HIM 410 Final Exam & Practice Exam || Most Recent
Exam 2026|2027 Actual Complete Real Exam Questions
And Correct Answers (Verified Answers) Already
Graded A+ | Guaranteed Success!! Newest Exam |
Just Released!!
Which of the following activities do MCOs use as financial
incentives to control
costs?
a) Monitoring the settings of care
b) Rewarding providers who meet targets with bonuses
c) Varying members' rates of cost sharing
d) A and B only
e) All of the above - ANSWER-e) All of the above
All of the following types of services or populations are
common examples of
"carve outs"
EXCEPT:
a) Immunizations and well-
baby care
b) Chronically ill
children
,c) Dental
care
d) Behavioral and mental
health
e) Prescription drugs - ANSWER-a) Immunizations and
well-baby care
How did the PPS based on DRGs lead to hospital downsizing
in the United
States?
a) It mandated closure of beds based on occupancy rates
b) It lead to greater competition among hospitals
c) It created financial incentives to perform surgeries in
outpatient settings
d) It created financial incentives to minimize the patient's length
of stay - ANSWER-d) It created financial incentives to
minimize the patient's length of stay
All of the following actions reflect the roles of PCPs in MCOs
EXCEPT:
a) Authorize patients' vists to oncologists
b) Coordinate care of patients
c) Refer patients to colleagues for immunizations and other
general care
d) Provide primary care - ANSWER-c) Refer patients to
colleagues for immunizations and other general care
,A hybrid between an HMO and a PPO.
a) Point-of-service
plans
b) Mixed model
HMO
c)
IPA
d) Exclusive provider plans - ANSWER-a) Point-of-
service plans
Briefly explain the one main difference between a
nursing home and a
rehabilitation
center.
Short answer: - ANSWER-A nursing home provides ADLs.
A rehabilitation center provides skilled care.
What is the purpose of risk sharing with providers?
a) It makes providers immune to costs
b) It makes providers cost conscious
c) It rewards providers for quality
d) It keeps insurance premiums low - ANSWER-b) It makes
providers cost conscious
To participate in Medicare and Medicaid, a health care facility
must be
, a) conditioned
b) accredited
c) certified
d) licensed - ANSWER-c) certified
For whose financial benefit are proprietary hospitals operated?
a)
Stockholders
b) The American
public
c) The local
community
d) The governing body - ANSWER-a)
Stockholders
Briefly explain the importance of Accreditation, Licensure
and Certification to
hospitals in the United
States
Short answer: - ANSWER-Accreditation is voluntary and
many insurance
companies will only pay if you have
accreditation.
Licensure is required by the state to operate.
Exam 2026|2027 Actual Complete Real Exam Questions
And Correct Answers (Verified Answers) Already
Graded A+ | Guaranteed Success!! Newest Exam |
Just Released!!
Which of the following activities do MCOs use as financial
incentives to control
costs?
a) Monitoring the settings of care
b) Rewarding providers who meet targets with bonuses
c) Varying members' rates of cost sharing
d) A and B only
e) All of the above - ANSWER-e) All of the above
All of the following types of services or populations are
common examples of
"carve outs"
EXCEPT:
a) Immunizations and well-
baby care
b) Chronically ill
children
,c) Dental
care
d) Behavioral and mental
health
e) Prescription drugs - ANSWER-a) Immunizations and
well-baby care
How did the PPS based on DRGs lead to hospital downsizing
in the United
States?
a) It mandated closure of beds based on occupancy rates
b) It lead to greater competition among hospitals
c) It created financial incentives to perform surgeries in
outpatient settings
d) It created financial incentives to minimize the patient's length
of stay - ANSWER-d) It created financial incentives to
minimize the patient's length of stay
All of the following actions reflect the roles of PCPs in MCOs
EXCEPT:
a) Authorize patients' vists to oncologists
b) Coordinate care of patients
c) Refer patients to colleagues for immunizations and other
general care
d) Provide primary care - ANSWER-c) Refer patients to
colleagues for immunizations and other general care
,A hybrid between an HMO and a PPO.
a) Point-of-service
plans
b) Mixed model
HMO
c)
IPA
d) Exclusive provider plans - ANSWER-a) Point-of-
service plans
Briefly explain the one main difference between a
nursing home and a
rehabilitation
center.
Short answer: - ANSWER-A nursing home provides ADLs.
A rehabilitation center provides skilled care.
What is the purpose of risk sharing with providers?
a) It makes providers immune to costs
b) It makes providers cost conscious
c) It rewards providers for quality
d) It keeps insurance premiums low - ANSWER-b) It makes
providers cost conscious
To participate in Medicare and Medicaid, a health care facility
must be
, a) conditioned
b) accredited
c) certified
d) licensed - ANSWER-c) certified
For whose financial benefit are proprietary hospitals operated?
a)
Stockholders
b) The American
public
c) The local
community
d) The governing body - ANSWER-a)
Stockholders
Briefly explain the importance of Accreditation, Licensure
and Certification to
hospitals in the United
States
Short answer: - ANSWER-Accreditation is voluntary and
many insurance
companies will only pay if you have
accreditation.
Licensure is required by the state to operate.
