CHAPTER 8: REVENUE CYCLE
MANAGEMENT EXAM QUESTIONS AND
ANSWERS 100% CORRECT
The revenue cycle refers to the sequence of? - ANSWER-processes to progress a
patient account from creation to closing.
Healthcare revenue cycle management (RCM) refers to the strategy implemented to? -
ANSWER-direct administrative and clinical functions associated with capturing,
monitoring, and collecting of patient service revenue
The front end process of the revenue management life cycle consist of? - ANSWER-
patient access, including scheduling, preauthorization, insurance, insurance verification,
point-of-service collection, and financial counseling
The middle process of the revenue management life cycle consist of? - ANSWER-
charge capture, chargemaster, case management, clinical documentation, and coding
The back end process of the revenue management life cycle consist of? - ANSWER-
claims processing and payment posting, follow-up, collections, and denial management
Medicare defines medical necessity as a? - ANSWER-determination that a service is
reasonable and necessary for the related diagnosis or treatment of illness or injury
A Medicare Administrative Contractor (MAC) is a private healthcare insurer awarded
by? - ANSWER-Medicare for a geographic jurisdiction for multistate or regional
contractor responsibilities to process Medicare Part A and Part B (A/B) medical claims
Generally, this is done by reviewing the DNFB report that includes all patients who have
been discharged from the facility, but for whom the billing process is? - ANSWER-not
complete
Charge capture is a method of? - ANSWER-recording services and supplies or items
delivered to the patient and directing them to be billed on a claim form
The charge description master (CDM) is an? - ANSWER-electronic file that represents a
master list of all services, supplies, devices, and medications charged for inpatient or
outpatient services
Claims scrubber software contains a series of? - ANSWER-edits to determine if the
claim is ready to be submitted
A low A/R value is? - ANSWER-favorable
MANAGEMENT EXAM QUESTIONS AND
ANSWERS 100% CORRECT
The revenue cycle refers to the sequence of? - ANSWER-processes to progress a
patient account from creation to closing.
Healthcare revenue cycle management (RCM) refers to the strategy implemented to? -
ANSWER-direct administrative and clinical functions associated with capturing,
monitoring, and collecting of patient service revenue
The front end process of the revenue management life cycle consist of? - ANSWER-
patient access, including scheduling, preauthorization, insurance, insurance verification,
point-of-service collection, and financial counseling
The middle process of the revenue management life cycle consist of? - ANSWER-
charge capture, chargemaster, case management, clinical documentation, and coding
The back end process of the revenue management life cycle consist of? - ANSWER-
claims processing and payment posting, follow-up, collections, and denial management
Medicare defines medical necessity as a? - ANSWER-determination that a service is
reasonable and necessary for the related diagnosis or treatment of illness or injury
A Medicare Administrative Contractor (MAC) is a private healthcare insurer awarded
by? - ANSWER-Medicare for a geographic jurisdiction for multistate or regional
contractor responsibilities to process Medicare Part A and Part B (A/B) medical claims
Generally, this is done by reviewing the DNFB report that includes all patients who have
been discharged from the facility, but for whom the billing process is? - ANSWER-not
complete
Charge capture is a method of? - ANSWER-recording services and supplies or items
delivered to the patient and directing them to be billed on a claim form
The charge description master (CDM) is an? - ANSWER-electronic file that represents a
master list of all services, supplies, devices, and medications charged for inpatient or
outpatient services
Claims scrubber software contains a series of? - ANSWER-edits to determine if the
claim is ready to be submitted
A low A/R value is? - ANSWER-favorable
