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1. Credit balances may be created by any of the following activities except:
ANS: Credits to pharmacy charges posted before the claim final bills.
2. Which of the following statements represent common reasons for inpatient claim denials?
ANS: Failure to obtain a required pre-authorization; failure to complete a continued stay
authorization and services provided which were not medically necessary.
3. A 68-year-old patient, a Medicare beneficiary, was in a car accident. A medical insurance
claim was filed with the auto insurance carrier. Six months later this claim remains unpaid.
How can the provider pursue payment from Medicare?
ANS: The provider must first bill the auto insurer; however, after a period of 120 days, if the claim
remains unpaid, the provider may cancel the liability claim and bill Medicare.
4. The difference between bad debt and financial assistance (charity) is:
ANS: Bad debt represents a refusal to pay; charity represents an inability to pay.
5. In order to qualify for financial assistance, a patient or guarantor should:
ANS: Provide the following documents: prior year tax return, employment check stubs from the prior
three months and bank statements from the prior three months.
6. To comply with the requirements of Section 501(r) for tax-exempt hospitals chartered as
510(c)3 providers, the hospital must complete with of the following activities:
ANS: A community needs assessment.
7. The three types of bankruptcy as defined in the 1979 Bankruptcy Act are:
ANS: Chapter 7 - Straight Bankruptcy, Chapter 11 - Debtor Reorganization, and Chapter 13 - Debtor
Rehabilitation
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, 8. Which of the following medical debt collection practices are recommended as part of
HFMA's Best Practices for medical account resolution:
ANS: Establish policies and ensure that they are followed.
9. Organizations may opt to contract with or outsource to specific vendors for some or all
components of revenue cycle processing. This practice has both advantages and
disadvantages.
Which of the following statements is not an advantage of utilizing an outsourcing vendor?
ANS: The need for legal review if the outside vendor's staff represents themselves as employees of the
healthcare facility.
10. Each hospital covered by the 501(r) regulations is required to develop a financial assistance
policy. Which of the following elements is not a required element of the policy?
ANS: The notice that individuals eligible for financial assistance under this policy may be charged more
than the amount generally billed (AGB) to insured patients.
11. There are 9 daily reconciliation process steps.
Select the proper order of the first four steps.
ANS: 1. Obtain totals of all payments - cash, check credit card, debit card. 2. Divide remittances
into batches and obtain a second total of the electronic remittance advices by payment and
contractual allowances.
3. Endorse checks immediately.
4. Prepare the bank deposit for all payments.
12. There are 9 daily reconciliation process steps.
Select the proper order of steps 4 - 7.
ANS: 4. Prepare the bank deposit for all payments.
5. Separate cash payments and contractual adjustments into separate batches and use separate payment
and adjustment codes.
6. Post unidentified payments to an unidentified case account (deposit everything, do not hold
unidentified payments).
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