QUESTIONS WITH ANSWERS GRADED A+
◉ Key Performance Indicators (KPIs) set standards for accounts
receivables (A/R) and
a) Provide evidence of financial status
b) Provide a method of measuring the collection and control of A/R
c) Establish productivity targets
d) Make allowance for accurate revenue forecasting Answer: B
◉ Recognizing that health coverage is complicated and not all
patients are able to navigate
this terrain, HFMA best practices specify that
a) The patient accounts staff have someone assigned to research
coverage on behalf of patients
b) Patients should be given the opportunity to request a patient
advocate, family member, or other designee to help them in these
discussions
c) Patient coverage education may need to be provided by the
,health plan
d) A representative of the health plan be included in the patient
financial responsibilities discussion Answer: B
◉ When there is a request for service, the scheduling staff member
must confirm the
patient's unique identification information to
a) Check if there is any patient balance due
b) Verify the patient's insurance coverage if the patient is a returning
customer
c) Confirm that physician orders have been received
d) Ensure that she/he accesses the correct information in the
historical database Answer: D
◉ Once the price is estimated in the pre-service stage, a provider's
financial best practice
is to
a) Explain to the patient their financial responsibility and to
determine the plan for payment
b) Allow the patient time to compare prices with other providers
,c) Lock-in the prices
d) Have another employee double check the price estimate Answer:
A
◉ What type of account adjustment results from the patient's
unwillingness to pay a self-
pay balance?
a) Charity adjustment
b) Bad debt adjustment
c) Contractual adjustment
d) Administrative adjustment Answer: B
◉ All of the following are conditions that disqualify a procedure or
service from being paid
for by Medicare EXCEPT
a) Medically unnecessary
b) Not delivered in a Medicare licensed care setting
c) Offered in an outpatient setting
d) Services and procedures that are custodial in nature Answer: D
, ◉ All of the following are forms of hospital payment contracting
EXCEPT
a) Contracted Rebating
b) Per Diem Payment
c) Fixed Contracting
d) Bundled Payment Answer: A
◉ Overall aggregate payments made to a hospice are subject to a
computed "cap amount"
calculated by:
a) The Center for Medicare and Medicaid Services (CMS)
b) Each state's Medicaid plan
c) Medicare
d) The Medicare Administrative Contractor (MAC) at the end of the
hospice cap period Answer: D
◉ With the advent of the Affordable Care Act Health Insurance
Marketplaces and the
expansion of Medicaid in some states, it is more important than ever
for hospitals to
a) Reschedule the visit for non-payment of a prior balance