Healthcare Insurance, Medicare & Medicaid Systems, Managed Care
Organizations, Revenue Cycle Management, Coding Compliance,
Reimbursement Methodologies, DRG APC PPS IPPS HOPPS SNF PPS IRF PPS
LTCH PPS, Utilization Review, Case Mix Index Analysis, Risk Pooling,
Premiums Deductibles Copayments Coinsurance, HIPAA HITECH ACA ERISA
COBRA CLIA MACRA Legislation, Medical Billing and Coding ICD-10-CM CPT
HCPCS, Value-Based Purchasing Pay-for-Performance Models, ACO MIPS
Advanced APM, Health Information Technology EHR OASIS MDS, Clinical
Services Allied Health Roles, Continuum of Care Integrated Delivery
Systems, Hospital Administration Governance, Public and Private Insurance
Programs TRICARE CHAMPVA CHIP, Prospective vs Retrospective Payment
Systems, Medicare Parts A B C D Benefits, Compliance Audits RAC NCCI
Exam Questions Verified and Provided with Complete A+ Graded
Rationales Latest Updated 2026
Which are used to calculate reimbursement for hospital-based Medicare outpatient claims?
APCs
Which act authorized $1.5 billion for grants for construction, renovation, and equipment, as well
as for the acquisition of health information technology systems?
ARRA
,Which legislation was passed in 1997 that addresses health care fraud and abuse issues?
BBA
Which 1988 legislation resulted in the creation of a new program, TRICARE, which includes
options such as TRICARE Prime, TRICARE Extra, and TRICARE Standard
CRI
Which program provides health care benefits for dependents of permanently disabled veterans
CHAMPVA
Which program provides benefits to dependents of personnel serving in the armed forces as
well as uniformed branches of the Public Health Service and the National Oceanic and
Atmospheric Administration, created by amendments to the Dependents' Medical Care Act of
1956, and was renamed TRICARE?
CHAMPUS
Which legislation established quality standards for all laboratory testing to ensure the accuracy,
reliability, and timeliness of patient test results regardless of where the test was performed?
CLIA
The CMS-1500 claim is submitted for reimbursement of:
physician office procedures and services
, Coinsurance is the:
percentage of costs a patient shares with the health plan
Which legislation allows employees to continue health care coverage beyond the benefit
termination date by paying appropriate premiums?
COBRA
Which was introduced as a way to encourage individuals to locate the best health care at the
lowest possible price?
Consumer-driven health plans
The primary purpose of the medical record is to ensure:
continuity of care
Which provision of an insurance policy requires policyholders (and patients) to pay a specified
dollar amount to a health care provider for each visit or medical service received?
copayment
The amount for which the patient is financially responsible before an insurance policy provides
payment is called the:
Organizations, Revenue Cycle Management, Coding Compliance,
Reimbursement Methodologies, DRG APC PPS IPPS HOPPS SNF PPS IRF PPS
LTCH PPS, Utilization Review, Case Mix Index Analysis, Risk Pooling,
Premiums Deductibles Copayments Coinsurance, HIPAA HITECH ACA ERISA
COBRA CLIA MACRA Legislation, Medical Billing and Coding ICD-10-CM CPT
HCPCS, Value-Based Purchasing Pay-for-Performance Models, ACO MIPS
Advanced APM, Health Information Technology EHR OASIS MDS, Clinical
Services Allied Health Roles, Continuum of Care Integrated Delivery
Systems, Hospital Administration Governance, Public and Private Insurance
Programs TRICARE CHAMPVA CHIP, Prospective vs Retrospective Payment
Systems, Medicare Parts A B C D Benefits, Compliance Audits RAC NCCI
Exam Questions Verified and Provided with Complete A+ Graded
Rationales Latest Updated 2026
Which are used to calculate reimbursement for hospital-based Medicare outpatient claims?
APCs
Which act authorized $1.5 billion for grants for construction, renovation, and equipment, as well
as for the acquisition of health information technology systems?
ARRA
,Which legislation was passed in 1997 that addresses health care fraud and abuse issues?
BBA
Which 1988 legislation resulted in the creation of a new program, TRICARE, which includes
options such as TRICARE Prime, TRICARE Extra, and TRICARE Standard
CRI
Which program provides health care benefits for dependents of permanently disabled veterans
CHAMPVA
Which program provides benefits to dependents of personnel serving in the armed forces as
well as uniformed branches of the Public Health Service and the National Oceanic and
Atmospheric Administration, created by amendments to the Dependents' Medical Care Act of
1956, and was renamed TRICARE?
CHAMPUS
Which legislation established quality standards for all laboratory testing to ensure the accuracy,
reliability, and timeliness of patient test results regardless of where the test was performed?
CLIA
The CMS-1500 claim is submitted for reimbursement of:
physician office procedures and services
, Coinsurance is the:
percentage of costs a patient shares with the health plan
Which legislation allows employees to continue health care coverage beyond the benefit
termination date by paying appropriate premiums?
COBRA
Which was introduced as a way to encourage individuals to locate the best health care at the
lowest possible price?
Consumer-driven health plans
The primary purpose of the medical record is to ensure:
continuity of care
Which provision of an insurance policy requires policyholders (and patients) to pay a specified
dollar amount to a health care provider for each visit or medical service received?
copayment
The amount for which the patient is financially responsible before an insurance policy provides
payment is called the:
