SNHP 405 - Informatics and Data Management » Spring 2023 » Test 5
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Question #1
What is the HIPAA rule that requires covered entities who transmit certain patient data electronically to use specific electronic transactions and code sets?
A.
HIPAA Code Set Rule
B.
HIPAA Transactions Rule
C.
HIPAA Privacy Rule
D.
HIPAA Security Rule
Question #2
If you wish to know how much money an organization has and how it has been spent, which document would you request?
A.
Balance sheet
B.
Income statement
C.
Cash flow statement
Question #3
Medical necessity does not refer to the principle requiring health care providers to make reasonable efforts to limit the treatments and services rendered to the patient to those that are necessary to accomplish the intended purpose of care
A.
FALSE
B.
TRUE
Question #4
Which of the following statements is true regarding financial accounting?
A.
The information is displayed in reports called the balance sheet, income statement, and cash flow statement.
B.
It is used only in for-profit organizations.
C.
It serves as a basis for managerial accounting.
D.
It is the day-to-day assessment of an organization’s financial health.
Question #5
Which of the following is covered by Medicare?
A.
Dental care
B.
Routine eye examinations
C.
Hearing aids
D.
100 days of post-hospitalization care in a skilled nursing facility
Question #6
Which of the following refer to the efficient and effective use of administrative and clinical functions to capture, manage, and collect revenue related to the delivery of patient services?
A.
Revenue cycle management
B.
Control management
C.
Financial management
D.
Management by objectives
Question #7
Which of the following is not a way of referring to ROI?
A.
Rate of income
B.
Rate of return
C.
Rate of profit
D.
Rate
Question #8
Which part of Medicare helps pay for prescription drugs?
A.
A
B.
D
C.
B
D.
C
Question #9
Which part of Medicare helps pay for charges incurred during an inpatient hospital stay?
A.
A
B.
D
C.
C
D.
B
Question #10
What is something of value that can be used to serve an organization’s needs?
A.
Owner's equity
B.
Liability
C.
Asset
Question #11
Which part of Medicare helps pay for physician and outpatient charges?
A.
C
B.
A
C.
D
D.
B
Question #12
The inventory an organization has on hand would be called what?
A.
Credit
B.
Asset
C.
Liability
D.
Debit
Question #13
If you are given a document that summarizes the revenue and expenses of an organization, which document do you have?
A.
Income statement
B.
Balance sheet
C.
Cash flow statement
Question #14
The most powerful of third-party payers is the _____
A.
federal government
B.
republicans
C.
democrats
Question #15
What was the predominant method of payment used in the United States during the 20th century?
A.
Health insurance exchange
B.
Capitation
C.
Prospective payment
D.
Fee for service
Question #16
Which of the following is a formal document that seeks from a group of vendors pricing information for specific products or services?
A.
RFQ
B.
Budget
C.
RFP
D.
Capital expenditure forms
Question #17
Which of the following is true about managed care?
A.
It is steadily on the decline.
B.
It is based solely on financial criteria.
C.
They are second-party payors.
D.
It is a method used to assume and transfer risk.
Question #18
A 55-year-old patient is a veteran who is permanently and totally disabled. What program is the patient eligible for?
A.
Medicaid
B.
Medicare
C.
TRICARE
D.
CHAMPVA
Question #19
Which of the following statements is true about the BCBS (Blue Cross Blue Shield) Association?
A.
It covers hospital and related services only.
B.
It is a for-profit organization.
C.
It covers physician services only.
D.
It is the single largest trade association of private health care insurers in the United States.
Question #20
What part of Medicare is sometimes referred to as Medicare+Choice?
A.
B
B.
D
C.
C
D.
A
Question #21
What is an explanation of benefits (EOB)?
A.
Statement sent to the patient explaining what the patient owes
B.
Statement sent to the health care provider and the patient explaining what the patient owes
C.
Statement sent to the health care provider and the patient explaining what the third party paid
D.
Statement sent to the health care provider explaining what the third party paid
Question #22
The managers in an organization are responsible for which step of the financial cycle?
A.
Planning
B.
Assessment
C.
Execution
Question #23
How many days of skilled nursing care are covered under Part A?
A.
100
B.
90
C.
30
D.
60
Question #24
If you wish to review the true financial condition of an organization, which document should you request?
A.
Cash flow statement
B.
Income statement
C.
Balance sheet
Question #25
Forecasting is best defined as which of the following?
A.
Activities involved in the purchasing of goods and the contracting for services
B.
A financial projection of how an organization is likely to perform in the future
C.
An organization’s revenue and expenditure plan
D.
