Revenue Cycle Management Question with
Verified Answers
In which issue of the Federal Register are updates to Medicare outpatient
reimbursement NOT published? {correct ANSW} October
Medicare part _____ is a prescription drug benefit. {correct ANSW} Part D
_____ assignment is when a provider does not bill a patient for the difference between
the service cost and Medicare allowed. {correct ANSW} Accepting
Which of the following would be considered a discount that would be permitted as a
"safe harbor" from fraud and abuse regulations? {correct ANSW} HMO contracts with
laboratory for laboratory services and receives a discounted price.
Which is not a component that is taken into account with a Relative Value Unit (RVU)?
{correct ANSW} work, malpractice and overhead (all are listed components)
Which group does the Medicare program not cover? {correct ANSW} Prisoners
Healthcare is more heavily regulated than most other businesses in the United States.
{correct ANSW} True
Which type of health insurance plan uses primary care clinician gatekeepers to
coordinate the care of plan participants? {correct ANSW} HMO
Which type of healthcare reimbursement system pays a fixed amount per patient?
{correct ANSW} Capitation
A legal document required in most states for expanding a hospital is {correct ANSW}
Certificate of Need
A small, closely held corporation is owned by {correct ANSW} private investors
The responsibility of medical services at most hospitals lies with {correct ANSW} The
chief of staff or medical director
Home healthcare services___ {correct ANSW} are eligible for Medicare and Medicare
reimbursement
Hospice care___ {correct ANSW} is for patients and their families.
, Nursing home costs for elderly Americans___ {correct ANSW} are most covered by
Medicaid
The emergency department of a hospital is {correct ANSW} an out-patient facility
A not-for-profit hospital must {correct ANSW} adopt a corporate structure
Ambulatory care refers to services provided by paramedics and emergency medical
technologists while transporting a patient to the hospital. {correct ANSW} False
Most proprietorship's form professional corporations in order to {correct ANSW} reduce
financial liabilities
Which of the following financial management issues differentiates healthcare from other
businesses? {correct ANSW} third party payers
Which of the following provides hospitalization insurance? {correct ANSW} Blue Cross
An individual works at a business that covers half the cost of a group healthcare
insurance plan with the other half paid by the employee. The individual quits his job but
wishes to retain group healthcare insurance as per COBRA. How much will he pay for
coverage? {correct ANSW} Twice the amount he paid while employed plus an
administrative fee
Prescription drugs for the elderly are covered under {correct ANSW} MMA (2003)
The following is true about a preferred provider organization plans and explain their
limited ability to control healthcare costs. {correct ANSW} A PPO plan is a form of
managed care in which the insurer contracts with healthcare providers that agree to a
reduced cost fee schedule. and Covered persons who use a PPO pay less through
combination of lower premiums. lower deductibles, and smaller co-payments. A PPO
plan is a fee-for-service and providers have no incentives for reducing services.
Premiums payments from Medicare recipients cover what portions of Medicare's
prescription drug benefits? {correct ANSW} 10%
Healthcare providers who participate in a capitated payment type of health maintenance
organization {correct ANSW} get paid a per member per month rate
Medicare beneficiary premiums cover only one-fourth of Medicare Part B costs.
{correct ANSW} True
A self employed person who earns $100K must pay a Medicare payroll tax of $______.
{correct ANSW} $2900 (or 2.9%)
Verified Answers
In which issue of the Federal Register are updates to Medicare outpatient
reimbursement NOT published? {correct ANSW} October
Medicare part _____ is a prescription drug benefit. {correct ANSW} Part D
_____ assignment is when a provider does not bill a patient for the difference between
the service cost and Medicare allowed. {correct ANSW} Accepting
Which of the following would be considered a discount that would be permitted as a
"safe harbor" from fraud and abuse regulations? {correct ANSW} HMO contracts with
laboratory for laboratory services and receives a discounted price.
Which is not a component that is taken into account with a Relative Value Unit (RVU)?
{correct ANSW} work, malpractice and overhead (all are listed components)
Which group does the Medicare program not cover? {correct ANSW} Prisoners
Healthcare is more heavily regulated than most other businesses in the United States.
{correct ANSW} True
Which type of health insurance plan uses primary care clinician gatekeepers to
coordinate the care of plan participants? {correct ANSW} HMO
Which type of healthcare reimbursement system pays a fixed amount per patient?
{correct ANSW} Capitation
A legal document required in most states for expanding a hospital is {correct ANSW}
Certificate of Need
A small, closely held corporation is owned by {correct ANSW} private investors
The responsibility of medical services at most hospitals lies with {correct ANSW} The
chief of staff or medical director
Home healthcare services___ {correct ANSW} are eligible for Medicare and Medicare
reimbursement
Hospice care___ {correct ANSW} is for patients and their families.
, Nursing home costs for elderly Americans___ {correct ANSW} are most covered by
Medicaid
The emergency department of a hospital is {correct ANSW} an out-patient facility
A not-for-profit hospital must {correct ANSW} adopt a corporate structure
Ambulatory care refers to services provided by paramedics and emergency medical
technologists while transporting a patient to the hospital. {correct ANSW} False
Most proprietorship's form professional corporations in order to {correct ANSW} reduce
financial liabilities
Which of the following financial management issues differentiates healthcare from other
businesses? {correct ANSW} third party payers
Which of the following provides hospitalization insurance? {correct ANSW} Blue Cross
An individual works at a business that covers half the cost of a group healthcare
insurance plan with the other half paid by the employee. The individual quits his job but
wishes to retain group healthcare insurance as per COBRA. How much will he pay for
coverage? {correct ANSW} Twice the amount he paid while employed plus an
administrative fee
Prescription drugs for the elderly are covered under {correct ANSW} MMA (2003)
The following is true about a preferred provider organization plans and explain their
limited ability to control healthcare costs. {correct ANSW} A PPO plan is a form of
managed care in which the insurer contracts with healthcare providers that agree to a
reduced cost fee schedule. and Covered persons who use a PPO pay less through
combination of lower premiums. lower deductibles, and smaller co-payments. A PPO
plan is a fee-for-service and providers have no incentives for reducing services.
Premiums payments from Medicare recipients cover what portions of Medicare's
prescription drug benefits? {correct ANSW} 10%
Healthcare providers who participate in a capitated payment type of health maintenance
organization {correct ANSW} get paid a per member per month rate
Medicare beneficiary premiums cover only one-fourth of Medicare Part B costs.
{correct ANSW} True
A self employed person who earns $100K must pay a Medicare payroll tax of $______.
{correct ANSW} $2900 (or 2.9%)
