Structured Questions with Correct Answers
Graded A+ 2026
Overall aggregate payments made to a hospice are subject to a computed "cap
amount" calculated by ANSWER >>> The Medicare Administrative Contractor (MAC) at
the end of the hospice cap period
Which of the following is required for participation in Medicaid ANSWER >>> Meet
Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and
foremost ANSWER >>> Respect the patients privacy
A nightly room charge will be incorrect if the patient's ANSWER >>> Transfer from ICU
(intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
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,The Affordable Care Act legislated the development of Health Insurance Exchanges,
where individuals and small businesses can ANSWER >>> Purchase qualified health
benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing
includes: ANSWER >>> Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment
from Medicare? ANSWER >>> Revenue codes
This directive was developed to promote and ensure healthcare quality and value and
also to protect consumers and workers in the healthcare system. This directive is called
ANSWER >>> Patient bill of rights
The activity which results in the accurate recording of patient bed and level of care
assessment, patient transfer and patient discharge status on a real-time basis is known
as ANSWER >>> Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act)
violation? ANSWER >>> Registration staff may routinely contact managed are plans for
prior authorizations before the patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard
transactions to identify the employer of an individual described in a transaction EIN's are
assigned by ANSWER >>> The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all
examples of ANSWER >>> Control points for cash posting
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, What are some core elements if a board-approved financial assistance policy?
ANSWER >>> Eligibility, application process, and nonpayment collection activities
A recurring/series registration is characterized by ANSWER >>> The creation of one
registration record for multiple days of service
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
ANSWER >>> Assist patients in understanding their insurance coverage and their
financial obligation
The purpose of a financial report is to: ANSWER >>> Present financial information to
decision makers
Patient financial communications best practices produce communications that are
ANSWER >>> Consistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD)
and National Coverage Determinations (NCD) that establish ANSWER >>> What
services or healthcare items are covered under Medicare
Any provider that has filed a timely cost report may appeal an adverse final decision
received from the Medicare Administrative Contractor (MAC). This appeal may be filed
with ANSWER >>> The Provider Reimbursement Review Board
Concurrent review and discharge planning ANSWER >>> Occurs during service
Duplicate payments occur: ANSWER >>> When providers re-bill claims based on
nonpayment from the initial bill submission
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is known
as ANSWER >>> A beneficiary appeal
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