Principles of Healthcare Reimbursement
& Revenue Cycle Management
Questions and Answers
In this healthcare delivery model, the government is the only payer that funds universal
healthcare coverage through taxes ✅NATIONAL INSURANCE MODEL
In this healthcare delivery model, the insurance company determines that contribution
amount that is not based on the policyholder's income ✅PRIVATE INSURANCE
MODEL
In this healthcare delivery model, employees and employers contribute an income-
based amount of money to funds that are regulated by the government ✅SOCIAL
INSURANCE MODEL
The US healthcare sector represents a significant portion of the US economy. The trend
of __ spending on healthcare has been consistent for more than a decade
✅INCREASED
An employee paying for 40 percent of the insurance premium through payroll
processing is an example of a transaction between _and ✅PATIENT & EMPLOYER
A physician office submitting an invoice (claim) for payment when the patient has health
insurance is an example of a transaction between __and - ✅PROVIDER & THIRD
PARTY PAYER
Why do health insurers pool premium payments for all the insureds in a group and use
actuarial data to calculate the group's premiums ✅1. TO ASSURE THE POOL IS
LARGE ENOUGH TO PAY LOSSES OF ENTIRE GROUP
Dr. Gilbert sees a 14-old-male with adolescent idiopathic thoracic scoliosis. Surgery for
spinal fusion was cancelled after the patient was diagnosed with mononucleosis. On
today's visit the patient is started on prednisone for severe sore throat and difficulty
swallowing. The patient was accompanied by his parents who have health insurance
through the mother's employment at the State Department of Treasury. Who is the first
party in this healthcare reimbursement scenario ✅PARENTS
Dr. Gilbert sees a 14-old-male with adolescent idiopathic thoracic scoliosis. Surgery for
spinal fusion was cancelled after the patient was diagnosed with mononucleosis. On
today's visit the patient is started on prednisone for severe sore throat and difficulty
swallowing. The patient was accompanied by his parents who have health insurance
& Revenue Cycle Management
Questions and Answers
In this healthcare delivery model, the government is the only payer that funds universal
healthcare coverage through taxes ✅NATIONAL INSURANCE MODEL
In this healthcare delivery model, the insurance company determines that contribution
amount that is not based on the policyholder's income ✅PRIVATE INSURANCE
MODEL
In this healthcare delivery model, employees and employers contribute an income-
based amount of money to funds that are regulated by the government ✅SOCIAL
INSURANCE MODEL
The US healthcare sector represents a significant portion of the US economy. The trend
of __ spending on healthcare has been consistent for more than a decade
✅INCREASED
An employee paying for 40 percent of the insurance premium through payroll
processing is an example of a transaction between _and ✅PATIENT & EMPLOYER
A physician office submitting an invoice (claim) for payment when the patient has health
insurance is an example of a transaction between __and - ✅PROVIDER & THIRD
PARTY PAYER
Why do health insurers pool premium payments for all the insureds in a group and use
actuarial data to calculate the group's premiums ✅1. TO ASSURE THE POOL IS
LARGE ENOUGH TO PAY LOSSES OF ENTIRE GROUP
Dr. Gilbert sees a 14-old-male with adolescent idiopathic thoracic scoliosis. Surgery for
spinal fusion was cancelled after the patient was diagnosed with mononucleosis. On
today's visit the patient is started on prednisone for severe sore throat and difficulty
swallowing. The patient was accompanied by his parents who have health insurance
through the mother's employment at the State Department of Treasury. Who is the first
party in this healthcare reimbursement scenario ✅PARENTS
Dr. Gilbert sees a 14-old-male with adolescent idiopathic thoracic scoliosis. Surgery for
spinal fusion was cancelled after the patient was diagnosed with mononucleosis. On
today's visit the patient is started on prednisone for severe sore throat and difficulty
swallowing. The patient was accompanied by his parents who have health insurance
