RHIA DOMAIN 4- Practice Exam
Questions and Answers
B. inpatient registered with observation stay type
This is not typically a registration error as the former is an inpatient type while the latter
is an outpatient type registration - correct Answer-All of the following are considered the
most common types of registration errors affecting the revenue cycle, except
A. patient registered with more than one medical record number
B. inpatient registered with observation stay type
C. missing guarantor or employer information
D. insurance eligibility verification failure
C. local managed care contract language
Local managed care contracts are independent contracts are independent of Medicare
NCD and LCD. - correct Answer-regulator requirements and revisions regarding
national and local coverage determinations( NCDs and LCDs) can be found in all the
following documents, except
A. Medicare billing manuals
B. Medicare administrative contractor
C. local managed care contract language
D. national reporting requirements
A. Determining whether the patient is eligible for charity care.
Assessing the patient's ability to pay for services is the primary responsibility of a
financial counselor - correct Answer-328. which of the following processes are financial
counselors typically responsible for
A. determining whether the patient is eligible for charity care
B. verifying whether the patients insurance plan is in network or out of network
C. determining whether scheduled services will be covered by the insurance plan
D. understanding which procedures require preauthorization
D. after medical screening
Many organizations, Create policies to follow, reasonable registration for seizures and
occur after medical screening - correct Answer-329. The insurance verification process
,involves confirming the patient is a member of the insurance plan communicated to the
provider. Which of the following describes the most common time when insurance
verification occurs for an unscheduled patient
A. Prior to medical screening.
B during or directly after pre-registration
C after the patient is released from Care
D after the medical screening
A. catheter associated urinary track infection.
The patient was not admitted with a catheter associate a urinary infection, so that
condition cannot be coded as present on admission (POA ) - correct Answer-A patient
was admitted to the hospital with symptoms of a stroke and secondary diagnosis of
chronic obstructive, pulmonary disease, COPD and hypertension. The patient was
subsequently discharged from the hospital with a principal diagnosis of cerebral
vascular accident and secondary diagnosis of catheter associated urinary track
infection, COPD, and hypertension, which of the following diagnosis should not be
reported as POA.
A . Catheter associate a urinary track infection.
B cerebral vascular accident
C COPD
D hypertension
C health, information management
Resolved filled edits is one of the many duties of the health information management
department. Various medical department depend on the coding expertise of HIM
professionals to avoid and correct, coding and potential compliance issues. - correct
Answer-333. Patient accounting is reporting an increase in national coverage decisions.
(NCDs) , and loco coverage determination (LCDs) failed edits, an observation accounts.
Which of the following departments will be task to resolve this issue
A utilization management
B patient access
C health, information management
D patient accounts
B determining wether services are set up to reflect the proper CPT/HCPCS codes in
revenue cycle
This is typically the responsibility of the charge description master staff - correct
Answer-334 which of the following is typically not the responsibility of the contract
management team
, A. Analysis of the financial impact of providing the patient services.
B determining whether services are set up to reflect the proper CPT/HCPCS codes in
revenue code on the billing claim
C analyzing with her discounted rates are providing financial incentives that steer the
patient population
D understanding the local competitors in the market rates for services
D. write off the field charges to bad debt and bill Medicare for the clean charges
Edits are used to review a Coding claim for accuracy and send back a flag if an error
has been detected in the claim. Most organizations run all the claims through edits prior
sending out any pay her to look for errors, correct them, and then sent out a clean
claim. In this instance, the facility has determined to write off the field charges because
ABN notice was not signed by the patients. - correct Answer-335. Patient accounts has
submitted a report to the revenue cycle team detailing $100,000 of outpatient accounts
that are failing (NCD) edits national coverage decisions. All attempts to clear the edits
have failed. There are no ABN on file for these accounts. Based only on this
information, the revenue cycle team should.
A, bill the patients for these accounts
B contact the patience to obtain ABN
C write off the accounts to contractual allowances
D. Write off the field charges to bad debt and bill Medicare for the clean charges
C work value, and practice expenses
Each resource base relative value scale ( RBRVS) comprises three elements: position,
work, physician, practice, expense, and Malpractice, each of which of the national
average available in the federal register - correct Answer-336. Under RBRVS, which
elements are used to calculate a Medicare payment?
