FRESENIUS NEW HIRE WRITTEN EXAM
QUESTIONS AND ANSWERS 100% CORRECT. Buy
Quality Materials!
Revenue Cycle
A reoccurring set of business activities with the main goal of obtaining revenue
3 Areas of the Revenue Cycle
1. Registration
2. Billing
3. Collections
How does your position impact the Revenue Cycle?
If I input information (ssn, insurance, dob, etc.) it can slow down the revenue cycle
Direct Admission
unscheduled, urgent admission
Revocation Code: 0 Open Spell
PT has an active Hospice episode
What is the most important registration issue regarding compliance with
EMTALA?
Mentioning payment and delaying care
EMTALA
Emergency Medical Treatment Active Labor Act
T or F: once triaged by the Emergency Department nurse, payment arrangements
can be made with the PT?
FALSE
T or F: it is appropriate for the hospital's Emergency Department to withhold
providing emergency medical treatment until obtaining prior auth on only those
PTs whose health plans or insurance companies require such auth?
FALSE
T or F: if possible, registrars should encourage PTs to defer discussion of
financial responsibility until after the medical screening is complete?
TRUE
Under HIPAA, a pre-existing medical condition will be covered w/o a waiting
period when the insured joins a new plan, if they have been insured the previous
_______ months (w/o a break in coverage of 63 days or more)
12
HIPAA
Health Insurance Portability and Accountability Act
What organization evaluates and accredits hospitals?
TJC
TJC
The Joint Commission
Name 3 issues that general consent forms cover
, 1. Medical treatment
2. Diagnostic testing
3. Blood Transfusions
T or F: The Patient Bill of Rights guarantees basic rights that every PT should
have when accessing healthcare services
TRUE
PPACA
Patient Protection Affordable Care Act
What 4 orgs., statues, or regulations affect your daily process in the healthcare
industry?
HIPAA
TJC
EMTALA
PPACA
Name 3 different types of payers
1. Government
2. Managed Care
3. Commercial
What is the difference between Government and Managed Care insurances?
Government is funded by tax dollars and regulated govt
Managed Care is privately owned and funded by subscriber and/or employer
What special programs might be available for patients without insurance?
Financial Assistance
Self-Pay discounts
T or F: Managed Care was developed by the federal govt to compete with
insurance companies in providing healthcare
FALSE
Types of managed care programs:
HMO
PPO
EPO
POS
T or F: It is the responsibility of the HMO patient to obtain auth for procedures
rendered by a hospital
FALSE
T or F: The hospital can utilize the same HMO auth number provided to the PTs
attending physician to ensure payment
FALSE
What is managed care?
Designed to deliver quality, cost effective health care
Patient
A person receiving treatment
Subscriber
The person who pays the insurance premiums
Guarantor
The person financially responsible for any balance after applicable insurance payments
QUESTIONS AND ANSWERS 100% CORRECT. Buy
Quality Materials!
Revenue Cycle
A reoccurring set of business activities with the main goal of obtaining revenue
3 Areas of the Revenue Cycle
1. Registration
2. Billing
3. Collections
How does your position impact the Revenue Cycle?
If I input information (ssn, insurance, dob, etc.) it can slow down the revenue cycle
Direct Admission
unscheduled, urgent admission
Revocation Code: 0 Open Spell
PT has an active Hospice episode
What is the most important registration issue regarding compliance with
EMTALA?
Mentioning payment and delaying care
EMTALA
Emergency Medical Treatment Active Labor Act
T or F: once triaged by the Emergency Department nurse, payment arrangements
can be made with the PT?
FALSE
T or F: it is appropriate for the hospital's Emergency Department to withhold
providing emergency medical treatment until obtaining prior auth on only those
PTs whose health plans or insurance companies require such auth?
FALSE
T or F: if possible, registrars should encourage PTs to defer discussion of
financial responsibility until after the medical screening is complete?
TRUE
Under HIPAA, a pre-existing medical condition will be covered w/o a waiting
period when the insured joins a new plan, if they have been insured the previous
_______ months (w/o a break in coverage of 63 days or more)
12
HIPAA
Health Insurance Portability and Accountability Act
What organization evaluates and accredits hospitals?
TJC
TJC
The Joint Commission
Name 3 issues that general consent forms cover
, 1. Medical treatment
2. Diagnostic testing
3. Blood Transfusions
T or F: The Patient Bill of Rights guarantees basic rights that every PT should
have when accessing healthcare services
TRUE
PPACA
Patient Protection Affordable Care Act
What 4 orgs., statues, or regulations affect your daily process in the healthcare
industry?
HIPAA
TJC
EMTALA
PPACA
Name 3 different types of payers
1. Government
2. Managed Care
3. Commercial
What is the difference between Government and Managed Care insurances?
Government is funded by tax dollars and regulated govt
Managed Care is privately owned and funded by subscriber and/or employer
What special programs might be available for patients without insurance?
Financial Assistance
Self-Pay discounts
T or F: Managed Care was developed by the federal govt to compete with
insurance companies in providing healthcare
FALSE
Types of managed care programs:
HMO
PPO
EPO
POS
T or F: It is the responsibility of the HMO patient to obtain auth for procedures
rendered by a hospital
FALSE
T or F: The hospital can utilize the same HMO auth number provided to the PTs
attending physician to ensure payment
FALSE
What is managed care?
Designed to deliver quality, cost effective health care
Patient
A person receiving treatment
Subscriber
The person who pays the insurance premiums
Guarantor
The person financially responsible for any balance after applicable insurance payments
