HSA 528 Midterm Exam
Culver County Hospital has the lowest cost of an hospital in its region. However, it has
continually reported very large operating losses and has depended upon tax support for
the county. Assuming that positive operating margins are an objective of Culver County
Hospital, the hospital could be described as:
efficient but not effective
One use of financial information is to assess the efficiency of operations. In that context,
efficiency refers to:
the ratio of the organization's outputs to its inputs.
The controller in a hospital is usually responsible for which of the following activities
(choose all that apply):
1. collection of accounts receivable
2. filing Medicare cost reports
3. developing budgets
T or F: governmental health care organizations are able to raise funds through equity
investments.
False
T or F: one of the advantages of a nonprofit organization compared with an investor-
owned company is that the investor-owned company is subject to federal income taxes.
True
T or F: the earnings of a standard ("C") corporation can be subject to double taxation.
True
What is the primary goal of a NFP healthcare organization?
To serve the community through the provision of health care services.
T or F: both DRGs and APCs are assigned based upon data in the CMS-1500 form.
False
T or F: CMS developed the National Correct Coding Initiative (NCCI) to promote
national correct coding methodologies and to control improper coding that leads to
inappropriate payment of Part B health insurance claims.
True
T or F: claims editing is initiated once the claim has been submitted to the payer for
payment.
, False
T or F: data in the medical record is the primary source for documenting the provision of
services.
True
T or F: HIPAA requires that two categories of information be reported to payers:
diagnosis codes and procedure codes.
True
T or F: healthcare facilities use CPT coding in order to be reimbursed inpatient
procedures provided to patients.
False
T or F: lost charges resulting from improper documentation or poor coding and billing
practices do not have a major impact on the finances of healthcare providers.
False
T or F: Medicare payment for hospital outpatient services is based on APCs and each
APC is related to one of more HCPCS/CPT code.
True
T or F: Payers, as well as providers, often employ some type of claim-editing software.
True
T or F: since most hospitals are NFP, they are not generally business oriented.
False
T or F: a hospital that is caring for a Medicare patient on an inpatient basis generally
can increase its reimbursement by providing additional services.
False
T or F: a hospital that is caring for a Medicare patient on an outpatient basis generally
can increase its reimbursement by providing additional services.
True
T or F: all outpatient procedures have an assigned Ambulatory Payment Classification
(APC) code.
False
T or F: Medicare uses Resource Utilization Groups III as its basis for reimbursement to
home health agencies.
False
T or F: some benefits under Medicare part A include hospital stays, skilled nursing care,
and home health care.
Culver County Hospital has the lowest cost of an hospital in its region. However, it has
continually reported very large operating losses and has depended upon tax support for
the county. Assuming that positive operating margins are an objective of Culver County
Hospital, the hospital could be described as:
efficient but not effective
One use of financial information is to assess the efficiency of operations. In that context,
efficiency refers to:
the ratio of the organization's outputs to its inputs.
The controller in a hospital is usually responsible for which of the following activities
(choose all that apply):
1. collection of accounts receivable
2. filing Medicare cost reports
3. developing budgets
T or F: governmental health care organizations are able to raise funds through equity
investments.
False
T or F: one of the advantages of a nonprofit organization compared with an investor-
owned company is that the investor-owned company is subject to federal income taxes.
True
T or F: the earnings of a standard ("C") corporation can be subject to double taxation.
True
What is the primary goal of a NFP healthcare organization?
To serve the community through the provision of health care services.
T or F: both DRGs and APCs are assigned based upon data in the CMS-1500 form.
False
T or F: CMS developed the National Correct Coding Initiative (NCCI) to promote
national correct coding methodologies and to control improper coding that leads to
inappropriate payment of Part B health insurance claims.
True
T or F: claims editing is initiated once the claim has been submitted to the payer for
payment.
, False
T or F: data in the medical record is the primary source for documenting the provision of
services.
True
T or F: HIPAA requires that two categories of information be reported to payers:
diagnosis codes and procedure codes.
True
T or F: healthcare facilities use CPT coding in order to be reimbursed inpatient
procedures provided to patients.
False
T or F: lost charges resulting from improper documentation or poor coding and billing
practices do not have a major impact on the finances of healthcare providers.
False
T or F: Medicare payment for hospital outpatient services is based on APCs and each
APC is related to one of more HCPCS/CPT code.
True
T or F: Payers, as well as providers, often employ some type of claim-editing software.
True
T or F: since most hospitals are NFP, they are not generally business oriented.
False
T or F: a hospital that is caring for a Medicare patient on an inpatient basis generally
can increase its reimbursement by providing additional services.
False
T or F: a hospital that is caring for a Medicare patient on an outpatient basis generally
can increase its reimbursement by providing additional services.
True
T or F: all outpatient procedures have an assigned Ambulatory Payment Classification
(APC) code.
False
T or F: Medicare uses Resource Utilization Groups III as its basis for reimbursement to
home health agencies.
False
T or F: some benefits under Medicare part A include hospital stays, skilled nursing care,
and home health care.