a. Work value and extent of the physical exam
b. Malpractice expenses and detail of the patient history
c. Work value and practice expenses
d. Practice expenses and review of systems
A. Query the attending physician and ask him to validate a diagnosis based on the
chest x-ray results
a query is a routine, communication and education tool used to advocate for complete
and compliant documentation. The intent is to clarify what has been recorded, not to call
Questions and Answers
B. inpatient registered with observation stay type
This is not typically a registration error as the former is an inpatient type while the latter
is an outpatient type registration - correct Answer-All of the following are considered the
most common types of registration errors affecting the revenue cycle, except
A. patient registered with more than one medical record number
B. inpatient registered with observation stay type
C. missing guarantor or employer information
D. insurance eligibility verification failure
C. local managed care contract language
Local managed care contracts are independent contracts are independent of Medicare
NCD and LCD. - correct Answer-regulator requirements and revisions regarding
national and local coverage determinations( NCDs and LCDs) can be found in all the
following documents, except
A. Medicare billing manuals
B. Medicare administrative contractor
C. local managed care contract language
D. national reporting requirements
A. Determining whether the patient is eligible for charity care.
Assessing the patient's ability to pay for services is the primary responsibility of a
financial counselor - correct Answer-328. which of the following processes are financial
counselors typically responsible for
A. determining whether the patient is eligible for charity care
B. verifying whether the patients insurance plan is in network or out of network
C. determining whether scheduled services will be covered by the insurance plan
D. understanding which procedures require preauthorization
D. after medical screening
Many organizations, Create policies to follow, reasonable registration for seizures and
occur after medical screening - correct Answer-329. The insurance verification process
,involves confirming the patient is a member of the insurance plan communicated to the
provider. Which of the following describes the most common time when insurance
verification occurs for an unscheduled patient
A. Prior to medical screening.
B during or directly after pre-registration
C after the patient is released from Care
D after the medical screening
A. catheter associated urinary track infection.
The patient was not admitted with a catheter associate a urinary infection, so that
condition cannot be coded as present on admission (POA ) - correct Answer-A patient
was admitted to the hospital with symptoms of a stroke and secondary diagnosis of
chronic obstructive, pulmonary disease, COPD and hypertension. The patient was
subsequently discharged from the hospital with a principal diagnosis of cerebral
vascular accident and secondary diagnosis of catheter associated urinary track
infection, COPD, and hypertension, which of the following diagnosis should not be
reported as POA.
A . Catheter associate a urinary track infection.
B cerebral vascular accident
C COPD
D hypertension
C health, information management
Resolved filled edits is one of the many duties of the health information management
department. Various medical department depend on the coding expertise of HIM
professionals to avoid and correct, coding and potential compliance issues. - correct
Answer-333. Patient accounting is reporting an increase in national coverage decisions.
(NCDs) , and loco coverage determination (LCDs) failed edits, an observation accounts.
Which of the following departments will be task to resolve this issue
A utilization management
B patient access
C health, information management
D patient accounts
B determining wether services are set up to reflect the proper CPT/HCPCS codes in
revenue cycle
This is typically the responsibility of the charge description master staff - correct
Answer-334 which of the following is typically not the responsibility of the contract
management team
, A. Analysis of the financial impact of providing the patient services.
B determining whether services are set up to reflect the proper CPT/HCPCS codes in
revenue code on the billing claim
C analyzing with her discounted rates are providing financial incentives that steer the
patient population
D understanding the local competitors in the market rates for services
D. write off the field charges to bad debt and bill Medicare for the clean charges
Edits are used to review a Coding claim for accuracy and send back a flag if an error
has been detected in the claim. Most organizations run all the claims through edits prior
sending out any pay her to look for errors, correct them, and then sent out a clean
claim. In this instance, the facility has determined to write off the field charges because
ABN notice was not signed by the patients. - correct Answer-335. Patient accounts has
submitted a report to the revenue cycle team detailing $100,000 of outpatient accounts
that are failing (NCD) edits national coverage decisions. All attempts to clear the edits
have failed. There are no ABN on file for these accounts. Based only on this
information, the revenue cycle team should.
A, bill the patients for these accounts
B contact the patience to obtain ABN
C write off the accounts to contractual allowances
D. Write off the field charges to bad debt and bill Medicare for the clean charges
C work value, and practice expenses
Each resource base relative value scale ( RBRVS) comprises three elements: position,
work, physician, practice, expense, and Malpractice, each of which of the national
average available in the federal register - correct Answer-336. Under RBRVS, which
elements are used to calculate a Medicare payment?
a. Work value and extent of the physical exam
b. Malpractice expenses and detail of the patient history
c. Work value and practice expenses
d. Practice expenses and review of systems
A. Query the attending physician and ask him to validate a diagnosis based on the
chest x-ray results
a query is a routine, communication and education tool used to advocate for complete
and compliant documentation. The intent is to clarify what has been recorded, not to call
