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Correct Answer: Enrollment and premium payment
Federal government focus on encouraging development of health information systems was
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Correct Answer: Cost Prior accounting
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HITT 1311 Study Questions Check Your Understanding Chapter 19
Question
Streamlining1.
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practices to reduce the cost of financial and administrative operations in
Question 31. Questions and Answers
Federal government
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Aids with which
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Correct Answer: Administrative and benefits
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of 1996 2.
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1311 Study Questions Check Your Understanding Chapter 19
Question
Correct 4.
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appointment
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care
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alternative payment model
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Question
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necessitated
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paymentby lack cycle management
of acknowledgements
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Correct Answer: Enrollment and premium payment
Federal government focus on encouraging development of health information systems was
Correct
Question Answer:
11. Acknowledgement
initiated with which piece of legislation?
Question
Which the25.
of 1311 following
HITT
Correct Answer: Studyserves as a process
Questions improvement
Check technique often not
Your Understanding used in 19
Chapter
Question 30. The
Used for settings?
provider utilization
Health
review
Insurance Portability and Accountability Act (HIPAA)
of 1996 Questions and Answers
Provides instructions specific to conducting transactions with a health plan
Correct Answer: Cost Prior accounting
authorization request
Correct
Question Answer:
2. Companion guide
HITT 1311 Study Questions Check Your Understanding Chapter 19
Question
Streamlining1.
26.
12.
practices to reduce the cost of financial and administrative operations in
Question 31. Questions and Answers
Federal government
Enables
healthcare
Revenue focus
point-of-service
is referred
cycle onbegins
to payment
management as: encouraging
with: development of health information systems was
initiated
Aids with which
transmission ofpiece of legislation?
electronic data interchange standards
Correct Answer: Administrative and benefits
Eligibility verification verification
Simplification
Correct
Question Answer:
1. The Health Insurance
Healthcare clearinghouse Portability and Accountability Act (HIPAA)
Question
of 1996 2.
27.
3.
13.
Federal government focus on encouraging development of health information systems was
Question
initiated
Explains
A hallmark
Providers with32.
of which
intended
will need piece
usage of ___________in
and
consumer-driven
to adopt legislation?
provides instructions
health is the for use risk
shifttotoreduce
order of ain
transaction standard
a value-based payment
Question
Supports 2.
model. furtherance of administrative simplification use of transaction standards
Correct Answer: The Health
Implementation
a "retail" Insurance
model guide
that Portability
focuses and Accountability
on directly Act (HIPAA)
collecting from
Streamlining practices to reduce the cost of financial and administrative operations in
of 1996 Answer: Operating
individuals.
Correct Cost-sharing rules
healthcare is referred to as:
Question
Correct 3.
Answer:
14. Administrative Simplification
2.
4.
33.
Streamlining
To improve
Transaction
Unlike practices
value
largely
fee-for-service, toareduce
innecessitated
healthcare,
in shared the
payment
by cost
lack
risk ofacknowledgements
financial and
ofmechanisms
arrangement: areadministrative operations
being redesigned to: in
Question 3.
healthcare is referred to as:
Correct Answer: Tie Claim
Lump payments
status
sum to results
inquiry
payments areand value
supplied
A hallmark of consumer-driven health is the shift to
Correct Answer: Administrative Simplification
HITT Answer:
1311 Study Questions Check Your Understanding Chapter 19
Question
Correct 4.
15. a "retail" model that focuses on directly collecting from
5.
34.
individuals.
Question 3.describe Questions and Answers
Which
Analyticsstatement
A value-basedthat is trueamodel
payment concerning
provider's the HIPAA
unique
that most closelytransaction
characteristics
resemblesinstandards?
a local marketis:
fee-for-service aids:
A hallmark of consumer-driven health is the shift to
Correct
Question Answer:
4. Only
Contract the claim
Pay-for-performance transaction
negotiation (P4P) is implemented at this time.
Correct Answer:
Question 1. a "retail" model that focuses on directly collecting from
To improve value in healthcare, payment mechanisms are being redesigned to:
Question
individuals. 5.
6.
35.
16.
Federal government focus on encouraging development of health information systems was
Correct Answer: Tie payments to results and value
initiated
How
A can with
In service
which thatwhich
Eligibility
deliverycanmodel piece
increase ofrevenue
verification
are legislation?
be improved?
physicians may be obtained
allowed through:negotiate for health plan
to collectively
Question
contracts? 4.
Correct
Question Answer:
5. The
ConductHealth
Preventive Insurance
eligibility
service Portability
verification
reminders andpatient
when Accountability
makes an Act (HIPAA)
To improve value in healthcare, payment mechanisms are being redesigned to:
of 1996 Answer:
appointment
Correct or has elective
Clinically hospitalization
integrated network scheduled.
(CIN) Create web portals
Which statement is true concerning the HIPAA transaction standards?
Correct
and/or call
Question Answer:
centers
36. Tieforpayments
providers toto results
checkand value
eligibility.
Correct Answer:
Question Only the claim transaction is implemented at this time.
Failure for a2. 17.
provider to conduct which of the following transactions will result in a large
Question
Streamlining
number
Which ofof 6.
