HIMA 240 | Final Exam
HIMA 240-
FINAL EXAM
Healthcare Payment Systems
Exam Elaborations Questions and Answers
,Question 1 (1 point)
Saved
In which type of healthcare payment method does the
healthcare plan recompense providers with a fixed rate for
each day a covered member is hospitalized?
Question 1 options:
Traditional
Episode-of-care
Per diem
Fee-for-service
Question 2 (1 point)
Saved
Which healthcare payment method does Medicare use to
reimburse physicians based on the cost of providing services
in terms of effort, overhead, and malpractice insurance?
Question 2 options:
Global payment
Capitated rate
CPR
Resource-based relative value scale
Question 3 (1 point)
Saved
MS-DRG relationships comparing with MCC or CC (major
complications/comorbidities/complications/comorbidities) to
without MCC/CC MS-DRGs for the same clinical condition
should be reviewed because:
Question 3 options:
MCC/CCs can be over-coded by coders
MCC/CCs can be under-coded by coders
MCC/CCs should not be reported by coders
Both a and b are correct
a, b, and c are all correct
, Question 4 (1 point)
Saved
All of the following are discounted fee-for-service healthcare
payment methods except:
Question 4 options:
ACO
CPR
RBRVS
UCR
Question 5 (1 point)
Saved
The financial manager of the physician group practice
explained that the healthcare insurance company would be
reimbursing the practice for its treatment of the exacerbation
of congestive heart failure that Mrs. Zale experienced. The
exacerbation, treatment, and resolution covered
approximately five weeks. The payment covered all the
services that Mrs. Zale incurred during the period. What
method of reimbursement was the physician group practice
receiving?
Question 5 options:
Traditional
Episode-of-care
Per diem
Fee-for-service
Question 6 (1 point)
Saved
Which of the following coding systems was created for
reporting procedures and services performed by physicians in
clinical practice?
Question 6 options:
ICD-9-CM
CPT
HIMA 240-
FINAL EXAM
Healthcare Payment Systems
Exam Elaborations Questions and Answers
,Question 1 (1 point)
Saved
In which type of healthcare payment method does the
healthcare plan recompense providers with a fixed rate for
each day a covered member is hospitalized?
Question 1 options:
Traditional
Episode-of-care
Per diem
Fee-for-service
Question 2 (1 point)
Saved
Which healthcare payment method does Medicare use to
reimburse physicians based on the cost of providing services
in terms of effort, overhead, and malpractice insurance?
Question 2 options:
Global payment
Capitated rate
CPR
Resource-based relative value scale
Question 3 (1 point)
Saved
MS-DRG relationships comparing with MCC or CC (major
complications/comorbidities/complications/comorbidities) to
without MCC/CC MS-DRGs for the same clinical condition
should be reviewed because:
Question 3 options:
MCC/CCs can be over-coded by coders
MCC/CCs can be under-coded by coders
MCC/CCs should not be reported by coders
Both a and b are correct
a, b, and c are all correct
, Question 4 (1 point)
Saved
All of the following are discounted fee-for-service healthcare
payment methods except:
Question 4 options:
ACO
CPR
RBRVS
UCR
Question 5 (1 point)
Saved
The financial manager of the physician group practice
explained that the healthcare insurance company would be
reimbursing the practice for its treatment of the exacerbation
of congestive heart failure that Mrs. Zale experienced. The
exacerbation, treatment, and resolution covered
approximately five weeks. The payment covered all the
services that Mrs. Zale incurred during the period. What
method of reimbursement was the physician group practice
receiving?
Question 5 options:
Traditional
Episode-of-care
Per diem
Fee-for-service
Question 6 (1 point)
Saved
Which of the following coding systems was created for
reporting procedures and services performed by physicians in
clinical practice?
Question 6 options:
ICD-9-CM
CPT
