Revenue Management Exam UPDATED Exam Questions and CORRECT Answers
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Course
Revenue Management
Institution
Revenue Management
Revenue Management Exam UPDATED
Exam Questions and CORRECT Answers
Patients who are assigned the same DRG have all of the following comparable criteria,
except:
A.Diagnosis code
B.Healthcare protocol
C.Length of stay
D.Utilization management - Correct Answer- C.Length of stay
Revenue Management Exam UPDATED
Exam Questions and CORRECT Answers
Patients who are assigned the same DRG have all of the following comparable criteria,
except:
A.Diagnosis code
B.Healthcare protocol
C.Length of stay
D.Utilization management - Correct Answer- C.Length of stay
Joe Patient was admitted to Community Hospital. two days later, he was transferred to big
Medical Center for further evaluation and treatment. He was discharged to home after three
days. Community Hospital will receive from Medicare:
A.The full DRG amount, and Big Medical Center will receive a per diem rate for the three-
day stay
B.A per diem rate for the two-day stay, and Big Medical Center will receive the full DRG
payment
C.The full DRG amount, and Big Medical Center will bill Community Hospital a per diem
rate for the three-day stay
D.No payment; Community Hospital must bill Big Medical Center a per diem rate for the
two-day stay - Correct Answer- B.A per diem rate for the two-day stay, and Big Medical
Center will receive the full DRG payment
The accounts not selected for billing report is used to track accounts that are:
A.Awaiting payment in accounts receivable
B.Paid at different rates
C.In bill hold or in error and awaiting billing
D.Pulled for quality review - Correct Answer- C.In bill hold or in error and awaiting billing
For a provider who has a fee-for-service payment arrangement, what action should be taken
after the respective diagnosis and procedure codes have been assigned?
A.Percent discount for each procedure service
B.Fee for bundled services
C.Send fee schedule to third party payer
,D.Assign a fee to each procedure code - Correct Answer- D.Assign a fee to each procedure
code
Which of the following is an example of a common form of healthcare fraud and abuse?
A.Billing for services not furnished to patients
B.Clinical documentation improvement
C.Refiling claims after denials
D.Use of a claim scrubber prior to submitting bills - Correct Answer- A.Billing for services
not furnished to patients
In most instances, the "owner" of the charge description master (CDM) in a healthcare
facility is the:
A.HIM Department
B.Information technology department
C.Finance department
D.Patient accounts department - Correct Answer- C.Finance department
Using the charge description master (CDM) to automatically link a service to the appropriate
CPT/HCPCS code is referred to as:
A.Concurrent coding
B.Hard coding
C.Official coding
D.Upcoding - Correct Answer- B.Hard coding
If the provider is a Medicare participating provider, the balance between the amount charged
for a service and the amount Medicare allows is:
A.Adjusted off from the patient account
B.Charged to the patient
C.Billed to the secondary insurance
D.The health insurance claim should be rebilled for higher reimbursement - Correct Answer-
A.Adjusted off from the patient account
, A Medicare patient had two physician office visits, underwent hospital radiology
examinations and clinical laboratory tests, and received take-home surgical dressings. Which
of the following could be reimbursed under the outpatient prospective payment system?
A.Clinical laboratory tests
B.Physician office visits
C.Radiology examinations
D.Take-home surgical dressings - Correct Answer- C.Radiology examinations
Sandra currently has Medicare for primary insurance and Medicaid for secondary insurance.
The hospital billed $2,500 for a colonoscopy. Medicare allowed $950 and paid $760. The
Medicaid allowed amount for the colonoscopy is $750. What amount should Medicaid
reimburse as the secondary payer?
A.$19
B.$150
C.$190
D.Nothing - Correct Answer- D.Nothing
Which of the following is the definition of revenue cycle management?
A.The regularly repeating set of events that produce revenue or income
B.The method by which patients are grouped together based on a set of characteristics
C.the systematic ccomparison of the products, services, and outcomes of one organization
with those of a similar organization
D.Coordination of all administrative and clinical functions that contribute to the capture,
management, and collection of patient service revenue - Correct Answer- D.Coordination of
all administrative and clinical functions that contribute to the capture, management, and
collection of patient service revenue
Most facilities begin counting days in accounts receivable at which of the following times?
A.The date the patient registers
B.The date the patient is discharged
C.The date the bill drops
D.the date the bill is received by the payer - Correct Answer- C.The date the bill drops
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