HCM 425 MIDTERM EXAM| HCM 425 FINAL
EXAM ALL COMBINED PRACTICE
QUESTIONS WITH VERIFIED SOLUTIONS
NEW MODIFIED!!!
The skilled nursing facility prospective payment system (SNFPPS)
generates ____ payments for each skilled nursing facility admission --
ANSWER--per diem
In 2000, which type of health plan was introduced as a way to
encourage individuals to locate the best health care at the lowest price
possible, with the goal of holding down health care costs? --
ANSWER--consumer-driven
The systematic method of documentation that consist of four
components (database, problem list, initial plan, and progress notes) is
called the: --ANSWER--problem oriented record
The primary purpose of the record is to provide for ___, which
involves documenting patient care services so that others who treat
Page 1 of 50
,the patient have a source of information to assist with additional care
and treatment --ANSWER--continuity of care
Employees and dependents who join a managed care plan are called --
ANSWER--enrollees
If a physician provides services that cost less than the managed care
capitation amount, the physician will --ANSWER--make a profit
The primary care provider is responsible for --ANSWER--supervising
and coordinating health care services for enorllees
Which is the method of controlling health care cost and quality of
care by reviewing the appropriateness and necessity of care provided
to patients --ANSWER--utilization management
Assigning passwords to users who are authorized to access patient is a
form of: --ANSWER--security
Which party signs a contract with a health insurance company thus,
owns the health insurance policy? --ANSWER--policy holder
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,Which has as its goal access to health care coverage for every
individual, regardless of the system implemented to achieve that goal?
--ANSWER--universal health insurance
The terms electronic health record (EHR) and electronic medical
record (EMR) are often used interchangeably, but the ____ is a more
global concept that includes the collection of patient information
documented by a number of providers at different facilities regarding
one patient --ANSWER--electronic health record
Total practice management software (TPMS) is used to generate the
EMR, automating which of the following medical practice functions -
-ANSWER--patient registration
If a veteran is rated as 100% permanently and totally disabled as a
result of service-connected condition, which program will provide
benefits to the veteran's dependents? --ANSWER--CHAMPVA
A new fee schedule for Medicare services was implemented as part of
OBRA in 1989 and 1990, replacing the regional "usual and
reasonable" payment basis with a fixed fee schedule called: --
ANSWER--RBRVs
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, Quality standards for all laboratory testing to ensure the accuracy,
reliability, and timeliness of patient test results regardless of where
the tests are performed were established specifically by ____
legislation --ANSWER--CLIA
CMS developed the National Correct Coding Initiative (NCCI) to: --
ANSWER--eliminate improper coding and promote national correct
coding methodologies
Which act protects whistleblowers-individuals who make specified
disclosures relating to funds covered by the act> --ANSWER--ARRA
The first step a physician practice can take to identify areas in the
practice that are vulnerable to fraud and abuse is to: --ANSWER--
perform periodic audits to internally monitor billing processes
An example of an overpayment is: --ANSWER--duplicate processing
of claim
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EXAM ALL COMBINED PRACTICE
QUESTIONS WITH VERIFIED SOLUTIONS
NEW MODIFIED!!!
The skilled nursing facility prospective payment system (SNFPPS)
generates ____ payments for each skilled nursing facility admission --
ANSWER--per diem
In 2000, which type of health plan was introduced as a way to
encourage individuals to locate the best health care at the lowest price
possible, with the goal of holding down health care costs? --
ANSWER--consumer-driven
The systematic method of documentation that consist of four
components (database, problem list, initial plan, and progress notes) is
called the: --ANSWER--problem oriented record
The primary purpose of the record is to provide for ___, which
involves documenting patient care services so that others who treat
Page 1 of 50
,the patient have a source of information to assist with additional care
and treatment --ANSWER--continuity of care
Employees and dependents who join a managed care plan are called --
ANSWER--enrollees
If a physician provides services that cost less than the managed care
capitation amount, the physician will --ANSWER--make a profit
The primary care provider is responsible for --ANSWER--supervising
and coordinating health care services for enorllees
Which is the method of controlling health care cost and quality of
care by reviewing the appropriateness and necessity of care provided
to patients --ANSWER--utilization management
Assigning passwords to users who are authorized to access patient is a
form of: --ANSWER--security
Which party signs a contract with a health insurance company thus,
owns the health insurance policy? --ANSWER--policy holder
Page 2 of 50
,Which has as its goal access to health care coverage for every
individual, regardless of the system implemented to achieve that goal?
--ANSWER--universal health insurance
The terms electronic health record (EHR) and electronic medical
record (EMR) are often used interchangeably, but the ____ is a more
global concept that includes the collection of patient information
documented by a number of providers at different facilities regarding
one patient --ANSWER--electronic health record
Total practice management software (TPMS) is used to generate the
EMR, automating which of the following medical practice functions -
-ANSWER--patient registration
If a veteran is rated as 100% permanently and totally disabled as a
result of service-connected condition, which program will provide
benefits to the veteran's dependents? --ANSWER--CHAMPVA
A new fee schedule for Medicare services was implemented as part of
OBRA in 1989 and 1990, replacing the regional "usual and
reasonable" payment basis with a fixed fee schedule called: --
ANSWER--RBRVs
Page 3 of 50
, Quality standards for all laboratory testing to ensure the accuracy,
reliability, and timeliness of patient test results regardless of where
the tests are performed were established specifically by ____
legislation --ANSWER--CLIA
CMS developed the National Correct Coding Initiative (NCCI) to: --
ANSWER--eliminate improper coding and promote national correct
coding methodologies
Which act protects whistleblowers-individuals who make specified
disclosures relating to funds covered by the act> --ANSWER--ARRA
The first step a physician practice can take to identify areas in the
practice that are vulnerable to fraud and abuse is to: --ANSWER--
perform periodic audits to internally monitor billing processes
An example of an overpayment is: --ANSWER--duplicate processing
of claim
Page 4 of 50
