Revenue Cycle for
Healthcare 1st Edition
ST
TEST BANK
UV
IA
_A
Linda J. Parks
PP
Comprehensive Test Bank for Instructors
RO
and Students
VE
© Linda J. Parks. All rights reserved. Reproduction or distribution without permission is
D?
prohibited.
?
©MEDGEEK
, TABLE OF CONTENTS
Test Bank – Revenue Cycle for Healthcare, 1st Edition (ISBN 9780357625514)
Linda J. Parks
ST
Chapter 1. Overview of Revenue Cycle Management,
Chapter 2. Reimbursement Processes and Tools,
Chapter 3. Healthcare Financial Information, a Strategic Resource,
UV
Chapter 4. Inpatient Prospective Payment System,
Chapter 5. Outpatient Prospective Payment System,
Chapter 6. Measures of Hospital Performance,
Chapter 7. Pay-for-Performance and Value-Based Purchasing,
Chapter 8. Charge Description Master,
IA
Chapter 9. Clinical Documentation Integrity,
Chapter 10. Physician Queries,
Chapter 11. Claims Denials and Appeals,
_A
Chapter 12. Compliant Billing and Audits
PP
RO
VE
D?
?
©MEDGEEK
, Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
1. What is the first step of the life cycle of a payment claim?
a. The patient checks in at the front desk.
b. Denials and appeals have been closed.
c. Coinsurance payments are met.
ST
d. Treatment plans have been identified.
ANSWER: a
FEEDBACK: a. Correct. The revenue cycle is the life cycle of a payment claim that begins
when the patient checks in at the front desk and ends after all payments or
UV
denials and appeals have been made.
b. Incorrect. The revenue cycle ends when all payments or denials and appeals
have been made.
c. Incorrect. Coinsurance is the percentage the patient pays for covered services
after the deductible has been met and the copay has been paid.
d. Incorrect. Bills must accurately describe the treatment or service so that the
IA
claim can be paid appropriately.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: Introduction
_A
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.1 - Identify the steps in the revenue cycle.
OTHER: Bloom's: Understand
PP
DATE CREATED: 6/2/2023 1:17 AM
DATE MODIFIED: 6/2/2023 1:20 AM
2. Why is it important that the process of managing billing cycles be performed accurately and on a timely basis?
a. to maintain cash flows
RO
b. to ensure deductibles have been met
c. to enable the organization to become a covered entity
d. to prevent Medicare abuse
ANSWER: a
FEEDBACK: a. Correct. Throughout the process of managing billing cycles, cash flow must be
VE
maintained to enable health care facilities to deliver quality care to their patients
and stay in business.
b. Incorrect. The insurance provider, not the provider of the service, will ensure
that deductibles have been met.
c. Incorrect. Health care organizations that are required to comply with HIPAA
D?
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
d. Incorrect. Medicare defines abuse as “practices that directly or indirectly result
in unnecessary costs to Medicare.”
POINTS: 1
?
DIFFICULTY: Easy
REFERENCES: Introduction
QUESTION TYPE: Multiple Choice
Copyright Cengage Learning. Powered by Cognero. Page 1
, Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.1 - Identify the steps in the revenue cycle.
OTHER: Bloom's: Analyze
ST
DATE CREATED: 6/2/2023 2:01 AM
DATE MODIFIED: 6/2/2023 2:03 AM
3. How does HIPAA apply to the revenue cycle?
a. It protects patient information.
UV
b. It tracks copays and deductibles for patients.
c. It indicates what a patient will owe for services.
d. It determines eligibility for Medicare and Medicaid.
ANSWER: a
FEEDBACK: a. Correct. HIPAA applies to the revenue cycle because it protects the
IA
transmission of patient information as well as the privacy of the patient’s
information as it is shared in the business of reimbursing for services rendered.
b. Incorrect. Patients and their insurance companies must be billed for services in
accordance with the terms of their health insurance coverage, deductibles,
_A
copays, and coinsurances.
c. Incorrect. Coinsurance is the percentage the patient pays for covered services
after the deductible has been met and the copay has been paid.
d. Incorrect. Medicare and Medicaid are covered and monitored under
amendments to the Social Security Act.
POINTS: 1
PP
DIFFICULTY: Easy
REFERENCES: HIPAA and the Revenue Cycle
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
RO
LEARNING OBJECTIVES: LO: 1.2 - Describe the role of HIPAA in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 2:03 AM
DATE MODIFIED: 6/2/2023 2:06 AM
VE
4. What is the role of health care clearinghouses in the revenue cycle?
a. to convert nonstandard transactions into standard ones
b. to transmit all information protected under HIPAA
c. to monitor the impact of privacy rules
d. to provide information to lessen imminent danger
D?
ANSWER: a
FEEDBACK: a. Correct. Health care clearinghouses are companies that convert nonstandard
transactions into standard transactions and transmit the data to health plans
and the reverse process.
b. Incorrect. Health care organizations that are required to comply with HIPAA
?
