CHFP KEY TERMS & CONCEPTS EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Medicare Cost Report
Annual report that institutional providers participating in the Medicare program must
submit to their Medicare administrative contractor. For providers paid prospectively, the
cost report determines reimbursement for certain add on payments but does not affect
the overall payment rate. For providers paid retrospectively, the cost report determines
the payment rate. CMS uses cost report data to update DRG and APC weights and
determine market basket updates.
Medicare trust fund
A portion of FICA taxes that pays for Medicare part a and part B. Unless Medicare is
reformed or payroll taxes are increased, the trust fund is expected to be depleted within
the next 10 years.
Value-based purchasing
Links provider payments to improved performance.
Patient protection and affordable care act
PPACA 1) reformed HealthCare 2) expanded Medicaid and 3) accelerated healthcare
delivery system
Medical loss ratio
The percentage of premium revenue spent on medical expenses. >80%
Individual mandate
, Requirement that individuals get health insurance or pay a tax penalty to the federal
government.
Employer mandate
A legal requirement for employers to help pay for their employees' health insurance.
Double entry system
A system that records the two-sided effect of each transaction in appropriate accounts
Accounting equation
Assets = Liabilities + Owner's Equity
The matching principle
Revenues earned in a given. Must be matched with the corresponding expenses
incurred in earning that revenue
Accrual
Records an asset for a service rendered but for which payment has not been collected
for a matching cost incurred but not yet paid.
Cash basis accounting
Revenue equal cash receipts and expenses equal cash disbursements
Income statement or statement of activities
Summarizes revenues expenses and income for an organization over a specified period
of time. Ties to the balance sheet through net assets.
Net assets plus net income equal net assets at the end of the period.
Balance sheet or statement of financial position
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Medicare Cost Report
Annual report that institutional providers participating in the Medicare program must
submit to their Medicare administrative contractor. For providers paid prospectively, the
cost report determines reimbursement for certain add on payments but does not affect
the overall payment rate. For providers paid retrospectively, the cost report determines
the payment rate. CMS uses cost report data to update DRG and APC weights and
determine market basket updates.
Medicare trust fund
A portion of FICA taxes that pays for Medicare part a and part B. Unless Medicare is
reformed or payroll taxes are increased, the trust fund is expected to be depleted within
the next 10 years.
Value-based purchasing
Links provider payments to improved performance.
Patient protection and affordable care act
PPACA 1) reformed HealthCare 2) expanded Medicaid and 3) accelerated healthcare
delivery system
Medical loss ratio
The percentage of premium revenue spent on medical expenses. >80%
Individual mandate
, Requirement that individuals get health insurance or pay a tax penalty to the federal
government.
Employer mandate
A legal requirement for employers to help pay for their employees' health insurance.
Double entry system
A system that records the two-sided effect of each transaction in appropriate accounts
Accounting equation
Assets = Liabilities + Owner's Equity
The matching principle
Revenues earned in a given. Must be matched with the corresponding expenses
incurred in earning that revenue
Accrual
Records an asset for a service rendered but for which payment has not been collected
for a matching cost incurred but not yet paid.
Cash basis accounting
Revenue equal cash receipts and expenses equal cash disbursements
Income statement or statement of activities
Summarizes revenues expenses and income for an organization over a specified period
of time. Ties to the balance sheet through net assets.
Net assets plus net income equal net assets at the end of the period.
Balance sheet or statement of financial position
