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NR507 Week 8 Final Exam For 2026/2027With Questions And Answers

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Which of the following si true about a capitated Managed Care Organization (MCO) arrangement: a) The provider shifts financial risk to the MCO b) The provider can bil separately for each service provided c) The provider must wait to bil the MCO until services have been provided to a patient d) The provider is paid a set fee - Correct Answers d) The provider is paid a set fee Which of the following is a unit of measure commonly used to determine provider productivity? a) RVU b) CMS c) IPA d) TJC - Correct Answers a) RVU

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FACHE - ACHE BOG EXAM SAMPLE FOR 2026/2027 WITH CORRECT ANSWERS



Which of the following si true about a capitated Managed Care Organization (MCO) arrangement:



a) The provider shifts financial risk to the MCO

b) The provider can bil separately for each service provided

c) The provider must wait to bil the MCO until services have been provided to a patient

d) The provider is paid a set fee - Correct Answers d) The provider is paid a set fee



Which of the following is a unit of measure commonly used to determine provider productivity?



a) RVU

b) CMS

c) IPA

d) TJC - Correct Answers a) RVU



What population factor is currently having the greatest impact on healthcare organizations?



a) Ethnic composition

b) Economic status

c) Geographic distribution

d) Age cohort - Correct Answers d) Age cohort



The principle reason for small and midsized employers to join buyers' cooperatives si to enable them
to:



a) Drop coverage from existing insurers

b) Gain leverage to obtain prices similar to large employers

c) Negotiate directly with physicians and hospitals

d) Lobby government agencies for more protection from insurers - Correct Answers b) Gain
leverage to obtain prices similar to large employers

,All areas of healthcare facilities are subject to safety and other regulatory requirements as

dictated by state life safety codes, The Joint Commission, Occupational Safety and Health
Administration, state fire marshal, and others. Which area of the facility typically has the

highest standards?



a) The energy plant

b) Highly used public areas

c) Areas under construction

d) Patient care areas - Correct Answers d) Patient care areas



Participating providers in the federal Medicare program must:



a) Be accredited by The Joint Commission

b) Serve Medicaid beneficiaries

c) Meet the Conditions of Participation

d) Be in compliance with state certificate of need laws - Correct Answers c) Meet the
Conditions of Participation



Which organization is responsible for accrediting residency training programs?



a) ACGME

b) AAMC

c) AMA

d) BPQA - Correct Answers a) ACGME



A patient is requesting their full medical record. Which of the following is true regarding the record
that will be provided to the patient:



a) Psychotherapy notes may be excluded b) Physical therapy notes may be excluded

c) Labs and diagnostic imaging may be excluded d) The full record must always be provided. - Correct
Answers a) Psychotherapy notes may be excluded

, An inpatient admission reimbursed based on the patient's diagnosis and anticipated length of stay
and services is known as:



a) ICD-10 payment

b) Capitation payment

c) Fee for service payment

d) DRG payment - Correct Answers d) DRG payment



Bundled pricing (paying a single fee for al services) for such services as total hip

replacement or coronary artery bypass surgery affected physician-hospital relationships by:



a) Reducing the need to devote administrative effort to measuring outcomes and performance
indicators

b) Putting the physician and hospital in competition with each other for reimbursement c) Promoting
collaboration and integration efforts to provide more efficient care d) Guaranteeing only top
providers are allowed to participate in such programs - Correct Answers c) Promoting
collaboration and integration efforts to provide more efficient care



A hospital acquires another hospital. This would be known as:



a) Vertical integration

b) Diagonal integration

c) Circular integration

d) Horizontal integration - Correct Answers d) Horizontal integration



Under capitation, the risks of over-utilization are shifted ot the:



a) Patient receiving the health services

b) Provider of the health services

c) Third-party payers

d) Health insurance company - Correct Answers b) Provider of the health services

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