QUESTIONS (REVENUE CYCLE) WITH
COMPLETE SOLUTIONS
(491) A Medicare patient had two physician office visits , underwent hospital radiology
examinations and clinical laboratory tests, and received take-home surgical dressings.
Which of the following could be reimbursed under the outpatient prospective payment
system?
A) Clinical laboratory tests
B) Physician office visits
C) Radiology examinations
D) Take-home surgical dressings - ANSWER-C) Radiology examinations
(492) In conducting a qualitative review, the clinical documentation specialist sees that
the nursing staff has documented the patient's skin integrity on admission to support the
presence of a Stage I pressure ulcer. However, the physician's documentation is
unclear as to whether this condition was present on admission. How should the clinical
documentation specialist proceed?
A) Note the condition as present on admission
B) Query the physician to determine if the condition was present on admission
C) Note the condition as unknown on admission
D) Note the condition as not present on admission - ANSWER-B) Query the physician
to determine if the condition was present on admission
(503) Which of the following is NOT reimbursed according to the Medicare outpatient
prospective payment system?
A) CMHC partial hospitalization services
B) Critical access hospitals
C) Hospital outpatient departments
D) Vaccines provided by CORFs - ANSWER-B) Critical access hospitals
(504) How often are the Medicare fee schedules updated?
A) Annually
B) Monthly
C) Semiannually
D) Weekly - ANSWER-A) Annually
, (505) Which of the following would a healthcare technician use to perform the billing
function for a physician's office?
A) Screen 837P or CMS 1500
B) UB-04
C) UB-92
D) Screen 8371 or UB-04 - ANSWER-A) Screen 837P or CMS 1500
(506) When a provider accepts assignment, this means that the:
A) Patient authorizes payment to be made directly to the provider
B) Provider accepts payment in full the allowed charge from the fee schedule
C) Balance filling is allowed on patient accounts, but at a limited rate
D) Participating provider receives a fee-for-service reimbursement - ANSWER-B)
Provider accepts as payment in full he allowed charge from the fee schedule
(494) Which of the following is the definition of revenue cycle management?
A) The regularity repeating set of events that produce a revenue or income
B) The method by which patients are grouped together based on a set of characteristics
C) The systematic comparison of the products, services, and outcomes of one
organization with those of a similar organization
D) Coordination of all administrative and clinical functions that contribute to the capture,
management, and collection of patient service revenue - ANSWER-D) Coordination of
all administrative and clinical functions that contribute to the capture, management, and
collection of patient service revenue.
(495) Most facilities begin counting days in accounts receivable at which of the following
times?
A) The date the patient registers
B) The date the patient is discharges
C) The date the bill drops
D) The date the bill is received by the payer - ANSWER-C) The date the bill drops
(496) The amount of money owed a healthcare facility when claims are pending is
called:
A) Dollars in accounts receivable
B) Bad debt
C) The write-off account
D) Delayed revenue - ANSWER-A) Dollars in accounts receivable
(497) In a typical acute-care setting, the Explanation of Benefits, Medicare Summary
Notice, and Remittance Advice documents (provided by the payer) are monitored in
which revenue cycle area?