LSUS MHA 706 Midterm
Study online at https://quizlet.com/_doj5p3
1. The major provisions of the Patient Protection & Affordable Care Act of 2010
were?: -Banning of preexisting condition coverage limitations
-Free preventative care
-Medicaid expansion
2. Which of the following statement(s) about the finance department a t large
healthcare organizations is/are correct?: -The CFO typically reports directly to
the chief executive officer (CEO)
-The CFO is usually assisted by a comptroller and treasurer
-The department is headed by the chief financial officer (CFO) (sometimes called
the vice president-finance)
3. In a not-for-profit hospital, the following are example(s) of a stakeholder.: -
-Vendor
-Employee
-Community
4. Stockholders have all of the following right(s)...: -Claim on residual liquidation
proceeds
-Right of control
-A possible dividend and/or capital gains
5. Which of the following statements about finance accounting, and financial
management is most correct?: Financial management provides the theory, con-
cepts, and tools necessary to help managers make better financial decisions.
6. External reporting: What is a DISADVANTAGE of being a corporation?
7. Facilities management: Which of the following are not finance activities?
8. What is NOT a advantage of proprietorship?: Unlimited liability
9. A not-for-profit corporation can also be called a 529(b).: False
10. The primary goal of investor-owned corporations is shareholder wealth
maximization.: True
11. Copayments: The fixed amount for a covered service that the insurer mandates
that the patient pay to the provider before the patient receives service from the
provider.
12. Coinsurance: Requires an individual to pay for a certain percentage of the
eligible medical expenses.
13. Adverse selection: Individuals at greater risk of needing health care are more
likely to purchase insurance.
14. Deductibles: The amount that must be paid out of pocket by the policyholder
before an insurance provider will pay any expenses.
15. Moral hazard: The risk of overuse of health services because the insured does
not bear the full cost of the consequences.
1/6
, LSUS MHA 706 Midterm
Study online at https://quizlet.com/_doj5p3
16. Medicare Part B: Covers physician services, ambulatory surgical services,
outpatient services, and certain other miscellaneous services.
17. Medicare Part A: Covers hospital and some skilled nursing coverage
18. Medicare Part D: Covers prescription drugs
19. Medicare Part C: Is often called Medicare Advantage
20. Charge-Based: Payers pay based off of pre-determined "chargemaster." These
payments are usually discounted up to 20% to 50%.
21. Cost-Based: Providers were reimbursed for "actual" costs.
22. Capitation: Payment is (usually) made on a per member per month basis
23. Prospective Payment: Are use to pay for either a predefined procedure, diag-
nosis, per diem or bundled service
24. Has potential to result in 'gamesmanship that can inflate healthcare
charges: Charge-Based
25. May result in up-coding: Prospective Payment
26. No incentive to control costs: Cost-Based
27. Providers may have an incentive to reduce utilization: Capitation
28. Under the broad category of fee-for-service (FFS), what are the three
main types of fee-for-service methodologies that were discussed in class?-
: -Cost-Based
-Charge-Based
-Prospective Payments
29. Select all of the TRUE statements about ICD Codes.: -The greater the number
of digits in the code, the more detailed the disease.
-The codes currently consist of 3, 4, 5, 6, or 7 digits/characters
-ICD- stands for International Classification of Diseases
-ICD-10 is the current standard
30. Identify all the different types of managed care insurance plans.: -Health
maintenance organizations (HMOs)
-Point-of-Service (POS) plans
-Preferred provider organizations (PPOs)
31. Relative Value (RVUs) are standards that are payment components con-
sisting of the following.: -Work Expense
-Malpractice/Liability Expense
-Practice Expenses
32. For insurance to "work," it must have these basic characteristics.: -Pooling
of losses
-Payment only for random (unforeseen and unexpected losses)
-Risk transfer
2/6
Study online at https://quizlet.com/_doj5p3
1. The major provisions of the Patient Protection & Affordable Care Act of 2010
were?: -Banning of preexisting condition coverage limitations
-Free preventative care
-Medicaid expansion
2. Which of the following statement(s) about the finance department a t large
healthcare organizations is/are correct?: -The CFO typically reports directly to
the chief executive officer (CEO)
-The CFO is usually assisted by a comptroller and treasurer
-The department is headed by the chief financial officer (CFO) (sometimes called
the vice president-finance)
3. In a not-for-profit hospital, the following are example(s) of a stakeholder.: -
-Vendor
-Employee
-Community
4. Stockholders have all of the following right(s)...: -Claim on residual liquidation
proceeds
-Right of control
-A possible dividend and/or capital gains
5. Which of the following statements about finance accounting, and financial
management is most correct?: Financial management provides the theory, con-
cepts, and tools necessary to help managers make better financial decisions.
6. External reporting: What is a DISADVANTAGE of being a corporation?
7. Facilities management: Which of the following are not finance activities?
8. What is NOT a advantage of proprietorship?: Unlimited liability
9. A not-for-profit corporation can also be called a 529(b).: False
10. The primary goal of investor-owned corporations is shareholder wealth
maximization.: True
11. Copayments: The fixed amount for a covered service that the insurer mandates
that the patient pay to the provider before the patient receives service from the
provider.
12. Coinsurance: Requires an individual to pay for a certain percentage of the
eligible medical expenses.
13. Adverse selection: Individuals at greater risk of needing health care are more
likely to purchase insurance.
14. Deductibles: The amount that must be paid out of pocket by the policyholder
before an insurance provider will pay any expenses.
15. Moral hazard: The risk of overuse of health services because the insured does
not bear the full cost of the consequences.
1/6
, LSUS MHA 706 Midterm
Study online at https://quizlet.com/_doj5p3
16. Medicare Part B: Covers physician services, ambulatory surgical services,
outpatient services, and certain other miscellaneous services.
17. Medicare Part A: Covers hospital and some skilled nursing coverage
18. Medicare Part D: Covers prescription drugs
19. Medicare Part C: Is often called Medicare Advantage
20. Charge-Based: Payers pay based off of pre-determined "chargemaster." These
payments are usually discounted up to 20% to 50%.
21. Cost-Based: Providers were reimbursed for "actual" costs.
22. Capitation: Payment is (usually) made on a per member per month basis
23. Prospective Payment: Are use to pay for either a predefined procedure, diag-
nosis, per diem or bundled service
24. Has potential to result in 'gamesmanship that can inflate healthcare
charges: Charge-Based
25. May result in up-coding: Prospective Payment
26. No incentive to control costs: Cost-Based
27. Providers may have an incentive to reduce utilization: Capitation
28. Under the broad category of fee-for-service (FFS), what are the three
main types of fee-for-service methodologies that were discussed in class?-
: -Cost-Based
-Charge-Based
-Prospective Payments
29. Select all of the TRUE statements about ICD Codes.: -The greater the number
of digits in the code, the more detailed the disease.
-The codes currently consist of 3, 4, 5, 6, or 7 digits/characters
-ICD- stands for International Classification of Diseases
-ICD-10 is the current standard
30. Identify all the different types of managed care insurance plans.: -Health
maintenance organizations (HMOs)
-Point-of-Service (POS) plans
-Preferred provider organizations (PPOs)
31. Relative Value (RVUs) are standards that are payment components con-
sisting of the following.: -Work Expense
-Malpractice/Liability Expense
-Practice Expenses
32. For insurance to "work," it must have these basic characteristics.: -Pooling
of losses
-Payment only for random (unforeseen and unexpected losses)
-Risk transfer
2/6
