Ch.3 HC Finance Information as a Strategic Resource

Question 1

proprietary organizations, privately owned &
responsible for paying taxes

Answer 1

Profit Oriented organization

Question 2

voluntary nonprofit organization

Answer 2

applied to be tax-exempt
churches, private schools/foundations

Question 3

Government Non-Profits

Answer 3

federal, state, county, city, university teaching hospitals

Question 4

HIM manager would have what kind viewpoint

Answer 4

process

Question 5

director of nursing would have what viewpoint

Answer 5

clinical

Question 6

Chief financial officer would have what viewpoint

Answer 6

financial

Question 7

revenue refers to

Answer 7

amount money an organization earns
represents an inflow

Question 8

contractual allowances

Answer 8

refer to the difference between the full rate charged and the contractual rate MCO will pay

Question 9

contractual allowance is considered a

Answer 9

deduction from revenue

Question 10

grouped revenue by the unit that brings in revenue

Answer 10

revenue center

Question 11

grouping revenue by different location care is provided

Answer 11

care setting

Question 12

grouping revenue by similar services

Answer 12

service line

Question 13

exchange goods/services for payment

Answer 13

financial transaction
1. service provided
2. transaction recorded
3. compensation exchanged

Question 14

clinical services

Answer 14

provide actual patient care, and doing documentation/records
responsible for input billing information in the charge description master

Question 15

Health Information Management dept

Answer 15

assigns correct code which drive reimburse
collect and maintain records

Question 16

Patient accounts dept

Answer 16

depend on clinical service, the HIM department to input reliable info so they can bill the payer

Question 17

financial dept

Answer 17

analyze the data to track reimbursement, control cost, forecast future activity, manage paying employment, equipment, etc

Question 18

represents the outflow of money

Answer 18

expenses

Question 19

charges equals

Answer 19

revenue

Question 20

costs equals

Answer 20

expenses

Question 21

Assets

Answer 21

resources the organization owns or due to receive
-cash
-inventory
-AR
-equipement

Question 22

Liabilities

Answer 22

debts or what the organization owes for g/s they have received
-accounts payable
-loans payable

Question 23

net worth

Answer 23

owners’ equity or what the organization is worth after liabilities subtracted from assets

Question 24

make decisions based on reports that are created to track what resources are used

Answer 24

managerial accounting

Question 25

direct costs

Answer 25

cost used by specific department
i.e payroll for medical coders

Question 26

indirect cost

Answer 26

the overall operation of the organization
i.e electricity

Question 27

fixed cost

Answer 27

stays the same even when there is a change
i.e nurse salary

Question 28

variable cost

Answer 28

change with volume
i.e increase treatment of patient = increased medication used by pharmacy

Question 29

budgets

Answer 29

used to forecast revenue and expenses for a dept/organization
sets budget next year
begins with board of directors

Question 30

goal for revenue is

Answer 30

to be met or exceeded

Question 31

goal for budgets

Answer 31

is to be met or lowered than forecast

Question 32

variance

Answer 32

difference between budget amount and actual

Question 33

favorable variance

Answer 33

actual result is better than budgeted for

Question 34

unfavorable variance

Answer 34

results are worse than what was budgeted for

Question 35

Advance Beneficiary Notice (ABN)

Answer 35

medicare liability waiver providers have to give the patient for services not covered

Question 36

Remittance Advice (RA)

Answer 36

sent to provider that explains the payment

Question 37

Explanation of Benefits (EOB)

Answer 37

communicate to patient of what total is, how much they pay, etc
-medicare summary notice

Question 38

remittance advice remark codes (RARCs)

Answer 38

bottom of a RA that go into detail of report

Question 39

Price Transparency

Answer 39

readily available info on the price of service, help define value of those services and enable patient/care purchaser too identify, compare, choose providers that offer desired level of care

Question 40

first way standard charges must be shown is Machine-readable file that list

Answer 40

gross charge
discounted cash price
payer-specific negotiated charge
di-identified min/max negotiated charge

Question 41

2nd way standard charges must be presented

Answer 41

consumer-friendly display

Question 42

challenge of implementation

Answer 42

publish standard charges of all service/item on a prominently or publicly available website
-price estimator tool