1. Which of the following statements are true of HFMA's Patient
Financial Communications Best Practices? - ANS -The best
practices were developed specifically to help patients understand
the cost of services, their individual insurance benefits and their
responsibility for balance after insurance if any
2. The patient experience includes all of the following except: - ANS
-The average number of positive mentions received by the health
system or practice and the public comments refuting unfriendly
posts on social media sites
3. Corporate compliance programs play an important role in
protecting the integrity of operations and ensuring compliance
, with federal and state requirements. The Code of Conduct is: -
ANS -A critical tool to ensure the compliance with the
organization's compliance standards and procedures, an essential
and integral component of the organization's culture, fosters and
environment where concerns and questions may be raised
without fear of retaliation or retribution
4. Specific to Medicare fee-for-service patients, which of the
following payers have always been liable for payment? - ANS -
Public health service programs, federal grant programs, VA
programs, black lung program services and workers comp claims
5. Provider policies and procedures should be in plan to reduce the
risk of ethics violations. Examples of ethics violations are: - ANS -
Financial misconduct, overcharging and miscoding claims, theft of
, property and falsifying records to boost reimbursement, financial
misconduct and applying policies in an inconsistent manner
Providers are now being reimbursed with a focus on the value of the
services provided, rather than volume, which requires collaboration
among providers.
6. What is the intended outcome of collaborations made through
an ACO delivery system for a population of patients? - ANS -To
eliminate duplicate services, prevent medical errors and ensure
appropriateness of care
7. What is the new terminology now employed in the calculation of
net patient service revenues? - ANS -Explicit price concessions
and implicit price concessions
, 8. What are the two KPIs used to monitor performance related to
the production and submission of claims to third party payers
and patients (self-pay)? - ANS -Elapsed days from discharge to
final bill and elapsed days from final bill to claim/bill submission
9. What are the three traditional steps of the Revenue Cycle? - ANS
-Pre-service, time-of-service and post-service
10. What are the steps during pre-service? - ANS -1. The
patient is scheduled and pre-registered for service
2. The encounter record is generated and the patient/guarantor
information is obtained or updated
3. The requested service is screened for med necessity; insurance is
verified and pre-auths obtained
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