C425 OA Review Exam Questions 100% Verified Correct

Which of the following is true in regards to health care today in the United States? There are more primary care physicians than specialty physicians. Primary care receives a higher reimbursement in professional fees. There are more specialty physicians than primary physicians. Outpatient care is slowly decreasing. -ANSWER There are more specialty physicians than primary physicians. What triggered the downsizing phase in the U.S. hospital industry during the 1980s? Hill-Burton Act Managed care Prospective payment system Medicare and Medicaid -ANSWER Prospective payment system Designated Related Groups (DRG) -based reimbursement necessitated hospitals to do what? Admit new patients at a faster rate than before Admit a greater number of Medicare patients than before Reduce the length of stay for hospitalized patients Admit a smaller number of Medicare patients than before -ANSWER Reduce the length of stay for hospitalized patients In which type of utilization management is a primary care physician's opinion necessary in referring or not referring a patient to a specialist? Concurrent Retrospective Gatekeeping Precertification -ANSWER Gatekeeping What is one aspect in which managed care differs from conventional insurance? Collection of premiums Assumption of risk Responsibility for delivery of services Payments to providers -ANSWER Responsibility for delivery of services What is the purpose of Skilled Nursing Facilities (SNF) certification? It enables a facility to be operated as a skilled nursing facility. It is required to legally operate a nursing home. It enables a facility to serve Medicare clients. It enables a facility to serve both Medicare and Medicaid clients. -ANSWER It enables a facility to serve Medicare clients. C425 OA Review Exam Questions 100% Verified Correct