Reference no: EM133922796
Questions
1. Healthcare financial management for providers requires they balance what items?
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.
2. Match the following activities and items to their relevant type of accounting:
Informs on the returns expected on investments in personnel.
Financial
Managerial
None of the above
3. Match the following activities and items to their relevant type of accounting:
Communicates information to outside parties like creditors and investors
Financial
Managerial
None of the above
4. Match the following activities and items to their relevant type of accounting:
Statements must meet accrediting standards
Financial
Managerial
none of the above
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
Financial
Managerial
None of the above
6. Match the following activities and items to their relevant type of accounting:
Provides the ability to determine future service demand levels
Financial
Managerial
None of the Above
7. Match the following activities and items to their relevant type of accounting:
Is useful for making decisions
Financial
Managerial
None of the above
8. Match the following activities and items to their relevant type of accounting:
Helps identify production bottlenecks and inefficiencies
Financial
Managerial
None of the above
9. Match the following activities and items to their relevant type of accounting:
Draws insights into the needs of patients and payers
Financial
Managerial
None of the above
10. Match the following activities and items to their relevant type of accounting:
Useful for inventory valuation
Financial
Managerial
None of the above
Match the following activities and items to their relevant type of accounting:
Determines cash flow from operations and investments
Financial
Managerial
None of the above
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)
A. The administration
B. The chief executive officer
C. The medical staff
D. Senior managers
E. The governing body
F. All of the above
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)
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
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)
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
15. Where can the leaders of an HCO's medical staff be drawn from? (choose all that apply)
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
16. An insurance company that pays a portion of a patient's hospital bill is referred to as a what?
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
17. Which category accounts for the largest share of National Health Expenditures?
A. Medicaid
B. A fee-for-service payer.
C. Hospital Expenditures
D. Physician and Clinician Services
E. Prescription Drugs
18. Retrospective reimbursement can refer to what?
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.
19. Who normally is billed charges from a health care provider? (Choose all that apply)
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.
20. Match the following descriptions of types reimbursement to their relevant term.
Payments made based on the provider's chargemaster
A. Prospective FFS - Per Procedure
B. Charge-based
C. Cost-based
D. Bundled
E. Prospective FFS - Per Diagnosis
F. Capitation
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.
A. Prospective FFS - Per Procedure
B. Charge-based
C. Cost-based
D. Bundled
E. Prospective FFS - Per Diagnosis
F. Capitation
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.
A. Prospective FFS - Per Procedure
B. Charge-based
C. Cost-based
D. Bundled
E. Prospective FFS - Per Diagnosis
F. Capitation
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.
A. Prospective FFS - Per Procedurevvv
B. Charge-based
C. Cost-based
D. Bundled
E. Prospective FFS - Per Diagnosis
F. Capitation
24. Under the Per Diagnosis reimbursement methodology, what is the appropriate method for Inpatient Hospital providers?
A. RUGs (RUG-IV)
B. HHRGs
C. SMUGs
D. MS-DRGs
E. None of the above
25. Under the Per Diagnosis reimbursement methodology, what is the appropriate method for Skilled Nursing providers?
A. RUGs (RUG-IV)
B. HHRGs
C. SMUGs
D. MS-DRGs
E. None of the above
26. What does a Contractual Allowance refer to?
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