Test Bank
,Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
1. What is the first step of the life cycle of a payment claim?
a. The patient checks in at the front desk.
b. Denials and appeals have been closed.
c. Coinsurance payments are met.
d. Treatment plans have been identified.
ANSWER: a
FEEDBACK: a. Correct. The revenue cycle is the life cycle of a payment claim that begins
when the patient checks in at the front desk and ends after all payments or
denials and appeals have been made.
b. Incorrect. The revenue cycle ends when all payments or denials and appeals
have been made.
c. Incorrect. Coinsurance is the percentage the patient pays for covered services
after the deductible has been met and the copay has been paid.
d. Incorrect. Bills must accurately describe the treatment or service so that the
claim can be paid appropriately.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: Introduction
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.1 - Identify the steps in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 1:17 AM
DATE MODIFIED: 6/2/2023 1:20 AM
2. Why is it important that the process of managing billing cycles be performed accurately and on a timely basis?
a. to maintain cash flows
b. to ensure deductibles have been met
c. to enable the organization to become a covered entity
d. to prevent Medicare abuse
ANSWER: a
FEEDBACK: a. Correct. Throughout the process of managing billing cycles, cash flow must be
maintained to enable health care facilities to deliver quality care to their patients
and stay in business.
b. Incorrect. The insurance provider, not the provider of the service, will ensure
that deductibles have been met.
c. Incorrect. Health care organizations that are required to comply with HIPAA
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
d. Incorrect. Medicare defines abuse as “practices that directly or indirectly result
in unnecessary costs to Medicare.”
POINTS: 1
DIFFICULTY: Easy
REFERENCES: Introduction
QUESTIONTYPE: MultipleChoice
Page 1
,Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.1 - Identify the steps in the revenue cycle.
OTHER: Bloom's: Analyze
DATE CREATED: 6/2/2023 2:01 AM
DATE MODIFIED: 6/2/2023 2:03 AM
3. How does HIPAA apply to the revenue cycle?
a. It protects patient information.
b. It tracks copays and deductibles for patients.
c. It indicates what a patient will owe for services.
d. It determines eligibility for Medicare and Medicaid.
ANSWER: a
FEEDBACK: a. Correct. HIPAA applies to the revenue cycle because it protects the
transmission of patient information as well as the privacy of the patient’s
information as it is shared in the business of reimbursing for services rendered.
b. Incorrect. Patients and their insurance companies must be billed for services in
accordance with the terms of their health insurance coverage, deductibles,
copays, and coinsurances.
c. Incorrect. Coinsurance is the percentage the patient pays for covered services
after the deductible has been met and the copay has been paid.
d. Incorrect. Medicare and Medicaid are covered and monitored under
amendments to the Social Security Act.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: HIPAA and the Revenue Cycle
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.2 - Describe the role of HIPAA in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 2:03 AM
DATE MODIFIED: 6/2/2023 2:06 AM
4. What is the role of health care clearinghouses in the revenue cycle?
a. to convert nonstandard transactions into standard ones
b. to transmit all information protected under HIPAA
c. to monitor the impact of privacy rules
d. to provide information to lessen imminent danger
ANSWER: a
FEEDBACK: a. Correct. Health care clearinghouses are companies that convert nonstandard
transactions into standard transactions and transmit the data to health plans
and the reverse process.
b. Incorrect. Health care organizations that are required to comply with HIPAA
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
Page 2
, Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
c. Incorrect. The Privacy Rule covers the use and disclosure of PHI that is
transmitted or maintained by electronic media, such as over the Internet to “the
cloud” or stored on computer modems or remote servers.
d. Incorrect. Information needed to prevent or lessen imminent danger may be
disclosed to law enforcement if the information is needed to identify or
apprehend an escapee or violent criminal.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: HIPAA and the Revenue Cycle
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 1.2 - Describe the role of HIPAA in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 2:06 AM
DATE MODIFIED: 6/2/2023 2:09 AM
5. In the revenue cycle system, which group is responsible for billing and receiving payment for health care services in the
normal course of business?
a. health care providers
b. health care plans
c. health care clearinghouses
d. health care covered entities
ANSWER: a
FEEDBACK: a. Correct. Health care providers are the people or organizations that furnish, bill,
and are paid for health care in the normal course of business.
b. Incorrect. Health plans are individual or group health insurance plans that pay
for medical care.
c. Incorrect. Health care clearinghouses are companies that convert nonstandard
transactions into standard transactions and transmit the data to health plans
and the reverse process.
d. Incorrect. Health care organizations that are required to comply with HIPAA
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: HIPAA and the Revenue Cycle
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.2 - Describe the role of HIPAA in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 2:09 AM
DATE MODIFIED: 6/2/2023 2:11 AM
6. What is used to protect how personal health information is transmitted or maintained by electronic media?
Page 3
,Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
1. What is the first step of the life cycle of a payment claim?
a. The patient checks in at the front desk.
b. Denials and appeals have been closed.
c. Coinsurance payments are met.
d. Treatment plans have been identified.
