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Question 1

Healthcare financial management for providers requires they balance what items?  

Group of answer choices

 

A. The generation of financial reports and timely delivery of medical care

 

B. Accurate pricing and provision of decision-making aids

 

C. Costs and the provision of quality care

 

D. Meeting accounting standards and legal requirements

 

E. None of the above.

 Question 2

Match the following activities and items to their relevant type of accounting:

Informs on the returns expected on investments in personnel.

Group of answer choices

 

Financial

 

Managerial

 

None of the above

Question 3

Match the following activities and items to their relevant type of accounting:

Communicates information to outside parties like creditors and investors 

Group of answer choices

 

Financial

 

Managerial

 

None of the above

 Question 4

Match the following activities and items to their relevant type of accounting:

Statements must meet accrediting standards 

Group of answer choices

 

Financial

 

Managerial

 

none of the above

Question 5

Match the following activities and items to their relevant type of accounting:

Allows for the type of analysis to determine the optimal sales mix for the firm’s products 

Group of answer choices

 

Financial

 

Managerial

 

None of the above

Question 6

Match the following activities and items to their relevant type of accounting:

Provides the ability to determine future service demand levels 

Group of answer choices

 

Financial

 

Managerial

 

None of the Above

Question 7

Match the following activities and items to their relevant type of accounting:

Is useful for making decisions

Group of answer choices

\

Financial

 

Managerial

 

None of the above

 Question 8

Match the following activities and items to their relevant type of accounting:

Helps identify production bottlenecks and inefficiencies 

Group of answer choices

 

Financial

 

Managerial

 

None of the above

 Question 9

Match the following activities and items to their relevant type of accounting:

 Draws insights into the needs of patients and payers 

Group of answer choices

 

Financial

 

Managerial

 

None of the above

 Question 10

Match the following activities and items to their relevant type of accounting:

Useful for inventory valuation

Group of answer choices

 

Financial

 

Managerial

 

None of the above

Question 11

Match the following activities and items to their relevant type of accounting:

Determines cash flow from operations and investments 

 

Group of answer choices

 

Financial

 

Managerial

 

None of the above

 Question 12

Identify the correct answers concerning the financial governance and responsibility structure of an HCO. 

Which of the following are recognized as the leaders of a healthcare organization? (Choose all that apply)

Group of answer choices

 

A. The administration

 

B. The chief executive officer

 

C. The medical staff

 

D. Senior managers

 

E. The governing body

 

F. All of the above

Question 13

Identify the correct answers concerning the financial governance and responsibility structure of an HCO. 

What are the implications for an HCO in having licensed independent contractors working within a healthcare organization in its ability to reach its goals?  (Choose all that apply)

Group of answer choices

 

A. These contractors’ decisions drive much of the organization’s use of resources

 

B. Their leadership must be chosen from within their own ranks

 

C. Participation in organizational quality programs are voluntary

 

D. These professionals cannot be clinically supervised by an unlicensed practitioner

 

E. They may not be hired as employees within the organization

 

F. None of the above

Question 14

Identify the correct answers concerning the financial governance and responsibility structure of an HCO. 

What are the differences between an organization’s Controller and Treasurer positions?  (Choose all that apply)

Group of answer choices

 

A. Controllers produces internal documents and statements whereas the Treasurer deals with external communications dealing with financial matters.

 

B. Both positions are concerned with similar activities but for different purposes.

 

C. Both report to the Chief Executive Officer

 

D. The Treasurer is the Chief Financial Officer with the Controller as the subordinate

 

E. Neither are responsible for the financial accounting function

 

F. None of the above

Question 15

Where can the leaders of an HCO’s medical staff be drawn from? (choose all that apply)

Group of answer choices

 

A. Internally from the medical staff, as from the nursing pool

 

B. From the licensed independent contractors used by the organization

 

C. After doing a national search

 

D. Anyone already serving on the governing board

 

E. A non-practicing physician or nurse

 

F. All of the above

 Question 16

An insurance company that pays a portion of a patient’s hospital bill is referred to as a what? 

Group of answer choices

 

A. A health care provider.

 

B. A payer of last resort.

 

C. An indemnity plan.

 

D. A third-party payer.

 

E. None of the above

 Question 17

Which category accounts for the largest share of National Health Expenditures?   

Group of answer choices

 

Which category accounts for the largest share of National Health Expenditures?

 

B. Medicaid

 

C. A fee-for-service payer.

 

D. Hospital Expenditures

 

E. Physician and Clinician Services

 

F. Prescription Drugs

Question 18

Retrospective reimbursement can refer to what? 

Group of answer choices

 

A. Paying for services based on an organization’s cost of care.

 

B. Paying for services where the providers have incentives to be inefficient.

 

C. Paying for services based on the charges of care.

 

D. Paying for services already rendered.

 

E. All of the above.

 

F. None of the above.

 Question 19

Who normally is billed charges from a health care provider? (Choose all that apply)

Group of answer choices

 

A. Those called private-pay patients.

 

B. Insurance plans that deem the provider out-of-network.

 

C. Self-pay patients.

 

D. Fee-for-service plans.

 

E. All of the above.

Question 20

Match the following descriptions of types reimbursement to their relevant term. 

Payments made based on the provider’s chargemaster 

Group of answer choices

 

A. Prospective FFS – Per Procedure

 

B. Charge-based

 

C. Cost-based

 

D. Bundled

 

E. Prospective FFS – Per Diagnosis

 

F. Capitation

 

 Question 21

Match the following descriptions of types reimbursement to their relevant term. 

Payments are based on a previously negotiated rate for an episode of care rather than individual services.

Group of answer choices

 

A. Prospective FFS – Per Procedure

 

B. Charge-based

 

C. Cost-based

 

D. Bundled

 

E. Prospective FFS – Per Diagnosis

 

F. Capitation

 

 Question 22

Match the following descriptions of types reimbursement to their relevant term

Payments are typically made for outpatient services for each type of medical activity performed.

Group of answer choices

 

A. Prospective FFS – Per Procedure

 

B. Charge-based

 

C. Cost-based

 

D. Bundled

 

E. Prospective FFS – Per Diagnosis

 

F. Capitation

 

Question 23

Match the following descriptions of types reimbursement to their relevant term. 

Providers are paid a fixed amount per covered life per period, regardless of the amount of services.

Group of answer choices

 

A. Prospective FFS – Per Procedurevvv

 

B. Charge-based

 

C. Cost-based

 

D. Bundled

 

E. Prospective FFS – Per Diagnosis

 

F. Capitation

 

Question 24

Under the Per Diagnosis reimbursement methodology, what is the appropriate method for Inpatient Hospital providers? 

Group of answer choices

 

A. RUGs (RUG-IV)

 

B. HHRGs

 

C. SMUGs

 

D. MS-DRGs

 

E. None of the above

Question 25

Under the Per Diagnosis reimbursement methodology, what is the appropriate method for Skilled Nursing providers? 

Group of answer choices

 

A. RUGs (RUG-IV)

 

B. HHRGs

 

C. SMUGs

 

D. MS-DRGs

 

E. None of the above

 

Question 26

What does a Contractual Allowance refer to? 

Group of answer choices

 

A. Payments for Medicare Part A and Part B medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries.

 

B. Taking into account the mix of patients being treated in a facility.

 

C. Allowing those Medicare-eligible to chose between traditional Medicare or Medicare Advantage

 

D. The difference between what a provider bills for the service rendered versus what it will be paid based on prior negotiations with a payer, typically Medicare

 

E. None of the above

 

 

 

SCIENCE
HEALTH SCIENCE
NURSING
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