HFMA Module 1 Exam Questions with
Complete Solutions5
Three segments of Patient-Centric Rev Cycle - ANSWERS-Pre-service, Time-of-Service, Post-
Service
Pre-service - ANSWERS-Set stage for effective patient comm and data collection.
Requests service, notifies patient's financial responsibility, schedules patient, gen encounter
record, ID cost of service and health plan/benefits
Time-of-Service - ANSWERS-Scheduled patients: complete final account review prior to patient
arrival. Sign consents, pay co-pays, ID patient
Unscheduled patients: registration and financial processing is completed. Mirrors "scheduled
patients" work, but includes unscheduled items/services provided to out-of-network patients
Post-Service - ANSWERS-Account activities after the patient is discharged until the account
reaches a zero balance (final coding, claim prep/submission, pay process and balance
billing/resolution)
Core of "patient-centric rev cycle" concept - ANSWERS-Consumer experience: ease of access
and improved quality
Patient experience: coordination of care (financial/clinical), compliant clinical doc
Customer experience: appropriate payment, effective/efficient account resolution, decrease
cost to collect
HFMA rev cycle initiatives - ANSWERS-1. Financial comm best practices
, 2. Price transparency
3. Medical account resolution
Hospital Consumer Assessment of Heatlhcare Providers and Systems - ANSWERS-Survey
assessment for delivered to patients to measure satisfactions w/in facilities
Hard cost vs. Soft cost - ANSWERS-Hard: loss of future rev
Soft: customer passes info about neg experience to potential patient or through social media
Rev cycle activities to improve comm and customer service: - ANSWERS-1. Modify billing
formats/statements for patient comprehension
2. Extending normal business hours for patient inquiries and complaints
3. Resolving questions/complaints w/o transferring
4. Following up on all customer inquiries or complaints w/in 48 hours
5. Hold staff accountable during reviews for customer service responsibilities
Rev cycle functions benefiting from outsourcing: - ANSWERS-Appointment/scheduling
1. Admit, discharge, and transfer system (ADT) - Registration
Patient account systems:
1. Pre-bill editing
2. Electronic claim generation - insurance and patient billing
3. Payment tracking and automated follow-up queues
4. Accounts receivable
5. Cash posting
6. Denials management
7. Refund processing
8. Collection account transfers
Complete Solutions5
Three segments of Patient-Centric Rev Cycle - ANSWERS-Pre-service, Time-of-Service, Post-
Service
Pre-service - ANSWERS-Set stage for effective patient comm and data collection.
Requests service, notifies patient's financial responsibility, schedules patient, gen encounter
record, ID cost of service and health plan/benefits
Time-of-Service - ANSWERS-Scheduled patients: complete final account review prior to patient
arrival. Sign consents, pay co-pays, ID patient
Unscheduled patients: registration and financial processing is completed. Mirrors "scheduled
patients" work, but includes unscheduled items/services provided to out-of-network patients
Post-Service - ANSWERS-Account activities after the patient is discharged until the account
reaches a zero balance (final coding, claim prep/submission, pay process and balance
billing/resolution)
Core of "patient-centric rev cycle" concept - ANSWERS-Consumer experience: ease of access
and improved quality
Patient experience: coordination of care (financial/clinical), compliant clinical doc
Customer experience: appropriate payment, effective/efficient account resolution, decrease
cost to collect
HFMA rev cycle initiatives - ANSWERS-1. Financial comm best practices
, 2. Price transparency
3. Medical account resolution
Hospital Consumer Assessment of Heatlhcare Providers and Systems - ANSWERS-Survey
assessment for delivered to patients to measure satisfactions w/in facilities
Hard cost vs. Soft cost - ANSWERS-Hard: loss of future rev
Soft: customer passes info about neg experience to potential patient or through social media
Rev cycle activities to improve comm and customer service: - ANSWERS-1. Modify billing
formats/statements for patient comprehension
2. Extending normal business hours for patient inquiries and complaints
3. Resolving questions/complaints w/o transferring
4. Following up on all customer inquiries or complaints w/in 48 hours
5. Hold staff accountable during reviews for customer service responsibilities
Rev cycle functions benefiting from outsourcing: - ANSWERS-Appointment/scheduling
1. Admit, discharge, and transfer system (ADT) - Registration
Patient account systems:
1. Pre-bill editing
2. Electronic claim generation - insurance and patient billing
3. Payment tracking and automated follow-up queues
4. Accounts receivable
5. Cash posting
6. Denials management
7. Refund processing
8. Collection account transfers
