CH 9 - REVENUE CYCLE MANAGEMENT
EXAM QUESTIONS AND ANSWERS
100% CORRECT
Accounts Receivable - ANSWER-One of the four components of the revenue cycle. It
includes the management of amounts owed to the facility by customers who have
received services but whose payment is made at a later date.
Charge Capture - ANSWER-The process of collecting all services, procedures, and
supplies provided during patient care.
Charge description master (CDM) - ANSWER-Database used by healthcare facilities to
house the price list for all services provided to patients.
Claim processing activities - ANSWER-One of the four components of the revenue
cycle. It includes charge capture of all billable services, claim generation, and claim
corrections occurring before submission to the payer.
Claims reconciliation and collection - ANSWER-One of the four components of the
revenue cycle. Includes reconciling payments, denials, rejections via write-offs and
adjustments, and collection attempts.
Explanation of benefits (EOB) - ANSWER-Report sent from a healthcare insurer to the
policy holder and to the provider that describes the healthcare service, its cost,
applicable cost sharing, and the amount the healthcare insurer will cover. The
remainder is the policyholder's responsibility.
Hard coding - ANSWER-Use of the charge description master to code repetitive
services.
Integrated revenue cycle - ANSWER-The coordination of all revenue cycle activities
under a single leadership and team structure.
Key performance indicator (KPI) - ANSWER-Area identified for needed improvement
through benchmarking and continuous quality improvement.
Medicare Administrative Contractor (MAC) - ANSWER-Newly established contracting
authority to administer Medicare Part A and Part B as required by law (Medicare
Modernization Act of 2003). Replaces Carriers and Fiscal Intermediaries.
EXAM QUESTIONS AND ANSWERS
100% CORRECT
Accounts Receivable - ANSWER-One of the four components of the revenue cycle. It
includes the management of amounts owed to the facility by customers who have
received services but whose payment is made at a later date.
Charge Capture - ANSWER-The process of collecting all services, procedures, and
supplies provided during patient care.
Charge description master (CDM) - ANSWER-Database used by healthcare facilities to
house the price list for all services provided to patients.
Claim processing activities - ANSWER-One of the four components of the revenue
cycle. It includes charge capture of all billable services, claim generation, and claim
corrections occurring before submission to the payer.
Claims reconciliation and collection - ANSWER-One of the four components of the
revenue cycle. Includes reconciling payments, denials, rejections via write-offs and
adjustments, and collection attempts.
Explanation of benefits (EOB) - ANSWER-Report sent from a healthcare insurer to the
policy holder and to the provider that describes the healthcare service, its cost,
applicable cost sharing, and the amount the healthcare insurer will cover. The
remainder is the policyholder's responsibility.
Hard coding - ANSWER-Use of the charge description master to code repetitive
services.
Integrated revenue cycle - ANSWER-The coordination of all revenue cycle activities
under a single leadership and team structure.
Key performance indicator (KPI) - ANSWER-Area identified for needed improvement
through benchmarking and continuous quality improvement.
Medicare Administrative Contractor (MAC) - ANSWER-Newly established contracting
authority to administer Medicare Part A and Part B as required by law (Medicare
Modernization Act of 2003). Replaces Carriers and Fiscal Intermediaries.
