REVENUE CYCLE MANAGEMENT EXAM
WITH CORRECT SOLUTIONS
Aging of accounts - ANSWER-The practice of counting the days, generally in thirty-day
increments, from the time a bill was sent to the payer to the current day.
Accounts receivable - ANSWER-Records of the payments owed to the organization by
outside entities such as third-party payers and patients.
Late charge - ANSWER-A charge that has not been posted within the healthcare
facility's established bill hold time period.
Clean claim - ANSWER-A claim that has all the billing and coding information correct
and can be paid by the payer the first time it is submitted.
The office of inspector general - ANSWER-The office through which the federal
government established compliance plans for the healthcare industry.
Discharged not final billed - ANSWER-A repot that includes all patients who have been
discharged from the facility but for whom, for one reason or another, the billing process
is not complete.
Contractual allowance - ANSWER-The difference between what is charged by the
healthcare provider and what is paid by the managed care company or other payer.
Medicare part A - ANSWER-A federal program that covers the costs associated with
inpatient hospitalization as well as other healthcare services provided to Medicare
beneficiaries.
Fiscal intermediary - ANSWER-An organization that contracts with the Centers for
Medicare and Medicaid Services to serve as the financial agent between providers and
the federal government in the local administration of Medicare Part B claims.
Front end processes - ANSWER-The processes of preregistration, prebooking,
scheduling, and registration activities that collect patient demographic and insurance
information, perform verification of patient insurance, and determine medical necessity.
Bill hold - ANSWER-An established time between the date of service and the date the
claim is sent to the payer.
Credit balance - ANSWER-A balance on an account that is to be refunded to an insurer
or to the patient.
WITH CORRECT SOLUTIONS
Aging of accounts - ANSWER-The practice of counting the days, generally in thirty-day
increments, from the time a bill was sent to the payer to the current day.
Accounts receivable - ANSWER-Records of the payments owed to the organization by
outside entities such as third-party payers and patients.
Late charge - ANSWER-A charge that has not been posted within the healthcare
facility's established bill hold time period.
Clean claim - ANSWER-A claim that has all the billing and coding information correct
and can be paid by the payer the first time it is submitted.
The office of inspector general - ANSWER-The office through which the federal
government established compliance plans for the healthcare industry.
Discharged not final billed - ANSWER-A repot that includes all patients who have been
discharged from the facility but for whom, for one reason or another, the billing process
is not complete.
Contractual allowance - ANSWER-The difference between what is charged by the
healthcare provider and what is paid by the managed care company or other payer.
Medicare part A - ANSWER-A federal program that covers the costs associated with
inpatient hospitalization as well as other healthcare services provided to Medicare
beneficiaries.
Fiscal intermediary - ANSWER-An organization that contracts with the Centers for
Medicare and Medicaid Services to serve as the financial agent between providers and
the federal government in the local administration of Medicare Part B claims.
Front end processes - ANSWER-The processes of preregistration, prebooking,
scheduling, and registration activities that collect patient demographic and insurance
information, perform verification of patient insurance, and determine medical necessity.
Bill hold - ANSWER-An established time between the date of service and the date the
claim is sent to the payer.
Credit balance - ANSWER-A balance on an account that is to be refunded to an insurer
or to the patient.
