FREE MEDICAL AND STUDY GAMES ABOUT HFMA STUDY

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FREE MEDICAL AND STUDY GAMES ABOUT HFMA STUDY

EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -83 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation Question 1: Fair Debt Collection Practices Act (FDCPA) - Act of 1978 applies only to third-party collection agencies that collect consumer debt. As long as a hospital collects its own debts using its own name, it is not considered a debt collector under the Act.

Answer:

Title VIII

Question 2: There are three critical segments of the revenue cycle

Answer:

Pre-service segment Time-of-service segment Post-service segment

Question 3: n order to report a provider's revenue accurately

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it is important to calculate the difference between gross revenue and net revenue.

Question 4: The Three-Day DRG Window Rule requires

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certain outpatient services that are provided within three days of the admission date, by hospitals or by entities wholly owned or controlled by hospitals, to be billed as part of an inpatient stay.

Question 5: Days in A/R is calculated based on

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the value of the total accounts receivable on a specific date.

Question 6: Ethical behavior,

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which is considered to be actions that are the right thing to do, not just what is required by a law, regulation or rule, is very important in healthcare.Question 7: Section 6404 of the Patient Protection and ACA states that claims with dates of service on or after January 1, 2010, received later than one calendar year beyond the date of service, will be denied by Medicare.

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Time Limits for Billing Question 8: The situations where Medicare acts as secondary payer include:

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Working Aged Accident or Other Liability Disability End-Stage Renal Disease (ESRD) Question 9: A 68 year old patient Medicare beneficiary , was in a car accident . A medical insurance claim was filed with the auto insurance carrier . Six months later this claim remains unpaid . How can the provider pursue payment from Medicare ?

Answer:

The provider must first bill the auto insurer ; however , after a period of 120 days if the claim remains unpaid , the provider may cancel the liability claim and bill Medicare

Question 10: True or False: The following statement represents an advantage of outsourcing: Impact on customer service

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FALSE Question 11: True or False: Consents are signed as part of the post-service process

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FALSE Question 12: The departments that support and collaborate with the revenue cycle include:

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Information Technology - Clinical Services - Finance-provides analysis and reporting to ensure compliance.Health Plan Contracting Question 13: Fair Credit Reporting Act - affects those who "issue or use reports on consumers in connection with the approval of credit." This Act protects consumers' rights and has exact standards that limits the use of consumer credit reports. T

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Title VI Question 14: Case management and discharge planning services are a post-service activity.

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FALSE Question 15: Collection agency reports should be provided:

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In at least two formats regarding accounts assigned on a routine basis.

Question 16: Which option is NOT a HFMA best practice?

Answer:

Coordinate the resolution of bad debt accounts with a law firm

Question 17: What is the first component of a pricing determination?

Answer:

Verification of the patient's insurance eligibility and benefits

Question 18: In what manner do case managers assist revenue cycle staff?

Answer:

Providing assistance with written appeals to health plans related to utilization and other care issues.Question 19: The patient is scheduled and registered for service is a time-of-service activity.

Answer:

False -Pre-service:

Question 20: Sending the bill electronically to the health plan in a time-of-service activity.

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FALSE Question 21: The correct way to handle the retention and payment of agency fees is ?

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Follow the contractual agreement between the agency and the provider as to how monies sent to the agency will be handled.Question 22: True or False: The following statement represents an advantage of outsourcing: Impact on direct control of accounts receivable

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FALSE Question 23: Truth in Lending Act - establishes disclosure rules for consumer credit sales and consumer loans. The most important section is Regulation Z, which tells creditors how to comply with the law.

Answer:

Title I:

Question 24: Providers typically submit a single claim for an inpatient or outpatient episode of care, or a series or recurring claim or repeat outpatient services for the same condition

Answer:

Outpatient Series