HPA 332 Exam #3 With Complete Solutions
Leaders have a ___ focus:
Managers have a ____ focus: - ANSWER Strategy/Vision
Organization
Tasks related to organizational mission: - ANSWER Leaders: establish the
mission
Managers: Hire staff to meet the mission
Tasks related to organization strategy: - ANSWER Leaders: motivate
stakeholders to approve strategy
Managers: maintain resources to carry out strategy
Tasks related to spokesperson function: - ANSWER Leaders: organization
spokesperson for all employees
Managers: spokesperson for the department & counseling of employees to
reach organization's goals
Tasks related to future strategies: - ANSWER Leaders: develops strategies
Managers: follows regulations required to meet strategies
Tasks related to change: - ANSWER Leaders: transforms organization when
needed to meet future goals established by strategic plan
Managers: services employee and leader needs when creating change to meet
strategic goals
5 Leader/Manager skills (behavioral & technical) - ANSWER Behavioral:
establishing and maintaining working relationships & adapting actions and
styles to needs and circumstances, work life balance
Technical: removing obstacles and completing a task
Leadership styles: - ANSWER Coercive
Participative
Pacesetting
Coaching
Coercive style: - ANSWER Power: elicit a behavior by being forceful &
demanding
-effective with problematic employees
-ineffective with self motivated employees
, Participative style: - ANSWER Team oriented: solicits input, supportive, holds
meetings where employees share
-effective in healthcare settings
-ineffective with teams that don't want so support eachother
Pacesetting style: - ANSWER Manager sets high performance standards
-effective with self motivated employees
-ineffective with employees not self confident
Coaching style: - ANSWER Manager focused on employee's professional
development
-effective with top level employees highly motivated
-ineffective with groups of employees that will remain in their role
Fraud: - ANSWER intentional act of deceiving
Abuse: - ANSWER unintentional act that is inconsistent with standard practice
Up-coding & under-coding: - ANSWER -purposefully charging more than what is
allowable or what was performed
-charging less than should be charged for a procedure
False Claims Act: - ANSWER allows whistleblowers not to be prosecuted
Recovery Audit Contractors (RAC): - ANSWER program 2003-2007 with CMS
auditors matches payments to clinical notes to find fraud
Healthcare Fraud Prevention and Enforcement Action Team (HEAT): - ANSWER
created after RAC to continue the work
-HEAT team digs deeper to find patterns of behavior
Criminal Disclosure Provision: - ANSWER any provider/person in the
organization that possesses or fails to disclose information about fraud can be
convicted of a felony, charged fines, and sentenced to prison
Physician Self-Referral: - ANSWER physicians can't refer to themselves without
giving patient other choices as well
Stark I: - ANSWER Physicians can't refer to LABS in which they have a financial
interest
Stark II: - ANSWER Physicians must offer other choices if they are sending
patients to an entity they have a financial relationship with (ALL ancillary
services)
Leaders have a ___ focus:
Managers have a ____ focus: - ANSWER Strategy/Vision
Organization
Tasks related to organizational mission: - ANSWER Leaders: establish the
mission
Managers: Hire staff to meet the mission
Tasks related to organization strategy: - ANSWER Leaders: motivate
stakeholders to approve strategy
Managers: maintain resources to carry out strategy
Tasks related to spokesperson function: - ANSWER Leaders: organization
spokesperson for all employees
Managers: spokesperson for the department & counseling of employees to
reach organization's goals
Tasks related to future strategies: - ANSWER Leaders: develops strategies
Managers: follows regulations required to meet strategies
Tasks related to change: - ANSWER Leaders: transforms organization when
needed to meet future goals established by strategic plan
Managers: services employee and leader needs when creating change to meet
strategic goals
5 Leader/Manager skills (behavioral & technical) - ANSWER Behavioral:
establishing and maintaining working relationships & adapting actions and
styles to needs and circumstances, work life balance
Technical: removing obstacles and completing a task
Leadership styles: - ANSWER Coercive
Participative
Pacesetting
Coaching
Coercive style: - ANSWER Power: elicit a behavior by being forceful &
demanding
-effective with problematic employees
-ineffective with self motivated employees
, Participative style: - ANSWER Team oriented: solicits input, supportive, holds
meetings where employees share
-effective in healthcare settings
-ineffective with teams that don't want so support eachother
Pacesetting style: - ANSWER Manager sets high performance standards
-effective with self motivated employees
-ineffective with employees not self confident
Coaching style: - ANSWER Manager focused on employee's professional
development
-effective with top level employees highly motivated
-ineffective with groups of employees that will remain in their role
Fraud: - ANSWER intentional act of deceiving
Abuse: - ANSWER unintentional act that is inconsistent with standard practice
Up-coding & under-coding: - ANSWER -purposefully charging more than what is
allowable or what was performed
-charging less than should be charged for a procedure
False Claims Act: - ANSWER allows whistleblowers not to be prosecuted
Recovery Audit Contractors (RAC): - ANSWER program 2003-2007 with CMS
auditors matches payments to clinical notes to find fraud
Healthcare Fraud Prevention and Enforcement Action Team (HEAT): - ANSWER
created after RAC to continue the work
-HEAT team digs deeper to find patterns of behavior
Criminal Disclosure Provision: - ANSWER any provider/person in the
organization that possesses or fails to disclose information about fraud can be
convicted of a felony, charged fines, and sentenced to prison
Physician Self-Referral: - ANSWER physicians can't refer to themselves without
giving patient other choices as well
Stark I: - ANSWER Physicians can't refer to LABS in which they have a financial
interest
Stark II: - ANSWER Physicians must offer other choices if they are sending
patients to an entity they have a financial relationship with (ALL ancillary
services)
