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Consents are signed as part of the post service process. (True or Flase) - Answer-False Patient service costs are calculated in the pre-service process for scheduled patients.(True or False) - Answer-True The patient is scheduled and registered for service is a time of service activity (True or False) - Answer-False The patient account is monitored for payments is a time of service activity (True or False) - Answer-False case management and discharge planning service are a post servi...

AAR - Answer-After-hours activity report ABN - Answer-Advance Beneficiary Notice ACC - Answer-Ambulatory care center Access - Answer-Ability to receive hospital; physician or other medical services without regard to an individual's ability to pay Accounts receivable (A/R) - Answer-Money owed to an organization for goods or services furnished Accounts receivable (A/R) collection period - Answer-Number of days in the accounting period divided by accounts receivable turnover. This r...

Which option is NOT a main HFMA Healthcare Dollars and Sense revenue cycle initiative? A) Patient Financial Communications B) Medical Account Resolution C) Price Transparency D) Process Compliance - Answer-D) Process Compliance Approximately what ______% of billing information is obtained during the registration process (Patient Access). - Answer-40% What is the objective of the HCAHPS initiative? A) To conduct evaluations concerning patients' perspective on hospital care. B) To p...

Through what document does a hospital establish compliance standards? - Answer-code of conduct What is the purpose OIG work plant? - Answer-Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? - Answer-Non-diagnostic service provided on Tuesday through Friday What does a modifier allow a provider to do? - Answer-Report a specific circumstance that affected a procedure or ...

Revenue Cycle - Answer-All of the major processing steps required to process a patient account from the request for service through closing the account with a zero balance and purging it from the system. Pre-Service - Answer-1. Patient is scheduled and registered for service 2. Patient Service cost is calculated Time-of-Servce - Answer-1. Case Management and Discharge Plans are provided 2. Consent forms are signed Post-Service - Answer-1. Bills are sent electronically to health plan 2. ...

835 Record - Answer-A standard electronic message between a health plan and provider sending remittance data on a claim to the provider. 837 Record - Answer-A standard electronic message between a provider and health plan sending data on a claim to the health plan. AAR - Answer-After-hours activity report ABN - Answer-Advanced Beneficiary Notice ACC - Answer-ambulatory care center Access - Answer-The ability to receive hospital, physician or other medical services without regard t...

Net Days in AR - Answer-Measures how fast receivables are collected. It is a trending indicator of overall A/R performance & revenue cycle efficiency. A/R Aging - Answer-Reports divide the AR into 30, 60, 90, and 120 day categories, based on discharge. Credit Balances - Days Outstanding - Answer-The dollars in credit balance at the account level divided by the three month daily average of total net patient service revenue. Credit balances should be resolved timely and should be benchmarked...

Which of the following statements are true of HFMA's Patient Financial Communications Best Practices? - Answer-The best practices were developed specifically to help patients understand the cost of services, their individual insurance benefits, and their responsibility for balances after insurance, if any. The patient experience includes all of the following except: - Answer-Recognition that revenue cycle processes must be patient-centric and efficient. This is especially true in the areas o...

What do Case Managers do? - Answer-Monitor high resource cases to ensure effective utilization What is HIM responsible for? - Answer-all pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? - Answer-manage cases: services correct, on time What are the three types of utilization review? - Answer-Prospective, Concurrent, Retrospective Where can home health services be offered? - Answer-Home, Assist ...

The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of the following activities? A. Complete a community needs assessment and develop a discount program for patient balances after insurance payment. B. Pursue extraordinary collection activities with all patients eligible for financial assistance. C. Implement a financial assistance program for uninsured and underinsured patients. D. Discount all charges to self-pay patients to an amount generally billed to all othe...

code of conduct - Answer-hospital establish compliance standards Purpose of OIG work plan? - Answer-communicate issues that will be reviewed during the year for compliance with Medicare regulations Medicare pt. admitted on Friday, what services fall within the three day window rule? - Answer-Dx services and related charges provided on the W,R, and F before adm. What does modifier allow a provider to do? - Answer-Report a specific circumstance that affected a procedure or service without...

Which of the following statements are true of HFMA's Financial Communications Best Practices - Answer-The best practices were developed specifically to help patients understand the cost of services, their individual insurance benefits, and their responsibility for balances after insurance, if any. The patient experience includes all of the following except: - Answer-The average number of positive mentions received by the health system or practice and the public comments refuting unfriendly p...

Important revenue cycle activities in the pre-service stage include; - Answer-Obtaining or updating patient and guarantor information In the pre-service stage, the cost of the scheduled service is identified and the patient's health plan and benefits are used to calculate; - Answer-The amount the patient may be expected to pay after insurance. Demographic and health plan edit failures are identified and resolved within the Patient Access area. Census activity is processed, Discharges are ...

What customer service improvements might improve the patient accounts department? - Answer-Holding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - Answer-Inform a Medicare beneficiary that Medicare may not pay for the order or service What type of account adjustment results from the patient's unwillingness to pay for a self-pay balance? - Answer-Bad debt adjustment What is the initial hospic...

Long Range Plan (LRP) - Answer-A prediction of how the business will evolve within the next 3-5 years. Input is needed from all departments to formulate this plan; each of these groups has expectations that are translated into numbers to make a target Annual Business Plan (ABP) - Answer-How businesses capture expectations of stakeholder groups. Monthly tracking is essential, looking at the actual numbers of the previous month compared to the target. Reforcasting of expectations is done monthl...

What is business analytics? - Answer-refers to the skills, technologies, and practices for continuous investigation of past business performance Independent variable - Answer-Variable whose value impacts dependent variables Dependent variable - Answer-variables representing market objectives, response to change in independent variable Descriptive analytics - Answer-tools that summarize what happened Predictive analytics - Answer-a variety of statistical techniques that analyze data t...

business analytics - Answer-the use of data, information technology, statistical analysis, quantitative methods, and mathematical or computer-based models to help managers gain improved insight about their business operations and make better, fact-based decisions What are the three major components that support business analytics? - Answer-descriptive analytics, predictive analytics, and prescriptive analytics descriptive analytics - Answer-the use of data to understand past and current bu...

What is the most important consideration in business analytics? - Answer-Understanding the PROBLEMS and OPPORTUNITIES that the analytical tool will help with and consider the connections. Business Intelligence - Answer--Paved the way for the business analytics. -Caused people to realize that data is valuable for decision making -------------------------------------------------------------------------------- Extracts data and packages it got use in business. Uses: reporting, analytical p...

Three Principles of Business Analytics - Answer-Business problem/oportunity X3 Business Intelligence - Answer-The ability to apprehend the interrelationships of presented facts in such a way as to guide action towards a desired goal. Business Intelligence - Answer-Concepts and methods to improve business decision making by fact-based support systems Business Intelligence - Answer-_____________ paved the way for advanced business analytics as it prepared business for a new way of thinkin...

business analytics - Answer-the skills, technologies, practices for continuous iterative exploration and investigation of past business performance to gain insight and drive business planning business analytics focuses on - Answer-developing new insights and understanding of business performance based on data and statistical methods big data - Answer-a broad term used to describe the exponential growth and availability of data, both structured and unstructured three Vs - Answer--volume ...