Healthcare Reimbursement Questions with Complete Answers Latest Version 2024

Healthcare Reimbursement Questions with Complete Answers Latest Version 2024 the individual elements of organizational financial transactions - Answers financial data the exchange of goods or services for payment or the promise of payment - Answers financial transaction person or organization such as a corporation or professional association. - Answers entity when the analysis of the data shows that the organization can continue to operate for the forseeable future - Answers going concern all of an entity's transactions must be quantified using a standard measurement. - Answers stable monetary unit generally the accepted standard measurement ' the 'stable monetary unit' - Answers money also called the financial year, defined by the tax year. government = september 30, hospital june 30 - Answers fiscal year what is the fiscal year divided into - Answers four quarters not all financial data represent completed transactions within a period. the financial data must comply with ____ in that they fairly represent the financial results of the period - Answers conservatism the thresholds below which items are not considered significatn - Answers materiality refers to whether the data actually represent what occurred. - Answers reliability transactions are recorded at their... - Answers historical cost means that the measurement of any transaction takes place at the time of the transaction - Answers historical cost consists of funds, goods, services that increase the organization's assets as a result of it's activities (donation of volunteer time) - Answers revenue expenses are recorded in the same period as the associated revenue, thereby matching the expenses and revenues - Answers matching what is the most common variation - Answers depreciation the systematic adjustment to the historical cost of an asset - Answers depreciation requires that the method of depreciation not change over the life of the asset - Answers principal of consistency notes that accompany data and help the user to make informed decisions - Answers disclosure what are the accounting principals - Answers reliability, cost, revenue, matching, consistency, disclosure what are the accounting concepts - Answers entity, going concern, stable monetary unit, time period, conservatism, materiality, independent organization that sets accounting standards for businesses in the private sector - Answers financial accounting standards board government entities (GSAB) - Answers Government Accounting Standards Board GAAP. rules by which financial data are compiled and recorded - Answers Generally Accepted Accounting Principals GAAS - Answers generally accepted auditing standards what are the three basic forms forms of financial organization? - Answers sole proprietor, partnership, corporation all funds remaining after current obligations, including taxes, are profits - Answers for profit organizations not owned but held in trust for the benefit of the communities they serve. (hospitals, AHIMA) - Answers not-for-profit organizations *most professional associations are organized under this type, gives them some tax benefits and the freedom to engage in some activities unrelated to their organizational purpose - Answers 501(c)(6) largely exempt from taxes. MUST PUBLIC BENEFIT, tax deductible donations, - Answers 501 (c)(3) what are the three fundamental steps of transactions? - Answers goods/services provided, transaction recorded, compensation exchanged source document of clinical services - Answers clinical and billing documentaiton the source document and records everything clinically relevant that happened to the patient during interaction with organization - Answers clinical documentation reflects the item, amount, time, date, route of administration. charges must be communicated to patient accounts at the same time - Answers billing documentation collects recorded transactions, bills the payer, ensures correct receipt of payment - Answers patient accounts responsible for identifying and recording the appropriate clinical codes that describe the patient's interaction with the organization - Answers HIM department responsible for accuracy, aggregating and maintaining the documentation that supports the reimbursement - Answers HIM department either drives the reimbursement or supports billing - Answers coding money or what can be turned into cash quickly - Answers cash drugs, equiptment, paper - Answers inventory list of amounts due from various customers - Answers accounts receivable cash, inventory or accounts receivable, building - Answers assets long term assets - Answers building cumulative decrease in a value of an asset - Answers depreciation purchase price - Answers acquisition cost accounts payable or mortgage - Answers liabilities created when the organization has received goods or services. - Answers accounts payable liability that is created when the organization borrows money and uses a physical asset - Answers mortgage balancing what is owned versus what is owed - Answers equity/fund balance owners equity equation - Answers assets - liability liability + owners equity - Answers assets what is the main source of revenue - Answers patient services patient services - Answers operating revenue investment income/ gift shop revenue are examples of what category of revenue - Answers non- operating revenue represents the utilization of resources by the organization in order to generate reveune - Answers expenses what is generally the largest purchasing expense in a hospital? - Answers human resources contains at least one debit and one credit. when an invoice is received by the facility it is accrued or recorded in the period in which it was realized - Answers journal entry paper based accounting system comprised of individual accounts - Answers general ledger list of all the accounts - Answers general ledger rarely required to make entries into the general ledger - Answers non financial managers snapshot of the account equation at a point in time - Answers balance sheet balance sheet lists the major account categories grouped under their equation headings - Answers assets/liabilities/ equity- fund balance summarizes the revenue and expense transactions during the fiscal year - Answers income statement difference between total revenue and total expenses - Answers net income or net loss increase owners equity - Answers net income decreases owners equity - Answers net loss shows the analyst if cash was used to purchase equpitment or pay down debt - Answers cash flow statement of ___that expresses the change in retained earnings from the beginning of the period to the end - Answers retained earnings also called the fund balance - Answers stockholders equity what is one of the most common reasons to analyze financial statements - Answers lend/ invest in organization meant to be used within the context of the oranization's industry (APPLES TO APPLES) - Answers ratios publishes industry ratio medials annual that helps benchmark - Answers Healthcare Financial Management Association ease which assets are turned into cash - Answers liquidity what is a key to lenders and investors - Answers organization's ability to discharge it's financial obligations the extent to which those financial obligations are loans - Answers debt service the organizations ability to pay current liabilities with current assets (important to lenders) - Answers current ratio compares current liabilities to the current assets that are truly liquid - Answers acid test ratio total liabilites divided by total assets - Answers debt ratio key components of profitability - Answers ROI, ROE measures the increase in the value of an asset. interest - Answers ROI, return on investment important indicatorfor determining an organization's efficiency or profitability level - Answers ROE Return of Equity traceable to a specific good or service provided (cost of a particular machine to a particular patient) - Answers direct costs incurred by the organization in the process of providing goods or services (security, switchboard operators) - Answers indirect costs remains the same despite the changes in volume - Answers fixed costs sensitive to volume (paper, medications) - Answers variable costs distributes the cost of overhead soley to the revenue producing departments based on square footage, # employees, actual usage - Answers direct method of cost allocation distributes overhead costs once, beginning with the area that provides the least amount of non revenue producing services - Answers step down allocation where overhead costs are allocated twice. takes into account that some overhead departments provide services to each other - Answers double distribution captures all individual patient charges in the patient's accounts, charges and underlying costs of services provided are maintained in this data base, collects info on all goods and services that the facility provides to its clients - Answers charge description master CDM overall the purpose of the CDM is to - Answers facilitate charge capture by centralizing and standardizing charge data within the facility internal tracking number - Answers charge code reference to the facilities accounting system - Answers general ledger key three digit medicare billing reference - Answers revenue code multiple fields to reference alternative billing codes for the item for different payers - Answers insurance code mapping is maintenance of the CDM multidisciplinary? - Answers yes, HIM, purchasing, patient accounts, pharmacy, finance difference between the patient discharge date and the claim submission date - Answers bill hold