HIMA 240 | Exam 3
Principles of Healthcare Reimbursement:
HIMA 240 | Exam 3
Principles of Healthcare
Reimbursement:
Exam Elaborations Questions and Answers
,Principles of Healthcare Reimbursement: exam 3
Question 1 of 50
2.0 Points
In Medicare’s resource-based relative value scale payment system, to which type of code has a
relative value unit been assigned?
A. International Classification of Diseases
B. Health Insurance Prospective Payment System
C. Healthcare Common Procedure Coding System
D. Revenue
Answer Key:C
Question 2 of 50
2.0 Points
For which clinician is Medicare’s resource-based relative value scale payment system modified by a
formula that includes base units and time?
A. Anesthesiologists
, B. Nonparticipating providers
C. Nonphysician providers
D. Participating provider
Answer Key:A
Question 3 of 50
2.0 Points
In Medicare’s resource-based relative value scale payment system, which factor adjusts payments to
physicians and health professionals for price differences among various parts of the country?
A. Conversion factor
B. Geographic practice cost index
C. Party liability
D. Scaling
Answer Key:B
, Question 4 of 50
2.0 Points
Which element of the relative value unit accounts for the operational costs of delivering healthcare
services, such as rent, wages of technical personnel, and supplies and equipment?
A. Work value
B. Professional liability insurance
C. Geographic practice cost index
D. Practice expense
Answer Key:D
Question 5 of 50
2.0 Points
Jose, who is a Medicare patient, is seen in the Dr. Lee’s office. The total charge for the office visit is
$250.00. Jose has previously paid his Medicare Part B deductible. The Medicare fee schedule
amount for this service is $200.00. The nonparticipating Medicare fee schedule amount for this
service is $190.00. Dr. Lee is a Medicare participating physician. What is the total amount of the
patient’s cost sharing for this encounter?
A. $200.00
Principles of Healthcare Reimbursement:
HIMA 240 | Exam 3
Principles of Healthcare
Reimbursement:
Exam Elaborations Questions and Answers
,Principles of Healthcare Reimbursement: exam 3
Question 1 of 50
2.0 Points
In Medicare’s resource-based relative value scale payment system, to which type of code has a
relative value unit been assigned?
A. International Classification of Diseases
B. Health Insurance Prospective Payment System
C. Healthcare Common Procedure Coding System
D. Revenue
Answer Key:C
Question 2 of 50
2.0 Points
For which clinician is Medicare’s resource-based relative value scale payment system modified by a
formula that includes base units and time?
A. Anesthesiologists
, B. Nonparticipating providers
C. Nonphysician providers
D. Participating provider
Answer Key:A
Question 3 of 50
2.0 Points
In Medicare’s resource-based relative value scale payment system, which factor adjusts payments to
physicians and health professionals for price differences among various parts of the country?
A. Conversion factor
B. Geographic practice cost index
C. Party liability
D. Scaling
Answer Key:B
, Question 4 of 50
2.0 Points
Which element of the relative value unit accounts for the operational costs of delivering healthcare
services, such as rent, wages of technical personnel, and supplies and equipment?
A. Work value
B. Professional liability insurance
C. Geographic practice cost index
D. Practice expense
Answer Key:D
Question 5 of 50
2.0 Points
Jose, who is a Medicare patient, is seen in the Dr. Lee’s office. The total charge for the office visit is
$250.00. Jose has previously paid his Medicare Part B deductible. The Medicare fee schedule
amount for this service is $200.00. The nonparticipating Medicare fee schedule amount for this
service is $190.00. Dr. Lee is a Medicare participating physician. What is the total amount of the
patient’s cost sharing for this encounter?
A. $200.00
