MB 400 WEEK 1 EXAM UPDATED ACTUAL QUESTIONS
AND CORRECT ANSWERS
Question:
1. What is the first step in a provider being reimbursed for their services?
Answer:
The treatment must be administered.
Question:
2. When is a bill considered complete and ready to be generated?
Answer:
when appropriate diagnosis codes are applied.
Question:
3. What is one reason a bill may not be dropped in the three-day period and become DNFB?
Answer:
The claim was rejected because of missing data.
Question:
4. When a person is not eligible for health insurance from the government, where can they go for medical
coverage?
Answer:
commercial plans.
Question:
5. Which of the following provides health coverage to uninsured children in families that may not qualify
for Medicaid?
Answer:
CHIP
Question:
6. Which reimbursement method pays providers retrospectively after services have been provided?
Answer:
indemnity health insurance plans
Question:
7. Why is it important that revenue managers have a strategic plan when they transition from
fee-for-service methods to value-based health care payment systems?
Answer:
patient volume can erode revenue for the inpatient setting.
Question:
8. Under managed care, how are providers and patients incentivized to control costs?
Answer:
through the integration of finance and delivery of care.
, Question:
9. Which of the following is based on per-person premiums rather than itemized per-procedure charges?
Answer:
capitation
Question:
10. In which type of managed care organization do patients have the ability to obtain treatment without
having to choose a primary care provider?
Answer:
Preferred Provider Organization.
Question:
11. From both the provider and the patient perspective, what is one of the most advantageous
characteristics of managed care organizations?
Answer:
They do not sacrifice quality care.
Question:
12. Which of the following is a similarity of methods used by government payers and commercial payers
to reimburse for health care services?
Answer:
Reimbursement rates are negotiated by payment providers.
Question:
13. What is the most important connection between the use of CAC, software, and reimbursement for
services rendered?
Answer:
human oversight.
Question:
14. How does the use of AI software enhance the ability of medical coders?
Answer:
Coders are more accurate and efficient.
Question:
15. Which type of care requires collaboration across roles, including patients, caregivers, and social
workers?
Answer:
Case management.
Question:
16. Why would a service provider such as a hospital use a retrospective review as a type of utilization
review?
Answer:
to plan for post-discharge services.
AND CORRECT ANSWERS
Question:
1. What is the first step in a provider being reimbursed for their services?
Answer:
The treatment must be administered.
Question:
2. When is a bill considered complete and ready to be generated?
Answer:
when appropriate diagnosis codes are applied.
Question:
3. What is one reason a bill may not be dropped in the three-day period and become DNFB?
Answer:
The claim was rejected because of missing data.
Question:
4. When a person is not eligible for health insurance from the government, where can they go for medical
coverage?
Answer:
commercial plans.
Question:
5. Which of the following provides health coverage to uninsured children in families that may not qualify
for Medicaid?
Answer:
CHIP
Question:
6. Which reimbursement method pays providers retrospectively after services have been provided?
Answer:
indemnity health insurance plans
Question:
7. Why is it important that revenue managers have a strategic plan when they transition from
fee-for-service methods to value-based health care payment systems?
Answer:
patient volume can erode revenue for the inpatient setting.
Question:
8. Under managed care, how are providers and patients incentivized to control costs?
Answer:
through the integration of finance and delivery of care.
, Question:
9. Which of the following is based on per-person premiums rather than itemized per-procedure charges?
Answer:
capitation
Question:
10. In which type of managed care organization do patients have the ability to obtain treatment without
having to choose a primary care provider?
Answer:
Preferred Provider Organization.
Question:
11. From both the provider and the patient perspective, what is one of the most advantageous
characteristics of managed care organizations?
Answer:
They do not sacrifice quality care.
Question:
12. Which of the following is a similarity of methods used by government payers and commercial payers
to reimburse for health care services?
Answer:
Reimbursement rates are negotiated by payment providers.
Question:
13. What is the most important connection between the use of CAC, software, and reimbursement for
services rendered?
Answer:
human oversight.
Question:
14. How does the use of AI software enhance the ability of medical coders?
Answer:
Coders are more accurate and efficient.
Question:
15. Which type of care requires collaboration across roles, including patients, caregivers, and social
workers?
Answer:
Case management.
Question:
16. Why would a service provider such as a hospital use a retrospective review as a type of utilization
review?
Answer:
to plan for post-discharge services.
