WGU C425 OA EXAM 2025-2026 ACTUAL EXAM TEST BANK QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED
ANSWERS)
Terms in this set (54)
Which of the following is There are more specialty physicians than primary physicians.
true in regards to health
care today in the United
States?
There are more primary
care physicians than
specialty physicians.
Primary care receives a higher
reimbursement in
professional fees.
There are more specialty
physicians than primary
physicians.
Outpatient care is slowly
decreasing.
What triggered the Prospective payment system
downsizing phase in the
U.S. hospital industry during
the 1980s? Hill-Burton Act
Managed care
Prospective
payment system
Medicare and
Medicaid
,Designated Related Groups Reduce the length of stay for hospitalized patients
(DRG) -based
reimbursement
necessitated hospitals to
do what?
Admit new patients at a
faster rate than before
Admit a greater number of
Medicare patients than
before
Reduce the length of stay
for hospitalized patients
Admit a smaller number of
Medicare patients than
before
In which type of utilization Gatekeeping
management is a primary
care physician's opinion
necessary in referring or
not referring a patient to
a specialist?
Concurr
ent
Retrospe
ctive
Gatekee
ping
Precertification
What is one aspect in which Responsibility for delivery of services
managed care differs from
conventional insurance?
Collection of
premiums
Assumption of risk
Responsibility for delivery
of services Payments to
providers
, What is the purpose of It enables a facility to serve Medicare clients.
Skilled Nursing Facilities
(SNF) certification?
It enables a facility to be
operated as a skilled
nursing facility.
It is required to legally
operate a nursing home.
It enables a facility to serve
Medicare clients.
It enables a facility to serve
both Medicare
and Medicaid clients.
What is the main goal of Promote independence
long-term care as it relates
to a patient's function?
Restore function
Provide assistance
Promote
independence
Adapt to change
AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED
ANSWERS)
Terms in this set (54)
Which of the following is There are more specialty physicians than primary physicians.
true in regards to health
care today in the United
States?
There are more primary
care physicians than
specialty physicians.
Primary care receives a higher
reimbursement in
professional fees.
There are more specialty
physicians than primary
physicians.
Outpatient care is slowly
decreasing.
What triggered the Prospective payment system
downsizing phase in the
U.S. hospital industry during
the 1980s? Hill-Burton Act
Managed care
Prospective
payment system
Medicare and
Medicaid
,Designated Related Groups Reduce the length of stay for hospitalized patients
(DRG) -based
reimbursement
necessitated hospitals to
do what?
Admit new patients at a
faster rate than before
Admit a greater number of
Medicare patients than
before
Reduce the length of stay
for hospitalized patients
Admit a smaller number of
Medicare patients than
before
In which type of utilization Gatekeeping
management is a primary
care physician's opinion
necessary in referring or
not referring a patient to
a specialist?
Concurr
ent
Retrospe
ctive
Gatekee
ping
Precertification
What is one aspect in which Responsibility for delivery of services
managed care differs from
conventional insurance?
Collection of
premiums
Assumption of risk
Responsibility for delivery
of services Payments to
providers
, What is the purpose of It enables a facility to serve Medicare clients.
Skilled Nursing Facilities
(SNF) certification?
It enables a facility to be
operated as a skilled
nursing facility.
It is required to legally
operate a nursing home.
It enables a facility to serve
Medicare clients.
It enables a facility to serve
both Medicare
and Medicaid clients.
What is the main goal of Promote independence
long-term care as it relates
to a patient's function?
Restore function
Provide assistance
Promote
independence
Adapt to change
