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WGU C425 OA ACTUAL Exam Questions
And Answers 100% Pass
Which of the following is true in regards to health care today in the United States?
There are more primary care physicians than specialty physicians.
Primary care receives a higher reimbursement in professional fees.
There are more specialty physicians than primary physicians.
Outpatient care is slowly decreasing. - ANS There are more specialty physicians than primary
physicians.
What triggered the downsizing phase in the U.S. hospital industry during the 1980s?
Hill-Burton Act
Managed care
Prospective payment system
Medicare and Medicaid - ANS Prospective payment system
Designated Related Groups (DRG) -based reimbursement necessitated hospitals to do what?
Admit new patients at a faster rate than before
Admit a greater number of Medicare patients than before
Reduce the length of stay for hospitalized patients
Admit a smaller number of Medicare patients than before - ANS Reduce the length of stay
for hospitalized patients
, ©EVERLY 2025 ALL RIGHTS RESERVED
In which type of utilization management is a primary care physician's opinion necessary in
referring or not referring a patient to a specialist?
Concurrent
Retrospective
Gatekeeping
Precertification - ANS Gatekeeping
What is one aspect in which managed care differs from conventional insurance?
Collection of premiums
Assumption of risk
Responsibility for delivery of services
Payments to providers - ANS Responsibility for delivery of services
What is the purpose of Skilled Nursing Facilities (SNF) certification?
It enables a facility to be operated as a skilled nursing facility.
It is required to legally operate a nursing home.
It enables a facility to serve Medicare clients.
It enables a facility to serve both Medicare and Medicaid clients. - ANS It enables a facility to
serve Medicare clients.
What is the main goal of long-term care as it relates to a patient's function?
Restore function
Provide assistance
Promote independence
Adapt to change - ANS Promote independence
The U.S. government plays a limited role in the health delivery system. The government's role
in the arena of health care delivery consists of:
WGU C425 OA ACTUAL Exam Questions
And Answers 100% Pass
Which of the following is true in regards to health care today in the United States?
There are more primary care physicians than specialty physicians.
Primary care receives a higher reimbursement in professional fees.
There are more specialty physicians than primary physicians.
Outpatient care is slowly decreasing. - ANS There are more specialty physicians than primary
physicians.
What triggered the downsizing phase in the U.S. hospital industry during the 1980s?
Hill-Burton Act
Managed care
Prospective payment system
Medicare and Medicaid - ANS Prospective payment system
Designated Related Groups (DRG) -based reimbursement necessitated hospitals to do what?
Admit new patients at a faster rate than before
Admit a greater number of Medicare patients than before
Reduce the length of stay for hospitalized patients
Admit a smaller number of Medicare patients than before - ANS Reduce the length of stay
for hospitalized patients
, ©EVERLY 2025 ALL RIGHTS RESERVED
In which type of utilization management is a primary care physician's opinion necessary in
referring or not referring a patient to a specialist?
Concurrent
Retrospective
Gatekeeping
Precertification - ANS Gatekeeping
What is one aspect in which managed care differs from conventional insurance?
Collection of premiums
Assumption of risk
Responsibility for delivery of services
Payments to providers - ANS Responsibility for delivery of services
What is the purpose of Skilled Nursing Facilities (SNF) certification?
It enables a facility to be operated as a skilled nursing facility.
It is required to legally operate a nursing home.
It enables a facility to serve Medicare clients.
It enables a facility to serve both Medicare and Medicaid clients. - ANS It enables a facility to
serve Medicare clients.
What is the main goal of long-term care as it relates to a patient's function?
Restore function
Provide assistance
Promote independence
Adapt to change - ANS Promote independence
The U.S. government plays a limited role in the health delivery system. The government's role
in the arena of health care delivery consists of:
