HFMA Guide 2.0 | Questions with 100% Correct
Answers | Verified | Latest Update 2026
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Terms in this set (101)
Pre-Service, Time-of-Service, Post- 3 critical segments of the revenue cycle
Service
Pre-service segment (for scheduled Scheduling and pre-access processing is
patients) completed. The patient is scheduled, pre-
registered for service and the required data is
collected.
Time-of-service segment (scheduled A final account review is completed for a
and unscheduled patients) scheduled patient prior to his/her arrival. Upon
arrival, the patient is positively identified, the pre-
registration record is activated, consents are
signed, and co-payments or other agreed upon
amounts are collected. For unscheduled patients,
comprehensive registration and financial
processing is completed, this mirrors the work that
was completed for the scheduled patients prior to
service.
Post-service segment (after the Account activities occur after the patient is
patient is discharged) discharged until the account reaches a zero
balance
,Patient Financial Communications, Three HFMA revenue cycle initiatives
Price Transparency, Medical Account
Resolution
Medical Debt Task Force Developed medical account resolution best
practices
Out-of-pocket cost, the price of Patients are consumers of healthcare and want to
service prior to care, the provider's be informed of these 4 things
payment expectation, and the
payment terms.
Physicians Care providers within the healthcare system
Skilled Nursing Facilities
Home Health Agencies
Durable Medical Equipment
Hospice
Assisted Living
Continuum of Care way of coordinating and linking healthcare
resources to avoid duplication thus facilitating a
seamless movement among care settings.
involves healthcare professionals in multiple
settings at multiple levels working together with
the overall goal of coordinating patients'
healthcare
Purpose of a compliance program to mitigate potential fraud and abuse in the
industry-specific key risk areas.
, 2020 OIG Work Plan tasks Medicare Payments Made Outside of the Hospice
Benefit
Denials and Appeals in Medicare Part C and Part D
Medicare Part B Payments for End-Stage Renal
Disease Dialysis Services
Review of Home Health Claims for Services With 5
to 10 Skilled Visits
Three-Day DRG Window Rule requires certain outpatient services that are
provided within three days of the admission date,
by hospitals or by entities wholly owned or
controlled by hospitals, to be billed as part of an
inpatient stay.
Purpose of the ABN to inform a Medicare beneficiary "before he or she
receives specified items or services that might
otherwise be paid for" that Medicare certainly or
probably will not pay for those items or services on
that particular occasion.
Situations where Medicare acts as Working Aged
secondary payer Accident or Other Liability
Disability
End-Stage Renal Disease (ESRD)
Correct Coding Initiative (CCI) Ensures that the most comprehensive groups of
codes, rather than the component parts, are billed
Business ethics or organizational represent the principles and standards by which
ethics organizations operate.
Answers | Verified | Latest Update 2026
Save
Terms in this set (101)
Pre-Service, Time-of-Service, Post- 3 critical segments of the revenue cycle
Service
Pre-service segment (for scheduled Scheduling and pre-access processing is
patients) completed. The patient is scheduled, pre-
registered for service and the required data is
collected.
Time-of-service segment (scheduled A final account review is completed for a
and unscheduled patients) scheduled patient prior to his/her arrival. Upon
arrival, the patient is positively identified, the pre-
registration record is activated, consents are
signed, and co-payments or other agreed upon
amounts are collected. For unscheduled patients,
comprehensive registration and financial
processing is completed, this mirrors the work that
was completed for the scheduled patients prior to
service.
Post-service segment (after the Account activities occur after the patient is
patient is discharged) discharged until the account reaches a zero
balance
,Patient Financial Communications, Three HFMA revenue cycle initiatives
Price Transparency, Medical Account
Resolution
Medical Debt Task Force Developed medical account resolution best
practices
Out-of-pocket cost, the price of Patients are consumers of healthcare and want to
service prior to care, the provider's be informed of these 4 things
payment expectation, and the
payment terms.
Physicians Care providers within the healthcare system
Skilled Nursing Facilities
Home Health Agencies
Durable Medical Equipment
Hospice
Assisted Living
Continuum of Care way of coordinating and linking healthcare
resources to avoid duplication thus facilitating a
seamless movement among care settings.
involves healthcare professionals in multiple
settings at multiple levels working together with
the overall goal of coordinating patients'
healthcare
Purpose of a compliance program to mitigate potential fraud and abuse in the
industry-specific key risk areas.
, 2020 OIG Work Plan tasks Medicare Payments Made Outside of the Hospice
Benefit
Denials and Appeals in Medicare Part C and Part D
Medicare Part B Payments for End-Stage Renal
Disease Dialysis Services
Review of Home Health Claims for Services With 5
to 10 Skilled Visits
Three-Day DRG Window Rule requires certain outpatient services that are
provided within three days of the admission date,
by hospitals or by entities wholly owned or
controlled by hospitals, to be billed as part of an
inpatient stay.
Purpose of the ABN to inform a Medicare beneficiary "before he or she
receives specified items or services that might
otherwise be paid for" that Medicare certainly or
probably will not pay for those items or services on
that particular occasion.
Situations where Medicare acts as Working Aged
secondary payer Accident or Other Liability
Disability
End-Stage Renal Disease (ESRD)
Correct Coding Initiative (CCI) Ensures that the most comprehensive groups of
codes, rather than the component parts, are billed
Business ethics or organizational represent the principles and standards by which
ethics organizations operate.
