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 Security Rule
D.
HIPAA Privacy 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.
Income statement
B.
Cash flow statement
C.
Balance sheet
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.
TRUE
B.
FALSE
Question #4
Which of the following statements is true regarding financial accounting?
A.
It serves as a basis for managerial accounting.
B.
The information is displayed in reports called the balance sheet, income statement, and cash flow statement.
C.
It is the day-to-day assessment of an organization’s financial health.
D.
It is used only in for-profit organizations.
Question #5
Which of the following is covered by Medicare?
A.
Hearing aids
B.
Routine eye examinations
C.
Dental care
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.
Management by objectives
D.
Financial management
Question #7
Which of the following is not a way of referring to ROI?
A.
Rate of return
B.
Rate of income
C.
Rate of profit
D.
Rate
Question #8
Which part of Medicare helps pay for prescription drugs?
A.
D
B.
B
C.
C
D.
A
Question #9
Which part of Medicare helps pay for charges incurred during an inpatient hospital stay?
A.
B
B.
A
C.
D
D.
C
Question #10
What is something of value that can be used to serve an organization’s needs?
A.
Liability
B.
Owner's equity
C.
Asset
Question #11
Which part of Medicare helps pay for physician and outpatient charges?
A.
D
B.
B
C.
C
D.
A
Question #12
The inventory an organization has on hand would be called what?
A.
Debit
B.
Credit
C.
Liability
D.
Asset
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.
Cash flow statement
C.
Balance sheet
Question #14
The most powerful of third-party payers is the _____
A.
republicans
B.
democrats
C.
federal government
Question #15
What was the predominant method of payment used in the United States during the 20th century?
A.
Capitation
B.
Prospective payment
C.
Fee for service
D.
Health insurance exchange
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.
Capital expenditure forms
D.
RFP
Question #17
Which of the following is true about managed care?
A.
They are second-party payors.
B.
It is steadily on the decline.
C.
It is a method used to assume and transfer risk.
D.
It is based solely on financial criteria.
Question #18
A 55-year-old patient is a veteran who is permanently and totally disabled. What program is the patient eligible for?
A.
TRICARE
B.
CHAMPVA
C.
Medicare
D.
Medicaid
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.
D
B.
B
C.
C
D.
A
Question #21
What is an explanation of benefits (EOB)?
A.
Statement sent to the health care provider explaining what the third party paid
B.
Statement sent to the health care provider and the patient explaining what the third party paid
C.
Statement sent to the patient explaining what the patient owes
D.
Statement sent to the health care provider and the patient explaining what the patient owes
Question #22
The managers in an organization are responsible for which step of the financial cycle?
A.
Execution
B.
Assessment
C.
Planning
Question #23
How many days of skilled nursing care are covered under Part A?
A.
60
B.
100
C.
90
D.
30
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.
An organization’s revenue and expenditure plan
B.
Activities involved in the purchasing of goods and the contracting for services
C.
A financial projection of how an organization is likely to perform in the future
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.
secondary physician
B.
resident physician
C.
primary physician
Question #27
What is a debt or obligation owed by an organization?
A.
Owner’s equity
B.
Asset
C.
Liability
Question #28
Match the type with its descriptor. covers employees who suffer work-related injuries and illnesses
A.
PPO
B.
HIS
C.
TRICARE
D.
worker's compensation
Question #29
Match the type with its descriptor. provides health services to native American Indians and native Alaskans
A.
Medicaid
B.
HIS
C.
PPO
D.
HMO
Question #30
Match the type with its descriptor. covers active-duty members of the armed services
A.
worker's compensation
B.
TRICARE
C.
HIS
D.
HMO
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.
HMO
B.
Medicaid
C.
TRICARE
D.
PPO
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.
TRICARE
B.
worker's compensation
C.
HMO
D.
HIS
Question #33
Match the type with its descriptor. program designed to provide financing for the poor and impoverished
A.
TRICARE
B.
worker's compensation
C.
Medicaid
D.
PPO
Question #34
Which of the following is not an eligibility requirement for Medicare?
A.
Having a disability
B.
65 years and older
C.
Diagnosis of end stage renal disease
D.
Below the federal poverty level
Question #35
Which of the following serves to discover mistakes after their occurrence?
A.
Audits
B.
Bookkeeping
C.
Qualified reports
D.
Expense budgets
Question #36
What party is the health care provider?
A.
Fourth party
B.
Second party
C.
First party
D.
Third party
Question #37
In what year did Congress pass the Tax Equity and Fiscal Responsibility Act (TEFRA)?
A.
1982
B.
1985
C.
1987
D.
1980
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.
Adding to inventory
B.
Entering a debit
C.
Increasing owner’s equity
D.
Entering a credit
Question #39
Which factors greatly influenced the growth of managed care?
A.
Widespread bankruptcies being filed
B.
Change in the demands of patients
C.
Inflation and legislative changes
D.
Lawsuit actions
Question #40
Accounting procedures, precautions, and forms established to prevent and minimize errors and fraud are called what?
A.
Bookkeeping
B.
External controls
C.
Internal controls
D.
Audits
Question #41
Employees who are responsible for preparing the budget are involved in which step of the financial cycle?
A.
Execution
B.
Assessment
C.
Planning
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 information
C.
Request for quotation
Question #43
Which of the following is not an accrediting body that addresses managed care organizations?
A.
JC
B.
NCQA
C.
HEDIS
D.
AAAHC
Question #44
What type of budget focuses on the organization’s administrative, research and development, and marketing costs?
A.
Master budget
B.
Expense budget
C.
Cash budget
D.
Capital expenditure budget
Question #45
Which of the following would be considered a third-party payer?
A.
The organization paying for the care
B.
The laboratory services
C.
The patient
D.
The provider or institution providing care
Question #46
Which of the following is an example of an owner’s equity?
A.
The owner is sued and $2,000 is paid for retaining an attorney.
B.
An individual starts a new business and puts up $5,000 of their own money to get started.
C.
A customer pays $3,000 for a piece of equipment.
D.
An owner pays $7,000 for supplies and equipment.
Question #47
What is sometimes referred to as cost accounting?
A.
Cash accounting
B.
Managerial accounting
C.
Financial accounting
Question #48
Which of the following is the best definition for the insured?
A.
The insurance company that agrees to pay for health care
B.
he prepayment of a specified amount for health care coverage
C.
The one holding the insurance policy
D.
The insured includes the private insurance companies, employers, and managed care organizations
Question #49
The Federal Employment Compensation Act (FECA) provides workers’ compensation for which of the following?
A.
Nonmilitary nonfederal employees
B.
Nonmilitary federal employees
C.
Military nonfederal employees
D.
Military federal employees
Question #50
Accountants are mainly focused on which step of the finance cycle?
A.
Execution
B.
Assessment
C.
Planning
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