Part 6

Question 1

Which are the amounts owed to a business for services or goods provided?

A. Accounts payable
B. Assignment of benefits
C. Accounts receivable
D. Allowed charges

Answer 1

Accounts receivable

Question 2

The physician’s office sent a request for payment to Able Insurance Company. The term used in the healthcare industry for this request for payment is _______.

A. A block grant
B. An allowance
C. Reimbursement
D. A claim

Answer 2

A claim

Question 3

When does a Medicare patient start having to pay a co-payment amount during a benefit period?

A. For the first 60 days of hospitalization
B. For the first 30 days of hospitalization
C. For 90 days and beyond of hospitalization
D. For days 61-90 of hospitalization and beyond

Answer 3

For days 61-90 of hospitalization and beyond

Question 4

When the patient is covered by other medical and liability policies, Medicaid reimburses providers ________.

A. Last
B. First

Answer 4

Last

Question 5

Chargemaster _______ is the process of updating and revising key elements of the chargemaster to ensure accurate reimbursement.

A. Maintenance
B. Computerization
C. Revenue generation
D. Documentation

Answer 5

Maintenance

Question 6

Tricare Prime beneficiaries can receive care if they reside and work outside a military treatment ________ area, which is the region defined by code boundaries within a 40. mile radius of a military treatment facility.

A. Catchment
B. Local
C. Regional
D. State

Answer 6

Catchment

Question 7

PAR provider fee $100
PAR allowable charge $80
Patient copayment $20
Insurance payment $60
PAR provider write off amount \_\_\_\_\_\_\_

A. $40
B. $20
C. $10
D. $30

Answer 7

$20

Question 8

Program of All-inclusive Care for the Elderly (PACE) use a capitated payment system to provide a comprehensive package of community based services as an alternative to institutional care for persons age 55 older who require a(n) ________ level of care.

A. Nursing facility
B. Subacute hospital
C. Outpatient basis
D. Acute inpatient

Answer 8

Nursing facility

Question 9

A delinquent account is also called a __________ account, which means it is one that has not been paid within certain time frame (e.g. 120 days). Following up on such delinquent accounts is crucial to the success of the business

A. Deficient
B. Past due
C. Deductible
D. Payable

Answer 9

Past due

Question 10

Which is the fixed amount the patient pays each time he or she receives healthcare Services?

A. Copayment
B. Coinsurance
C. Deductible
D. Premium

Answer 10

Copayment