ANSWER: a
FEEDBACK: a. Correct. The revenue cycle is the life cycle of a payment claim that begins
when the patient checks in at the front desk and ends after all payments or
denials and appeals have been made.
b. Incorrect. The revenue cycle ends when all payments or denials and appeals
have been made.
c. Incorrect. Coinsurance is the percentage the patient pays for covered services
after the deductible has been met and the copay has been paid.
d. Incorrect. Bills must accurately describe the treatment or service so that the
claim can be paid appropriately.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: Introduction
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.1 - Identify the steps in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 1:17 AM
DATE MODIFIED: 6/2/2023 1:20 AM
2. Why is it important that the process of managing billing cycles be performed accurately and on a timely basis?
a. to maintain cash flows
b. to ensure deductibles have been met
c. to enable the organization to become a covered entity
d. to prevent Medicare abuse
ANSWER: a
FEEDBACK: a. Correct. Throughout the process of managing billing cycles, cash flow must be
maintained to enable health care facilities to deliver quality care to their patients
and stay in business.
b. Incorrect. The insurance provider, not the provider of the service, will ensure
that deductibles have been met.
c. Incorrect. Health care organizations that are required to comply with HIPAA
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
d. Incorrect. Medicare defines abuse as “practices that directly or indirectly result
in unnecessary costs to Medicare.”
POINTS: 1
DIFFICULTY: Easy
REFERENCES: Introduction
QUESTIONTYPE: MultipleChoice
Page 1
,Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.1 - Identify the steps in the revenue cycle.
OTHER: Bloom's: Analyze
DATE CREATED: 6/2/2023 2:01 AM
DATE MODIFIED: 6/2/2023 2:03 AM
3. How does HIPAA apply to the revenue cycle?
a. It protects patient information.
b. It tracks copays and deductibles for patients.
c. It indicates what a patient will owe for services.
d. It determines eligibility for Medicare and Medicaid.
ANSWER: a
FEEDBACK: a. Correct. HIPAA applies to the revenue cycle because it protects the
transmission of patient information as well as the privacy of the patient’s
information as it is shared in the business of reimbursing for services rendered.
b. Incorrect. Patients and their insurance companies must be billed for services in
accordance with the terms of their health insurance coverage, deductibles,
copays, and coinsurances.
c. Incorrect. Coinsurance is the percentage the patient pays for covered services
after the deductible has been met and the copay has been paid.
d. Incorrect. Medicare and Medicaid are covered and monitored under
amendments to the Social Security Act.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: HIPAA and the Revenue Cycle
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.2 - Describe the role of HIPAA in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 2:03 AM
DATE MODIFIED: 6/2/2023 2:06 AM
4. What is the role of health care clearinghouses in the revenue cycle?
a. to convert nonstandard transactions into standard ones
b. to transmit all information protected under HIPAA
c. to monitor the impact of privacy rules
d. to provide information to lessen imminent danger
ANSWER: a
FEEDBACK: a. Correct. Health care clearinghouses are companies that convert nonstandard
transactions into standard transactions and transmit the data to health plans
and the reverse process.
b. Incorrect. Health care organizations that are required to comply with HIPAA
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
Page 2
, Name: Class: Date:
Chapter 01 Overview of Revenue Cycle Management
c. Incorrect. The Privacy Rule covers the use and disclosure of PHI that is
transmitted or maintained by electronic media, such as over the Internet to “the
cloud” or stored on computer modems or remote servers.
d. Incorrect. Information needed to prevent or lessen imminent danger may be
disclosed to law enforcement if the information is needed to identify or
apprehend an escapee or violent criminal.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: HIPAA and the Revenue Cycle
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 1.2 - Describe the role of HIPAA in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 2:06 AM
DATE MODIFIED: 6/2/2023 2:09 AM
5. In the revenue cycle system, which group is responsible for billing and receiving payment for health care services in the
normal course of business?
a. health care providers
b. health care plans
c. health care clearinghouses
d. health care covered entities
ANSWER: a
FEEDBACK: a. Correct. Health care providers are the people or organizations that furnish, bill,
and are paid for health care in the normal course of business.
b. Incorrect. Health plans are individual or group health insurance plans that pay
for medical care.
c. Incorrect. Health care clearinghouses are companies that convert nonstandard
transactions into standard transactions and transmit the data to health plans
and the reverse process.
d. Incorrect. Health care organizations that are required to comply with HIPAA
regulations are known as covered entities (CE), and that definition includes all
organizations that electronically transmit any information that is protected under
HIPAA.
POINTS: 1
DIFFICULTY: Easy
REFERENCES: HIPAA and the Revenue Cycle
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: LO: 1.2 - Describe the role of HIPAA in the revenue cycle.
OTHER: Bloom's: Understand
DATE CREATED: 6/2/2023 2:09 AM
DATE MODIFIED: 6/2/2023 2:11 AM
6. What is used to protect how personal health information is transmitted or maintained by electronic media?
Page 3
