HEALTH CARE REVENUE CYCLE
MANAGEMENT EXAM QUESTIONS AND
ANSWERS 100% CORRECT
Account Receivable (A/R) - ANSWER-total charges entered that have not been
collected. Represents the revenue that still needs to be collected for services already
rendered.
A/R Aging Summary - ANSWER-categorizes account receivable according to the length
of time charges have been outstanding. Can be configured to report receivables based
on who is responsible to pay, either insurance or patient.
Days in A/R - ANSWER-refers to how long it takes a business to collect on charges.
An important tool to identify if your clinic is - ANSWER-collecting properly, billing
properly, coding properly, collecting co-pays and deductibles in a timely manner, billing
in a timely manner, properly credentialing providers, working collection on the back end
properly, and effectively following up on insurance denials
Days in A/R is a fraction - ANSWER-The numerator is the total A/R. The denominator is
the average daily charges.
How to calculate average daily charges - ANSWER-take the total charges over the last
"x" months and divide by the total number of days in that time frame. (Good A/R should
not exceed 45 days)
Bad Debt Ratio - ANSWER-calculated by taking total bad debt for the period, divided by
the total charges for the same period.
Total bad debt for period
___________________________
Total charges for period - ANSWER-Bad debt ratio
Prospective fee schedule - ANSWER-defined before services are rendered. Can be
negotiated witht he payer or can be tied to a percent of Medicare (based on the RBRVS
method)
Capitation - ANSWER-A prospective method of payment. It is determined on a per
capita method, meaning the payer will contract to pay the provider a set amount per
month for each patient they care for
MANAGEMENT EXAM QUESTIONS AND
ANSWERS 100% CORRECT
Account Receivable (A/R) - ANSWER-total charges entered that have not been
collected. Represents the revenue that still needs to be collected for services already
rendered.
A/R Aging Summary - ANSWER-categorizes account receivable according to the length
of time charges have been outstanding. Can be configured to report receivables based
on who is responsible to pay, either insurance or patient.
Days in A/R - ANSWER-refers to how long it takes a business to collect on charges.
An important tool to identify if your clinic is - ANSWER-collecting properly, billing
properly, coding properly, collecting co-pays and deductibles in a timely manner, billing
in a timely manner, properly credentialing providers, working collection on the back end
properly, and effectively following up on insurance denials
Days in A/R is a fraction - ANSWER-The numerator is the total A/R. The denominator is
the average daily charges.
How to calculate average daily charges - ANSWER-take the total charges over the last
"x" months and divide by the total number of days in that time frame. (Good A/R should
not exceed 45 days)
Bad Debt Ratio - ANSWER-calculated by taking total bad debt for the period, divided by
the total charges for the same period.
Total bad debt for period
___________________________
Total charges for period - ANSWER-Bad debt ratio
Prospective fee schedule - ANSWER-defined before services are rendered. Can be
negotiated witht he payer or can be tied to a percent of Medicare (based on the RBRVS
method)
Capitation - ANSWER-A prospective method of payment. It is determined on a per
capita method, meaning the payer will contract to pay the provider a set amount per
month for each patient they care for