5.
7.practices
claims
the following totrue
denials?
is reduce the cost trends
concerning of financial and administrative
in value-based payment?operations in
Question
healthcare
Which statement 6.
is referred
transaction to concerning
isistrue
often as:
initiated by thethe
HIPAA transaction
provider standards?
in anticipation of claim adjudication
Correct Answer: Eligibility
Growth in verification
alternative payment models is continuing
How can Eligibility verification be improved?
issues?
Correct Answer: Administrative Simplification
Only the claim transaction is implemented at this time.
Correct Answer:
Question 37. Claim Conduct eligibility verification when patient makes an
Attachment
Question
A successful7.
appointment 47.
3.
6. or has elective hospitalization scheduled. Create web portals
strategy to improve collection of a patient's balance after insurance is:
and/or call 8.
Question centers for providers to check eligibility.
A
Howkeycan
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strength
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of VBP
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improved? it from
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A means forpast is:
providers to manage the variation in standard transactions is to use:
Correct
Question Answer:
7. a "retail"eligibility
Conduct model that focuses on
verification directly
when collecting
patient makesfroman
Correct Answer:
individuals.
appointment or hasConsensus
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hospitalization and health
scheduled. Createplans for its need
web portals
Which transaction is often initiated by the provider in anticipation of claim adjudication
and/or call centers for providers to check eligibility.
issues?
Question 8. 48.
4.
Correct Answer:
Question 7. Claim Attachment
Which
To improve
of thevalue
following
in healthcare,
value-based
payment
delivery
mechanisms
models includes
are being
hospitals?
redesigned to:
Which transaction is often initiated by the provider in anticipation of claim adjudication
Correct
QuestionAnswer:
8. Tie payments
Accountable
Discount to results
care
for early and value
organization
payment
issues?
A means for providers to manage the variation in standard transactions is to use:
Question 9.
Correct Answer:
5.
38. Claim Attachment
Which statement
Services required is
bytrue concerning
health plans to the HIPAA
ensure transaction
medical standards?
necessity include:
Question 8.
, To improve value
Question 36. inBusiness
healthcare, payment mechanisms are being redesigned to:
Correct
Question Answer:
21. intelligence tools
Question
Correct
Failure for 38.
Answer:
a providerTietopayments
conduct whichto results and value
of the following transactions will result in a large
Question
Driving bad 31.debt down
number
Servicesof
Question claims
19. denials?
required by health plans to ensure medical necessity include:
Aids transmission of electronic data interchange standards
Correct Answer:
Question 5. Health insurance
Companion guidesexchange
Which of the following
Correct Answer: Eligibility is an example
Utilization of clinical intelligence?
verification
review
Correct Answer: Healthcare clearinghouse
Which statement is true concerning the HIPAA transaction standards?
Correct
Question Answer:
22. Info buttons for point-of-care knowledge acquisition
9.
Question
Correct 10.
37.
39. Only the claim transaction is implemented at this time.
Answer:
Question
Drives
The 32.
evidence-based
purpose of operating improvement
rules is to: in revenue cycle management
A successful
form
Questionof casestrategy
20. to improve
management collection
addressing of after
care a patient's balance
patients leave after insurance
a provider is: is:
setting
Supports furtherance of administrative simplification use of transaction standards
Correct Answer:
Question 6. Key
Discount
Provideperformance
more
for early indicators
uniformity
payment in use
Patients are
Correct payingCare
Answer: larger share of healthcare costs
coordination
Correct Answer: Operating rules
How can Eligibility verification be improved?
Question
Correct 11.
Answer:
38. Consumer-driven care
23.
10.
Question
Correct 40. Conduct eligibility verification when patient makes an
Answer:
Question
Business
Operating 18.
33. are
associate
Services required
rules that
by manages
developed
health by payment
plans to
which
ensure distribution
organization?
medical necessity include:
appointment
A charge
Question or hasmaster:
description
21. elective hospitalization scheduled. Create web portals
The Healthcare
Transaction Financial
largely Management
necessitated by lack Association (HFMA) has identified which of the
of acknowledgements
and/or call
Correct centers
Answer: for providers
Payer
Utilization
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Driving
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following as debt
Answer: down
the top priority need
Catalogs for value-based
supplies and services payment?
Correct Answer: Claim status inquiry
Question 12.
Correct Answer:7.
24.
11. Health insurance
39. Business exchange
intelligence tools
Question 41.
Question
Key
Which of the34.
transaction
to of
A form accurate is often
eligibility
following
case management initiated
information
serves by the
as a process
addressing provider in anticipation
improvement
care after patients leave aofprovider
technique claimnot
often adjudication
used inis:
setting
Which
Questionof the19.
following may no longer be necessary in a future value-based payment
22.
issues? settings?
provider
Analytics that describe a provider's unique characteristics in a local market aids:
Correct Answer: Enrollment
environment? and premium payment
Care coordination
Drives of
Which evidence-based improvement
the following is in revenue
an example of cycle management
clinical intelligence?
