CSBI HFMA EXAM 5 PRACTICE TEST 2026
QUESTIONS WITH CORRECT ANSWERS
◉ Any healthcare insurance plan that provides or ensures
comprehensive health maintenance and treatment services for an
enrolled group of persons based on a monthly fee is known as a.
Answer: HMO
◉ Identifying the patient, in the MPI, creating the registration
record, completing medical necessity screening, determining
insurance eligibility and benefits resolving managed care,
requirements and completing financial education/resolution are all.
Answer: The data collection steps for scheduling and pre-registering
a patient
◉ Medicare Part B has an annual deductible, and the beneficiary is
responsible for. Answer: A co-insurance payment for all Part B
covered services
◉ The standard claim form used for billing by hospitals, nursing
facilities, and other inpatient. Answer: UB-04
◉ Charges are the basis for. Answer: Separation of fiscal
responsibilities between the patient and the health plan
,◉ All of the following are forms of hospital payment contracting
EXCEPT. Answer: Contracted Rebating
◉ The most common resolution methods for credit balances include
all of the following EXCEPT:. Answer: Designate the overpayment for
charity care
◉ Ambulance services are billed directly to the health plan for.
Answer: The portion of the bill outside of the patient's self-pay
◉ A claim for reimbursement submitted to a third-party payer that
has all the information and documentation required for the payer to
make a decision on it is known as. Answer: A clean claim
◉ The healthcare industry is vulnerable to compliance issues, in
large part due to the complexity of the statutes and regulations
pertaining to. Answer: Medicare and Medicaid payments
◉ The Correct Coding Initiative Program consists of. Answer: Edits
that are implemented within providers' claim processing systems
◉ To provide a patient with information that is meaningful to them,
all of the following factors must be included EXCEPT. Answer: The
actual physician reimbursement
, ◉ Which department supports/collaborates with the revenue cycle?.
Answer: Information Technology
◉ Medicare Part B has an annual deductible and the beneficiary is
responsible for. Answer: a co-insurance payment for all Part B
covered services
◉ The two types of claims denial appeals are. Answer: Beneficiary
and Provider
◉ Which of the following is a violation of the EMTALA (Emergency
Medical Treatment and Labor Act?). Answer: Registration staff
members routinely contact managed care plans for prior
authorizations before the patient is seen by the on duty physician
◉ Rural Health Clinics (RHC) personnel can provide services in all of
the following locations, EXCEPT. Answer: Providing inpatient
services in the RHC
◉ The patient discharge process begins when. Answer: The
physician writes the discharge order
QUESTIONS WITH CORRECT ANSWERS
◉ Any healthcare insurance plan that provides or ensures
comprehensive health maintenance and treatment services for an
enrolled group of persons based on a monthly fee is known as a.
Answer: HMO
◉ Identifying the patient, in the MPI, creating the registration
record, completing medical necessity screening, determining
insurance eligibility and benefits resolving managed care,
requirements and completing financial education/resolution are all.
Answer: The data collection steps for scheduling and pre-registering
a patient
◉ Medicare Part B has an annual deductible, and the beneficiary is
responsible for. Answer: A co-insurance payment for all Part B
covered services
◉ The standard claim form used for billing by hospitals, nursing
facilities, and other inpatient. Answer: UB-04
◉ Charges are the basis for. Answer: Separation of fiscal
responsibilities between the patient and the health plan
,◉ All of the following are forms of hospital payment contracting
EXCEPT. Answer: Contracted Rebating
◉ The most common resolution methods for credit balances include
all of the following EXCEPT:. Answer: Designate the overpayment for
charity care
◉ Ambulance services are billed directly to the health plan for.
Answer: The portion of the bill outside of the patient's self-pay
◉ A claim for reimbursement submitted to a third-party payer that
has all the information and documentation required for the payer to
make a decision on it is known as. Answer: A clean claim
◉ The healthcare industry is vulnerable to compliance issues, in
large part due to the complexity of the statutes and regulations
pertaining to. Answer: Medicare and Medicaid payments
◉ The Correct Coding Initiative Program consists of. Answer: Edits
that are implemented within providers' claim processing systems
◉ To provide a patient with information that is meaningful to them,
all of the following factors must be included EXCEPT. Answer: The
actual physician reimbursement
, ◉ Which department supports/collaborates with the revenue cycle?.
Answer: Information Technology
◉ Medicare Part B has an annual deductible and the beneficiary is
responsible for. Answer: a co-insurance payment for all Part B
covered services
◉ The two types of claims denial appeals are. Answer: Beneficiary
and Provider
◉ Which of the following is a violation of the EMTALA (Emergency
Medical Treatment and Labor Act?). Answer: Registration staff
members routinely contact managed care plans for prior
authorizations before the patient is seen by the on duty physician
◉ Rural Health Clinics (RHC) personnel can provide services in all of
the following locations, EXCEPT. Answer: Providing inpatient
services in the RHC
◉ The patient discharge process begins when. Answer: The
physician writes the discharge order
