HIT 203 FINAL Exam Review Questions with
Verified Correct Answers
The purpose of prior authorization (PA) is:
Cost containment and ensuring services are medically necessary
Price transparency
Contracting with provider
Determine cost sharing
Cost containment and ensuring services are medically necessary
Which of the following is not a component of the revenue cycle front-end?
Schedule services
Claim submission
Prior authorization
Registration
Claim submission
Which of the following status indicators indicates that the APC payment is reduced
when multiple procedures with this status are reported together?
V - Clinic or emergency department visits
J1 - Comprehensive APC payment
T - Surgical procedures
S - Significant procedures
T - Surgical procedures
,The term "price transparency" refers to:
Readily available information about the price of healthcare services.
Consistent pricing for a service across different providers.
Government regulations that determine the price of healthcare services.
The amount that a patient is willing to pay for a service.
Readily available information about the price of healthcare services.
Information collected from the patient during scheduling includes:
Basic demographic data
Required services to be scheduled
Insurance coverage information
All of the above
All of the above
An Advance Beneficiary Notice (ABN) of Nonpayment applies to which program?
Medicaid
Medicare
TRICARE
Commercial Insurance
Medicare
Why is a HIPAA authorization form required before treating a patient?
So the patient has access to his or her own information
, To protect patient privacy
To document patient consent to treatment
So the provider can submit protected health information (PHI) to the insurance
company for billing purposes.
So the provider can submit protected health information (PHI) to the insurance company for
billing purposes.
Who handles submitting a request for prior authorization for care?
Patient
Insurance company
Provider
Employer
Provider
What information is needed in addition to the charge or price of a healthcare service to
determine the cost sharing amount?
Patient eligibility for coverage
Whether the provider is in or out of network
Patient income
Conversion factor
Whether the provider is in or out of network
The component of the revenue cycle responsible for determining the type of insurance
coverage and current insurance company for a patient is __________.
Verified Correct Answers
The purpose of prior authorization (PA) is:
Cost containment and ensuring services are medically necessary
Price transparency
Contracting with provider
Determine cost sharing
Cost containment and ensuring services are medically necessary
Which of the following is not a component of the revenue cycle front-end?
Schedule services
Claim submission
Prior authorization
Registration
Claim submission
Which of the following status indicators indicates that the APC payment is reduced
when multiple procedures with this status are reported together?
V - Clinic or emergency department visits
J1 - Comprehensive APC payment
T - Surgical procedures
S - Significant procedures
T - Surgical procedures
,The term "price transparency" refers to:
Readily available information about the price of healthcare services.
Consistent pricing for a service across different providers.
Government regulations that determine the price of healthcare services.
The amount that a patient is willing to pay for a service.
Readily available information about the price of healthcare services.
Information collected from the patient during scheduling includes:
Basic demographic data
Required services to be scheduled
Insurance coverage information
All of the above
All of the above
An Advance Beneficiary Notice (ABN) of Nonpayment applies to which program?
Medicaid
Medicare
TRICARE
Commercial Insurance
Medicare
Why is a HIPAA authorization form required before treating a patient?
So the patient has access to his or her own information
, To protect patient privacy
To document patient consent to treatment
So the provider can submit protected health information (PHI) to the insurance
company for billing purposes.
So the provider can submit protected health information (PHI) to the insurance company for
billing purposes.
Who handles submitting a request for prior authorization for care?
Patient
Insurance company
Provider
Employer
Provider
What information is needed in addition to the charge or price of a healthcare service to
determine the cost sharing amount?
Patient eligibility for coverage
Whether the provider is in or out of network
Patient income
Conversion factor
Whether the provider is in or out of network
The component of the revenue cycle responsible for determining the type of insurance
coverage and current insurance company for a patient is __________.