Correct Answer: CostClaimaccounting
ContractAttachment
negotiation
Correct Answer: Claims submission
Correct Answer:
Question 25. Key performance
40. Info indicators knowledge acquisition
buttons for point-of-care
Question
Used
A 13.
8.
12.
35.
for utilization
charge descriptionreview
master:
Question 42.
Question
means for
Revenue
A service 23.
20.
providers
cycle
that to manage
management
can increase revenuethewith:
begins variation
may in standard
be obtained transactions is to use:
through:
Correct
A document Answer:
sent by Prior
Catalogsauthorization
the healthsupplies request
and services
plan to patients to identify the portion of payment that is
Businessare
Patients associate
paying that
largermanages
share ofpayment distribution
healthcare costs
Correct
their Answer: Eligibility
responsibility Preventive
is: verification
service reminders
Correct
Question Answer:
41. Consumer-driven
26. Payer care
Correct Answer: Explanation of benefits
Question
Enables the14.
13.
36.
Which ofpoint-of-service
following may payment
no longer be necessary in a future value-based payment
Question
Providers
environment?
Failure 28.
24.
21.
forwill
a43.need to to
provider adopt ___________in
conduct order
which of the to reduce
following risk in a value-based
transactions will result inpayment
a large
Question
Correct Answer: Eligibility and benefits verification
Main tocause
model.
Key
Driving
number of
accurate
bad filing
debt
of claims claimsinformation
eligibility
down
denials? on paper
Correct
Information Answer: Claims
that helps submission
providers understand the amount being reimbursed by a health
Correct
plan is:
Question 27.Answer: Coordination
Enrollment
Cost-sharing
Health andof premium
insurance
Eligibility benefits
exchange
verification payment
Question
Explains 18.
42.
Correct intended
Answer: usage
Claims and provides instructions
adjustment reason codesfor use of a transaction standard
Question
The 15.
29.
14.
25.
22.
37.
Healthcare
A document Financial
sent Management
by the health Association
plan to patients (HFMA) the
to identify hasportion
identified which of the
of payment that is
Correct Answer: Implementation guide
following
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their
Question as 44.
aresponsibility
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Used
Drives
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for
successful the topis:
priority
standard
fee-for-service,
utilization
evidence-based in
review
strategy to need collection
improvement
improve for
transaction
a shared riskvalue-based
under HIPAA
inarrangement:
revenue payment?
cycle management
of a patient's balance after insurance is:
Correct
Which of Answer: Business
Acknowledgement
Explanation
Lump
Prior
Key
the following authorization
asumintelligence
isperformance
new payments
value-basedtools
of benefits
request
are supplied
indicators
payment model?
Question 18.
Correct Answer: Bundled payments
Question 16.
19.
30.
43.Financial Management Association (HFMA) has identified which of the
15.
26.
23.
The Healthcare
Provides
Question the following
instructions
Information
A
Enables
value-based
Which ofpoint-of-service
Business
following that
associate
as 45.
thepayment
helps
top thatis an need
specificexample
providers
modeltothat
payment
manages
priority of clinical
conducting
understand
most
payment
for theintelligence?
transactions
closely
value-based amount with
resembles
distribution being
payment? a reimbursed
health plan is:
fee-for-service by a health
plan is:
Correct
A patient-centered Info
Answer: Companion
Pay-for-performance
Eligibility
Payer buttons
Business
medical home for
guide
and apoint-of-care
isbenefits
new (P4P)
intelligence tools
form of: knowledge acquisition
verification
Correct Answer: Claims adjustment reason codes
Correct Answer: Payment model and delivery model
Question 17. 20.
31.
16.
24.
19.
27.
Question
Patients
Aids
In
Key
Which the44.
are paying
transmission
which
to
Explains delivery
accurate
of intended oflarger
model
eligibility
following
usage share
electronic
isare
an
and of healthcare
data
physicians
information
example
provides clinicalcosts
interchange
allowed tostandards
ofinstructions collectively
for use of anegotiate
intelligence? forstandard
transaction health plan
Question 46.
Which of the following is a new value-based payment model?
contracts?
Correct
Pay for performanceConsumer-driven
Answer: Healthcare
Enrollment
Info
is abuttonsclearinghouse
and
Implementation
payment for
modelcare
premium
that: payment
point-of-care
guide knowledge acquisition
Correct Answer: Clinically
Bundled payments
integrated network (CIN)
Correct Answer: Offers incentives for quality
Question 18. 32.
21.
25.
20.
Question
Driving
Supports
Used forbad
Patients 45.
17.
debt down
furtherance
utilization
are paying of administrative
review
larger simplification
share of healthcare costs use of transaction standards
A patient-centered
Which medical
of the following home
is true is a newtrends
concerning form of:
in value-based payment?
Health
Correct Answer: Operating
Prior insurance
rules exchange
authorization
Consumer-driven request
care
Payment
Correct Answer: Growth inmodel and delivery
alternative payment model
models is continuing
Question 19.22.
33.
26.
21.
Question
Enables
Driving 46.
Drives evidence-based
Transaction largely
point-of-service
bad debt improvement
necessitated
down in revenue
paymentby lack cycle management
of acknowledgements
