HFMA Test Questions with Correct Answers
Which statement is NOT a unique billing rule specific to providers?
A patient may be balance billed for whatever amount the non-contracting physician charges
above the health plan's reimbursement amount.
The correct way to handle the retention and payment of agency fees is:
Follow the contractual agreement between the agency and the provider as to how monies sent
to the agency will be handled.
Collection results are:
Accurately calculated to demonstrate the actual recovery percentage rate.
(True or False) Vendor absorbs some financial risk based on "efficiency" factor..
True
Which option is NOT a main HFMA Healthcare Dollars & Sense® revenue cycle
initiative?
Process Compliance
Which of these statements describes the new methodology for the determination of net
patient service revenue:
Net patient service revenue is defined as the total incurred charges, less the explicit price
concession, less any applicable implicit price concession(s) as applied to the specific
portfolio of accounts.
Which option is NOT a HFMA best practice?
Coordinate the resolution of bad debt accounts with a law firm
, Patient relations include:
The ability to sensitively deal with patients or individuals while managing collection
efficiency.
Which option is NOT a type of denial?
Contractual Adjustment
Which concept is NOT a contracted payment model?
Stop-Loss Provision
True or False: The following statement represents an advantage of outsourcing:
False
Agency fees are:
The cost to the provider for collection agency monies offset by the return on bad debt
accounts.
In what manner do case managers assist revenue cycle staff?
Providing assistance with written appeals to health plans related to utilization and other care
issues.
In order to promote the use of correct coding methods on a national basis and prevent
payment errors due to improper coding, CMS developed what?
The Correct Coding Initiative (CCI)
What do business/organizational ethics represent?
Principles and standards by which organizations operate
What are claim edits?
Which statement is NOT a unique billing rule specific to providers?
A patient may be balance billed for whatever amount the non-contracting physician charges
above the health plan's reimbursement amount.
The correct way to handle the retention and payment of agency fees is:
Follow the contractual agreement between the agency and the provider as to how monies sent
to the agency will be handled.
Collection results are:
Accurately calculated to demonstrate the actual recovery percentage rate.
(True or False) Vendor absorbs some financial risk based on "efficiency" factor..
True
Which option is NOT a main HFMA Healthcare Dollars & Sense® revenue cycle
initiative?
Process Compliance
Which of these statements describes the new methodology for the determination of net
patient service revenue:
Net patient service revenue is defined as the total incurred charges, less the explicit price
concession, less any applicable implicit price concession(s) as applied to the specific
portfolio of accounts.
Which option is NOT a HFMA best practice?
Coordinate the resolution of bad debt accounts with a law firm
, Patient relations include:
The ability to sensitively deal with patients or individuals while managing collection
efficiency.
Which option is NOT a type of denial?
Contractual Adjustment
Which concept is NOT a contracted payment model?
Stop-Loss Provision
True or False: The following statement represents an advantage of outsourcing:
False
Agency fees are:
The cost to the provider for collection agency monies offset by the return on bad debt
accounts.
In what manner do case managers assist revenue cycle staff?
Providing assistance with written appeals to health plans related to utilization and other care
issues.
In order to promote the use of correct coding methods on a national basis and prevent
payment errors due to improper coding, CMS developed what?
The Correct Coding Initiative (CCI)
What do business/organizational ethics represent?
Principles and standards by which organizations operate
What are claim edits?