A retrospective study that is then projected into the future with the assumption of consistency
Question #26
The ___________ __________ is the physician who serves as the gatekeeper or coordinator for all the patient’s care.
A.
primary physician
B.
secondary physician
C.
resident physician
Question #27
What is a debt or obligation owed by an organization?
A.
Liability
B.
Owner’s equity
C.
Asset
Question #28
Match the type with its descriptor. covers employees who suffer work-related injuries and illnesses
A.
PPO
B.
worker's compensation
C.
HIS
D.
TRICARE
Question #29
Match the type with its descriptor. provides health services to native American Indians and native Alaskans
A.
Medicaid
B.
HMO
C.
HIS
D.
PPO
Question #30
Match the type with its descriptor. covers active-duty members of the armed services
A.
TRICARE
B.
worker's compensation
C.
HMO
D.
HIS
Question #31
Match the type with its descriptor. an entity composed of health care providers who contract with an employer or private health insurance company to deliver services at a discounted rate in return for a promise of a high volume of patients
A.
Medicaid
B.
PPO
C.
TRICARE
D.
HMO
Question #32
Match the type with its descriptor. prepaid, organized system for providing comprehensive health care services within a geographic area to all persons under contract
A.
worker's compensation
B.
HIS
C.
HMO
D.
TRICARE
Question #33
Match the type with its descriptor. program designed to provide financing for the poor and impoverished
A.
worker's compensation
B.
Medicaid
C.
PPO
D.
TRICARE
Question #34
Which of the following is not an eligibility requirement for Medicare?
A.
Diagnosis of end stage renal disease
B.
Below the federal poverty level
C.
Having a disability
D.
65 years and older
Question #35
Which of the following serves to discover mistakes after their occurrence?
A.
Bookkeeping
B.
Audits
C.
Qualified reports
D.
Expense budgets
Question #36
What party is the health care provider?
A.
First party
B.
Second party
C.
Fourth party
D.
Third party
Question #37
In what year did Congress pass the Tax Equity and Fiscal Responsibility Act (TEFRA)?
A.
1985
B.
1980
C.
1982
D.
1987
Question #38
An employee receives their paycheck and records the amount in their personal checkbook. Which is the best term to describe this action?
A.
Entering a credit
B.
Entering a debit
C.
Adding to inventory
D.
Increasing owner’s equity
Question #39
Which factors greatly influenced the growth of managed care?
A.
Lawsuit actions
B.
Change in the demands of patients
C.
Inflation and legislative changes
D.
Widespread bankruptcies being filed
Question #40
Accounting procedures, precautions, and forms established to prevent and minimize errors and fraud are called what?
A.
Bookkeeping
B.
Internal controls
C.
External controls
D.
Audits
Question #41
Employees who are responsible for preparing the budget are involved in which step of the financial cycle?
A.
Planning
B.
Assessment
C.
Execution
Question #42
Which of the following is a formal document seeking information about products or services available in the marketplace that can meet the organization’s needs?
A.
Request for proposal
B.
Request for quotation
C.
Request for information
Question #43
Which of the following is not an accrediting body that addresses managed care organizations?
A.
HEDIS
B.
NCQA
C.
JC
D.
AAAHC
Question #44
What type of budget focuses on the organization’s administrative, research and development, and marketing costs?
A.
Capital expenditure budget
B.
Expense budget
C.
Cash budget
D.
Master budget
Question #45
Which of the following would be considered a third-party payer?
A.
The laboratory services
B.
The provider or institution providing care
C.
The organization paying for the care
D.
The patient
Question #46
Which of the following is an example of an owner’s equity?
A.
A customer pays $3,000 for a piece of equipment.
B.
An individual starts a new business and puts up $5,000 of their own money to get started.
C.
The owner is sued and $2,000 is paid for retaining an attorney.
D.
An owner pays $7,000 for supplies and equipment.
Question #47
What is sometimes referred to as cost accounting?
A.
Managerial accounting
B.
Cash accounting
C.
Financial accounting
Question #48
Which of the following is the best definition for the insured?
A.
The insured includes the private insurance companies, employers, and managed care organizations
B.
The insurance company that agrees to pay for health care
C.
The one holding the insurance policy
D.
he prepayment of a specified amount for health care coverage
Question #49
The Federal Employment Compensation Act (FECA) provides workers’ compensation for which of the following?
A.
Military nonfederal employees
B.
Nonmilitary federal employees
C.
Nonmilitary nonfederal employees
D.
Military federal employees
Question #50
Accountants are mainly focused on which step of the finance cycle?
A.
Planning
B.
Execution
C.
Assessment
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