AND 100% CORRECT WELL DETAILED
Which of the following is true about a capitated Managed Care Organization (MCO)
arrangement:
a) The provider shifts financial risk to the MCO
b) The provider can bil separately for each service provided
c) The provider must wait to bil the MCO until services have been provided to a patient
d) The provider is paid a set fee - ANSWER d) The provider is paid a set fee
Which of the following is a unit of measure commonly used to determine provider
productivity?
a) RVU
b) CMS
c) IPA
d) TJC - ANSWER a) RVU
What population factor is currently having the greatest impact on healthcare organizations?
a) Ethnic composition
b) Economic status
c) Geographic distribution
d) Age cohort - ANSWER d) Age cohort
1
,The principle reason for small and midsized employers to join buyers' cooperatives si to
enable them to:
a) Drop coverage from existing insurers
b) Gain leverage to obtain prices similar to large employers
c) Negotiate directly with physicians and hospitals
d) Lobby government agencies for more protection from insurers - ANSWER b) Gain
leverage to obtain prices similar to large employers
All areas of healthcare facilities are subject to safety and other regulatory requirements as
dictated by state life safety codes, The Joint Commission, Occupational Safety and Health
Administration, state fire marshal, and others. Which area of the facility typically has the
highest standards?
a) The energy plant
b) Highly used public areas
c) Areas under construction
d) Patient care areas - ANSWER d) Patient care areas
Participating providers in the federal Medicare program must:
a) Be accredited by The Joint Commission
b) Serve Medicaid beneficiaries
c) Meet the Conditions of Participation
d) Be in compliance with state certificate of need laws - ANSWER c) Meet the
Conditions of Participation
Which organization is responsible for accrediting residency training programs?
2
, a) ACGME
b) AAMC
c) AMA
d) BPQA - ANSWER a) ACGME
A patient is requesting their full medical record. Which of the following is true regarding the
record that will be provided to the patient:
a) Psychotherapy notes may be excluded b) Physical therapy notes may be excluded
c) Labs and diagnostic imaging may be excluded d) The full record must always be provided. -
ANSWER a) Psychotherapy notes may be excluded
An inpatient admission reimbursed based on the patient's diagnosis and anticipated length
of stay and services is known as:
a) ICD-10 payment
b) Capitation payment
c) Fee for service payment
d) DRG payment - ANSWER d) DRG payment
Bundled pricing (paying a single fee for al services) for such services as total hip
replacement or coronary artery bypass surgery affected physician-hospital relationships by:
a) Reducing the need to devote administrative effort to measuring outcomes and
performance indicators
b) Putting the physician and hospital in competition with each other for reimbursement c)
Promoting collaboration and integration efforts to provide more efficient care d)
Guaranteeing only top providers are allowed to participate in such programs -
3
Which of the following is true about a capitated Managed Care Organization (MCO)
arrangement:
a) The provider shifts financial risk to the MCO
b) The provider can bil separately for each service provided
c) The provider must wait to bil the MCO until services have been provided to a patient
d) The provider is paid a set fee - ANSWER d) The provider is paid a set fee
Which of the following is a unit of measure commonly used to determine provider
productivity?
a) RVU
b) CMS
c) IPA
d) TJC - ANSWER a) RVU
What population factor is currently having the greatest impact on healthcare organizations?
a) Ethnic composition
b) Economic status
c) Geographic distribution
d) Age cohort - ANSWER d) Age cohort
1
,The principle reason for small and midsized employers to join buyers' cooperatives si to
enable them to:
a) Drop coverage from existing insurers
b) Gain leverage to obtain prices similar to large employers
c) Negotiate directly with physicians and hospitals
d) Lobby government agencies for more protection from insurers - ANSWER b) Gain
leverage to obtain prices similar to large employers
All areas of healthcare facilities are subject to safety and other regulatory requirements as
dictated by state life safety codes, The Joint Commission, Occupational Safety and Health
Administration, state fire marshal, and others. Which area of the facility typically has the
highest standards?
a) The energy plant
b) Highly used public areas
c) Areas under construction
d) Patient care areas - ANSWER d) Patient care areas
Participating providers in the federal Medicare program must:
a) Be accredited by The Joint Commission
b) Serve Medicaid beneficiaries
c) Meet the Conditions of Participation
d) Be in compliance with state certificate of need laws - ANSWER c) Meet the
Conditions of Participation
Which organization is responsible for accrediting residency training programs?
2
, a) ACGME
b) AAMC
c) AMA
d) BPQA - ANSWER a) ACGME
A patient is requesting their full medical record. Which of the following is true regarding the
record that will be provided to the patient:
a) Psychotherapy notes may be excluded b) Physical therapy notes may be excluded
c) Labs and diagnostic imaging may be excluded d) The full record must always be provided. -
ANSWER a) Psychotherapy notes may be excluded
An inpatient admission reimbursed based on the patient's diagnosis and anticipated length
of stay and services is known as:
a) ICD-10 payment
b) Capitation payment
c) Fee for service payment
d) DRG payment - ANSWER d) DRG payment
Bundled pricing (paying a single fee for al services) for such services as total hip
replacement or coronary artery bypass surgery affected physician-hospital relationships by:
a) Reducing the need to devote administrative effort to measuring outcomes and
performance indicators
b) Putting the physician and hospital in competition with each other for reimbursement c)
Promoting collaboration and integration efforts to provide more efficient care d)
Guaranteeing only top providers are allowed to participate in such programs -
3