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
Copyright Cengage Learning. Powered by Cognero. Page 2
Healthcare 1st Edition
ST
TEST BANK
UV
IA
_A
Linda J. Parks
PP
Comprehensive Test Bank for Instructors
RO
and Students
VE
© Linda J. Parks. All rights reserved. Reproduction or distribution without permission is
D?
prohibited.
?
©MEDGEEK
, TABLE OF CONTENTS
Test Bank – Revenue Cycle for Healthcare, 1st Edition (ISBN 9780357625514)
Linda J. Parks
ST
Chapter 1. Overview of Revenue Cycle Management,
Chapter 2. Reimbursement Processes and Tools,
Chapter 3. Healthcare Financial Information, a Strategic Resource,
UV
Chapter 4. Inpatient Prospective Payment System,
Chapter 5. Outpatient Prospective Payment System,
Chapter 6. Measures of Hospital Performance,
Chapter 7. Pay-for-Performance and Value-Based Purchasing,
Chapter 8. Charge Description Master,
IA
Chapter 9. Clinical Documentation Integrity,
Chapter 10. Physician Queries,
Chapter 11. Claims Denials and Appeals,
_A
Chapter 12. Compliant Billing and Audits
PP
RO
VE
D?
?
©MEDGEEK
, Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
1. What is the first step of the life cycle of a payment claim?
a. The patient checks in at the front desk.
b. Denials and appeals have been closed.
c. Coinsurance payments are met.
ST
d. Treatment plans have been identified.
ANSWER: a
FEEDBACK: a. Correct. The revenue cycle is the life cycle of a payment claim that begins
when the patient checks in at the front desk and ends after all payments or
UV
denials and appeals have been made.
b. Incorrect. The revenue cycle ends when all payments or denials and appeals
have been made.
c. Incorrect. Coinsurance is the percentage the patient pays for covered services
after the deductible has been met and the copay has been paid.
d. Incorrect. Bills must accurately describe the treatment or service so that the
IA
claim can be paid appropriately.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: Introduction
_A
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.1 - Identify the steps in the revenue cycle.
OTHER: Bloom's: Understand
PP
DATE CREATED: 6/2/2023 1:17 AM
DATE MODIFIED: 6/2/2023 1:20 AM
2. Why is it important that the process of managing billing cycles be performed accurately and on a timely basis?
a. to maintain cash flows
RO
b. to ensure deductibles have been met
c. to enable the organization to become a covered entity
d. to prevent Medicare abuse
ANSWER: a
FEEDBACK: a. Correct. Throughout the process of managing billing cycles, cash flow must be
VE
maintained to enable health care facilities to deliver quality care to their patients
and stay in business.
b. Incorrect. The insurance provider, not the provider of the service, will ensure
that deductibles have been met.
c. Incorrect. Health care organizations that are required to comply with HIPAA
D?
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
d. Incorrect. Medicare defines abuse as “practices that directly or indirectly result
in unnecessary costs to Medicare.”
POINTS: 1
?
DIFFICULTY: Easy
REFERENCES: Introduction
QUESTION TYPE: Multiple Choice
Copyright Cengage Learning. Powered by Cognero. Page 1
, Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.1 - Identify the steps in the revenue cycle.
OTHER: Bloom's: Analyze
ST
DATE CREATED: 6/2/2023 2:01 AM
DATE MODIFIED: 6/2/2023 2:03 AM
3. How does HIPAA apply to the revenue cycle?
a. It protects patient information.
UV
b. It tracks copays and deductibles for patients.
c. It indicates what a patient will owe for services.
d. It determines eligibility for Medicare and Medicaid.
ANSWER: a
FEEDBACK: a. Correct. HIPAA applies to the revenue cycle because it protects the
IA
transmission of patient information as well as the privacy of the patient’s
information as it is shared in the business of reimbursing for services rendered.
b. Incorrect. Patients and their insurance companies must be billed for services in
accordance with the terms of their health insurance coverage, deductibles,
_A
copays, and coinsurances.
c. Incorrect. Coinsurance is the percentage the patient pays for covered services
after the deductible has been met and the copay has been paid.
d. Incorrect. Medicare and Medicaid are covered and monitored under
amendments to the Social Security Act.
POINTS: 1
PP
DIFFICULTY: Easy
REFERENCES: HIPAA and the Revenue Cycle
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
RO
LEARNING OBJECTIVES: LO: 1.2 - Describe the role of HIPAA in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 2:03 AM
DATE MODIFIED: 6/2/2023 2:06 AM
VE
4. What is the role of health care clearinghouses in the revenue cycle?
a. to convert nonstandard transactions into standard ones
b. to transmit all information protected under HIPAA
c. to monitor the impact of privacy rules
d. to provide information to lessen imminent danger
D?
ANSWER: a
FEEDBACK: a. Correct. Health care clearinghouses are companies that convert nonstandard
transactions into standard transactions and transmit the data to health plans
and the reverse process.
b. Incorrect. Health care organizations that are required to comply with HIPAA
?
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
Copyright Cengage Learning. Powered by Cognero. Page 2
