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Comprehensive Test- Principals of Healthcare Reimbursement and Revenue Cycle Management Review Questions and Correct Answers/ Latest Update / Already Graded

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The US healthcare sector represents a significant portion of the US economy. The trend of _________ spending on healthcare has been consistent for more than a decade. Ans: increased The goal of revenue integrity is to produce a claim that is __________. Ans: Clean, complete, and compliant A physician office submitting an invoice (claim) for payment when the patient has health insurance is an example of a transaction between ________ and ________. Ans: Provider; third-party payer In the US, what is health insurance? All rights reserved © 2025/ 2026 | Page | 2 entity Ans: Reduction of a person's or a group's exposure to risk for unknown healthcare costs by the assumption of that risk by an An employee paying for 40 percent of the insurance premium through payroll processing is an example of a transaction between ________ and ________. Ans: Patient; employer Which of the following is not a principle of revenue integrity? Ans: No oversight In this healthcare delivery model, the insurance company determines that contribution amount that is not based on the policyholder's income: Ans: Private health insurance model Successful RCM programs use this type of approach, which promotes collaboration am

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Comprehensive Test- Principals of
Healthcare Reimbursement and Revenue
Cycle Management Review Questions and
Correct Answers/ Latest Update / Already
Graded
The US healthcare sector represents a significant portion of the US
economy. The trend of _________ spending on healthcare has been
consistent for more than a decade.

Ans: increased


The goal of revenue integrity is to produce a claim that is __________.

Ans: Clean, complete, and compliant


A physician office submitting an invoice (claim) for payment when the
patient has health insurance is an example of a transaction between
________ and ________.

Ans: Provider; third-party payer


In the US, what is health insurance?




All rights reserved © 2025/ 2026 |

, Page |2


Ans: Reduction of a person's or a group's exposure to risk for
unknown healthcare costs by the assumption of that risk by an
entity


An employee paying for 40 percent of the insurance premium through
payroll processing is an example of a transaction between ________
and ________.

Ans: Patient; employer


Which of the following is not a principle of revenue integrity?

Ans: No oversight


In this healthcare delivery model, the insurance company determines
that contribution amount that is not based on the policyholder's
income:

Ans: Private health insurance model


Successful RCM programs use this type of approach, which promotes
collaboration amount various clinical departments and emphasizes and
education strategy for all members:

Ans: Multidisciplinary model



All rights reserved © 2025/ 2026 |

, Page |3

In this healthcare delivery model, employees and employers contribute
an income-based amount of money to funds that are regulated by the
government:

Ans: Social insurance model


Which of the following is a key factor in establishing a highly ethical
culture that promotes honesty and openness?

Ans: Transparency


Which of the following types of care represent healthcare services not
delivered by MCOs?

Ans: Experimental devices


What is the term that means evaluating, for a healthcare service, the
appropriateness of its setting and its level of service?

Ans: Utilization review


In the healthcare sector, what is the term for a group of individual
entities, such as individual persons, employers, or associations, whose
healthcare costs are combined for evaluating financial history and
estimating future costs?

Ans: Risk pool

All rights reserved © 2025/ 2026 |

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