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 Security Rule
C.
HIPAA Transactions 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 is used only in for-profit organizations.
B.
It is the day-to-day assessment of an organization’s financial health.
C.
It serves as a basis for managerial accounting.
D.
The information is displayed in reports called the balance sheet, income statement, and cash flow statement.
Question #5
Which of the following is covered by Medicare?
A.
Hearing aids
B.
Routine eye examinations
C.
100 days of post-hospitalization care in a skilled nursing facility
D.
Dental care
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.
Financial management
B.
Management by objectives
C.
Control management
D.
Revenue cycle management
Question #7
Which of the following is not a way of referring to ROI?
A.
Rate of income
B.
Rate of profit
C.
Rate
D.
Rate of return
Question #8
Which part of Medicare helps pay for prescription drugs?
A.
B
B.
C
C.
A
D.
D
Question #9
Which part of Medicare helps pay for charges incurred during an inpatient hospital stay?
A.
C
B.
A
C.
B
D.
D
Question #10
What is something of value that can be used to serve an organization’s needs?
A.
Asset
B.
Owner's equity
C.
Liability
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.
Credit
B.
Asset
C.
Debit
D.
Liability
Question #13
If you are given a document that summarizes the revenue and expenses of an organization, which document do you have?
A.
Cash flow statement
B.
Income statement
C.
Balance sheet
Question #14
The most powerful of third-party payers is the _____
A.
federal government
B.
democrats
C.
republicans
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.
Capital expenditure forms
B.
Budget
C.
RFP
D.
RFQ
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.
CHAMPVA
B.
TRICARE
C.
Medicare
D.
Medicaid
Question #19
Which of the following statements is true about the BCBS (Blue Cross Blue Shield) Association?
A.
It is the single largest trade association of private health care insurers in the United States.
B.
It covers physician services only.
C.
It covers hospital and related services only.
D.
It is a for-profit organization.
Question #20
What part of Medicare is sometimes referred to as Medicare+Choice?
A.
D
B.
A
C.
B
D.
C
Question #21
What is an explanation of benefits (EOB)?
A.
Statement sent to the health care provider and the patient explaining what the patient owes
B.
Statement sent to the health care provider 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 third party paid
Question #22
The managers in an organization are responsible for which step of the financial cycle?
A.
Planning
B.
Execution
C.
Assessment
Question #23
How many days of skilled nursing care are covered under Part A?
A.
60
B.
100
C.
30
D.
90
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.
A financial projection of how an organization is likely to perform in the future
B.
Activities involved in the purchasing of goods and the contracting for services
C.
A retrospective study that is then projected into the future with the assumption of consistency
D.
An organization’s revenue and expenditure plan
Question #26
The ___________ __________ is the physician who serves as the gatekeeper or coordinator for all the patient’s care.
A.
secondary physician
B.
primary physician
C.
resident physician
Question #27
What is a debt or obligation owed by an organization?
A.
Asset
B.
Liability
C.
Owner’s equity
Question #28
Match the type with its descriptor. covers employees who suffer work-related injuries and illnesses
A.
HIS
B.
TRICARE
C.
worker's compensation
D.
PPO
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.
TRICARE
B.
worker's compensation
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.
PPO
B.
Medicaid
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.
HMO
B.
TRICARE
C.
HIS
D.
worker's compensation
Question #33
Match the type with its descriptor. program designed to provide financing for the poor and impoverished
A.
TRICARE
B.
PPO
C.
worker's compensation
D.
Medicaid
Question #34
Which of the following is not an eligibility requirement for Medicare?
A.
Below the federal poverty level
B.
Diagnosis of end stage renal disease
C.
65 years and older
D.
Having a disability
Question #35
Which of the following serves to discover mistakes after their occurrence?
A.
Audits
B.
Qualified reports
C.
Bookkeeping
D.
Expense budgets
Question #36
What party is the health care provider?
A.
First party
B.
Third party
C.
Fourth party
D.
Second party
Question #37
In what year did Congress pass the Tax Equity and Fiscal Responsibility Act (TEFRA)?
A.
1987
B.
1985
C.
1982
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.
Increasing owner’s equity
B.
Adding to inventory
C.
Entering a debit
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.
Audits
B.
Bookkeeping
C.
Internal controls
D.
External controls
Question #41
Employees who are responsible for preparing the budget are involved in which step of the financial cycle?
A.
Assessment
B.
Planning
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.
AAAHC
D.
JC
Question #44
What type of budget focuses on the organization’s administrative, research and development, and marketing costs?
A.
Expense budget
B.
Master budget
C.
Capital expenditure budget
D.
Cash budget
Question #45
Which of the following would be considered a third-party payer?
A.
The patient
B.
The laboratory services
C.
The organization paying for the care
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.
A customer pays $3,000 for a piece of equipment.
C.
An individual starts a new business and puts up $5,000 of their own money to get started.
D.
An owner pays $7,000 for supplies and equipment.
Question #47
What is sometimes referred to as cost accounting?
A.
Cash accounting
B.
Financial accounting
C.
Managerial accounting
Question #48
Which of the following is the best definition for the insured?
A.
The one holding the insurance policy
B.
The insurance company that agrees to pay for health care
C.
The insured includes the private insurance companies, employers, and managed care organizations
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.
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.
Assessment
B.
Execution
C.
Planning
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