HFMA SET 1 Questions and Correct Solutions 2024

HFMA SET 1 Questions and Correct Solutions 2024 Define Revenue Cycle - Answer -REVENUE CYCLE ----- is the series of events and services provided prior to, during, and after the course of treatment Departments that contribute to the Revenue Cycle. - Answer -Departments that contribute to the Revenue Cycle. 1. Access 2. Health information management/ Medical records 3. Case-management 4. Patient Care Services 5. Patient Financial Services What led the creation of revenue management services? - Answer -The emphasis on the revenue cycle has resulted in the need to organize its components differently and created a new business unit known as revenue integrity or revenue management services. Benefit of Electronic transactions? - Answer -Electronic transactions."------ transactions are associated with revenue capture and collection activities. The implementation of electronic data interchange (EDI) allows actions previously conducted by telephone/ manual methods to be performed electronically ( improves workflow). 5010 Transaction Set Function? - Answer -5010 Transaction Set------new transaction processing system with new transaction standards. These standards will: a. Offer healthcare providers enhanced information. b. Require providers to provide payers with additional data to facilitate claim payments. 6 Transactions associated with the revenue cycle include: - Answer -6 Transactions associated with the revenue cycle include: a. Claim/Encounter (837-I, 837-P, 837-COB, 837-P COB, NCPD).b. Remittance (835). c. Claim Status Inquiry/Response (276/277). d. Eligibility Inquiry/Response (270/271). e. Healthcare Services Review (278) Pre-certification and Referrals. f. Acknowledgment (999) Which of the following would be a hard cost of customer dissatisfaction? Loss of future revenue Negative word-of-mouth advertising Decisions of future patients to use another facility Decisions of current patients to use other facilities for future ancillary services - Answer -loss of future revenue Define hard cost and soft cost. - Answer -1. Hard Cost -the loss of future revenue 2. Soft Cost- Negative word-of-mouth advertising that may influence others not to use the hospital. Single greatest reason for an inability to bill and collect accounts receivable in a timely manner? - Answer -Single greatest reason for an inability to bill and collect accounts receivable in a timely manner: Inadequate and incorrect information received from the admitting/patient access department The Access department's policies and procedures should also address the what 3 topics: - Answer -... The key is the timing of the collection of the financial data and payment is? - Answer -... When certain services are not covered, a Medicare patient should be issued a