Which of the following statements are true of HMFA's Patient Financial Communications Best
Practices? - ANSWERS-The best practices were developed specifically to help patients
understand the cost of services, their individual insurance benefits, and their responsibility for
balances after insurance, if any.
Patient experience includes all of the following expect: - ANSWERS-The average number of
positive entions received by the health system or practice and the public comments refuting
unfriendly posts on social media sites
Patient experience includes: - ANSWERS-- Recognition that revenue cycle processes must be
patient centric and efficient. This is especially true in the areas of scheduling, registration,
admitting, financial counseling and account resolution conversation with patient.
- Patient accounting is responsible for providing statements that are easy to understand and
supported y access to revenue cycle staff during extending business hours and via a variety of
contact options
-Ensuring that rework in minimized to avoid the adverse impact of missing authorization or the
provision of care that is not medically necessary in the place of service where care was provided
Corporate compliance programs play an important role in protecting the integrity of operations
and ensuring compliance with federal and state requirements. The Code of conduct is -
ANSWERS-Answer is all:
- a critical tool to ensure the compliance with org's compliance standards and procedures
- An essential and integral component of the org's culture
-Fosters an environment where concerns and questions may be raised without fear of
retaliation or retribution
, Specific to Medicare fee-for-service patients, which of the following payers have always been
liable for payment? - ANSWERS-Public health service programs, federal grant programs,
veterans affairs program, black lung program services and work related injuries and
accidents(workers comp claims)
Provider policies and procedures should be in place to reduce the risk of ethics violations.
Examples of ethics violations include: - ANSWERS-- Financial misconduct, overcharging and
miscoding claims,
-Theft of property and falsifying records to boost reimbursement
- Financial misconduct and applying policies in an inconsistent manner
Providers are now being reimbursed with a focus on the value of the services provided, rather
than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery system for a
population of patients? - ANSWERS-To eliminate duplicate services, prevent medical errors, and
ensures appropriateness of care
Historically, revenue cycle has dealt with contractual adjustments, bad debt and charity
deductions from gross revenue. Although deductions continue to exist, the definition of net
revenue has been modified through the implementation of ASC 606. Developed by the Financial
Accounting Standards Board (FASB), this change became effective in 2018.
What is the new terminology now employed in the calculation of net patient service revenues? -
ANSWERS-Explicit price concessions and implicit price concessions
Key performance indicators set standards for A/R and provide a method for measuring the
control and collection of A/R.
What are the two KPIs used to monitor performance related to the production and submission
of claims to third party payers and patients (self-pay)? - ANSWERS-Elapsed days from discharge
to final bill and elapsed days from final bill to claim/bill submission
Solutions7
Which of the following statements are true of HMFA's Patient Financial Communications Best
Practices? - ANSWERS-The best practices were developed specifically to help patients
understand the cost of services, their individual insurance benefits, and their responsibility for
balances after insurance, if any.
Patient experience includes all of the following expect: - ANSWERS-The average number of
positive entions received by the health system or practice and the public comments refuting
unfriendly posts on social media sites
Patient experience includes: - ANSWERS-- Recognition that revenue cycle processes must be
patient centric and efficient. This is especially true in the areas of scheduling, registration,
admitting, financial counseling and account resolution conversation with patient.
- Patient accounting is responsible for providing statements that are easy to understand and
supported y access to revenue cycle staff during extending business hours and via a variety of
contact options
-Ensuring that rework in minimized to avoid the adverse impact of missing authorization or the
provision of care that is not medically necessary in the place of service where care was provided
Corporate compliance programs play an important role in protecting the integrity of operations
and ensuring compliance with federal and state requirements. The Code of conduct is -
ANSWERS-Answer is all:
- a critical tool to ensure the compliance with org's compliance standards and procedures
- An essential and integral component of the org's culture
-Fosters an environment where concerns and questions may be raised without fear of
retaliation or retribution
, Specific to Medicare fee-for-service patients, which of the following payers have always been
liable for payment? - ANSWERS-Public health service programs, federal grant programs,
veterans affairs program, black lung program services and work related injuries and
accidents(workers comp claims)
Provider policies and procedures should be in place to reduce the risk of ethics violations.
Examples of ethics violations include: - ANSWERS-- Financial misconduct, overcharging and
miscoding claims,
-Theft of property and falsifying records to boost reimbursement
- Financial misconduct and applying policies in an inconsistent manner
Providers are now being reimbursed with a focus on the value of the services provided, rather
than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery system for a
population of patients? - ANSWERS-To eliminate duplicate services, prevent medical errors, and
ensures appropriateness of care
Historically, revenue cycle has dealt with contractual adjustments, bad debt and charity
deductions from gross revenue. Although deductions continue to exist, the definition of net
revenue has been modified through the implementation of ASC 606. Developed by the Financial
Accounting Standards Board (FASB), this change became effective in 2018.
What is the new terminology now employed in the calculation of net patient service revenues? -
ANSWERS-Explicit price concessions and implicit price concessions
Key performance indicators set standards for A/R and provide a method for measuring the
control and collection of A/R.
What are the two KPIs used to monitor performance related to the production and submission
of claims to third party payers and patients (self-pay)? - ANSWERS-Elapsed days from discharge
to final bill and elapsed days from final bill to claim/bill submission
