Introduction to Revenue Management 63 Assignment 3.6 – Multiple Choice

Introduction to Revenue Management 63 Assignment 3.6 – Multiple Choice Review 1. Which is an example of supporting documentation that is attached to a submitted claim? a. completed CMS-1500 claim b. explanation of benefits c. operative report d. remittance advice 2. When supporting documentation is attached to the CMS-1500 as a letter delineating the provision of an unlisted service, it is referred to in the CPT coding manual as a(n) a. attachment. b. detailed report. c. enclosed note. d. special report. 3. Institutional billing (or facility billing) involves generating claims for charges generated for inpatient and outpatient services provided by health care facilities. a. CMS-1500 b. UB-04 4. The patient underwent office surgery on October 10, and the third-party payer determined the reasonable charge to be $1,000. The patient paid the 20 percent coinsurance at the time of the office surgery. The physician and patient each received a check for $500, and the patient signed the check over to the physician. The overpayment was _ and the must reimburse the insurance company. (Remember! Coinsurance is the percentage of costs a patient shares with the health plan.) a. $200, patient c. $500, patient b. $200, physician d. $500, physician 5. The person in whose name the insurance policy is issued is the a. patient. c. policyholder. b. plan. d. provider. 6. Another name for the patient account record is the patient a. day sheet. c. explanation of benefits. b. encounter form. d. ledger. 7. A chronological summary of all transactions posted to an individual patient’s account on a specific day is recorded on a(n) a. day sheet. c. patient ledger. b. encounter form. d. remittance advice. 8. Appropriate consents for treatment and release of information are obtained during the process a. appointment scheduling c. patient discharge b. charge capture d. patient registration 9. Which is a continued-stay review for medical necessity of tests and procedures ordered during an inpatient hospitalization? a. concurrent review c. preauthorization b. discharge planning d. preadmission certification 10. Revenue monitoring involves assessing the revenue process to ensure financial viability and stability using a metric as the standard of measurement. Which is an example of a metric? a. coordination of benefits c. days in accounts receivable b. diagnosis and procedure coding d. preadmission certification 11. The auditing of diagnosis and procedure/service codes a, allows providers to use chargemasters or encounter forms to select codes. b. facilitates the verification of patient demographic data and insurance information. c. is performed by qualified personnel to ensure accuracy for reimbursement purposes. d. requires the submission of reports to government agencies for validation.

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