664 Class 1-8 Review

Question 1

Facility providers include physicians, pharmacists, nurses, advanced practice providers, and allied health professionals

Accepted Answer

False

Question 2

Cost-effective healthcare & preventive care through a network of providers & primary care provider to see specialists

Accepted Answer

Health Maintenance Organization

Question 3

The practice of estimating future demand for healthcare products & services

Accepted Answer

Demand Forecasting

Question 4

Services from a predetermined list of in-network providers without having to seek a referral from primary care

Accepted Answer

Exclusive Provider Organization

Question 5

Alphanumeric designations to classify mortality data by medical diagnoses and symptoms. Inpatient & Outptient

Accepted Answer

ICD-10CM

Question 6

The amount you pay for your health insurance every month

Accepted Answer

Premiums

Question 7

Spreads GL dollars in the department, but the basis is a value that indicates relative resource utilization

Accepted Answer

Relative Value Unit (RVU)

Question 8

Fee-for-Service is a high risk payment methodology to providers

Accepted Answer

False

Question 9

The contracted fixed amount paid per day to the hospital for an inpatient stay

Accepted Answer

Per Diem

Question 10

Divison of all DRGs into 25 mutually exclusive diagnostic areas. Further divided into medical and surgical groups.

Accepted Answer

MDC

Question 11

Physician Services are reimbursed using what methodology?

Accepted Answer

Fee for Schedule

Question 12

What are some factors or drivers that influence health insurance premiums?

Accepted Answer

All of the above

Question 13

Total Cost is the direct and indirect cost of providing services

Accepted Answer

True

Question 14

Offers a network of providers, but allows policy holders to seek care from both in- & out-of-network without a referral

Accepted Answer

Preferred Provider Organization

Question 15

A dollar amount by which the costs of a case must exceed payments in order to qualify

Accepted Answer

Stop-Loss

Question 16

The front end of the revenue cycle includes POS collections

Accepted Answer

True

Question 17

Capital allocation focused on initiatives that align with the long-term goals and mission of a healthcare organization

Accepted Answer

Strategic Investment

Question 18

Flat fee reimbursement for the entire patient encounter, regardless of resources utilized for a specific period of time.

Accepted Answer

Case Rate, Fixed Fees, Bundled Payments

Question 19

Fixed amount of money per patient per unit of time paid in advance to providers for the delivery of health care services

Accepted Answer

Capitation

Question 20

The cost associated with obtaining capital for healthcare investments

Accepted Answer

Cost of Capital

Question 21

Compatible with a Health Savings Account. Has a higher deductible than a traditional plan with lower premiums.

Accepted Answer

High Deductible Health Plan

Question 22

These codes are typically used in the outpatient setting.

Accepted Answer

CPT I

Question 23

The process of identifying, accumulating, and assigning costs to specific cost objects

Accepted Answer

True

Question 24

A complete listing of fees used by Medicare to pay doctors or other providers/suppliers

Accepted Answer

Fee Schedule

Question 25

A cost composed of a mixture of both fixed and variable components

Accepted Answer

Semi-Fixed Costs

Question 26

Patient charges which exceed a pre-determined threshold

Accepted Answer

Outliers

Question 27

This is an example of what kind of code: J0120

Accepted Answer

HCPCS

Question 28

The most you have to pay for covered services in a plan year

Accepted Answer

Maximum Out of Pocket

Question 29

Temporary codes used for new technologies, procedures, and services until they get FDA approval

Accepted Answer

CPT III

Question 30

Assigns department’s total costs directly to the products without distributing costs between different departments first

Accepted Answer

Direct Allocation

Question 31

Goal of Supply Chain is access to the right products, at the right time, in the right quantities, and at the right cost

Accepted Answer

True

Question 32

Who are the key player&#x27;s in the healthcare industry

Accepted Answer

Patients, Providers, Employers, Pharmaceutical, Payors

Question 33

Identifies a specific accomodation, ancillary service, or billing calculation incurred by a patient during a stay

Accepted Answer

Revenue Code

Question 34

The funds invested in long-term assets or projects in the healthcare sector

Accepted Answer

Capital Investment

Question 35

Do not increase as production or workload increases

Accepted Answer

Fixed Cost

Question 36

What are the goals of the patient protection and affordable care act?

Accepted Answer

All of the above

Question 37

Money you pay out of your own pocket toward a covered health care service before your insurance plan starts to pay

Accepted Answer

Deductible

Question 38

The Back phase of the revenue cycle inludes A/R Management, Compliance and Denials Management

Accepted Answer

False

Question 39

Alphanumeric codes used to report services, supplies, &equipment provided to Medicare and Medicaid where no CPT exists

Accepted Answer

HCPCS

Question 40

The middle phase of the revenue cycle includes Claims Processing

Accepted Answer

False

Question 41

Unique services provided by a hospital and paid at a percent of charge rather than a DRG

Accepted Answer

Carveouts

Question 42

Home Health and Skilled Nursing utilize what payment methodology?

Accepted Answer

Case Rate, Fixed Fess, Bundled Payments, Discount off Charges

Question 43

A listing of all goods, services and supplies for the hospital

Accepted Answer

Charge Description Master (CDM)

Question 44

Also known as a fee-for-service plan, it only pays a pre-determined percentage of your doctor and hospital bills.

Accepted Answer

Conventional Indemnity Plan

Question 45

Inpatient hospitalizations use what payment methodology?

Accepted Answer

DRG

Question 46

The difference between a healthcare organization&#x27;s current assets and current liabilities - funds available for daily op

Accepted Answer

Working Capital

Question 47

The individual&#x27;s share of the costs of a covered expense expressed in a percentage

Accepted Answer

Coinsurance

Question 48

The concept for analyzing the relationship between revenue, variable and fixed costs.

Accepted Answer

Contribution Margin

Question 49

Return on Investment is a measure of profitability and effectiveness of healthcare investments

Accepted Answer

True

Question 50

An aggregate of all the costs associated with performing a particular task or producing a product

Accepted Answer

Cost Pool

Question 51

4 Parts of Medicare include

Accepted Answer

Inpatient, Outpatient, Medicare Advantage, Prescription, None of the above

Question 52

A comprehensive payment covering all services involved in a patient&#x27;s episode of care across the continuum of care.

Accepted Answer

Episode of Care Payment

Question 53

PCP who manages your care & can offer you referrals to see specialists. Policy holders can go in & out of network

Accepted Answer

Point of Service

Question 54

This is an example of what kind of code: 047K0ZZ

Accepted Answer

ICD-10 PCS

Question 55

Increase as production or workload increases

Accepted Answer

Variable Cost

Question 56

Costs directly attributable to patient care

Accepted Answer

Variable Costs

Question 57

A list of doctors, health care providers, & hospitals that a plan contracts with to provide medical care to its members

Accepted Answer

Provider Networks

Question 58

Anything for which a separate measurement of costs is desired

Accepted Answer

Cost Object

Question 59

A metric that reflexts the complexity and severity of the patients treated at healthcare facility

Accepted Answer

Case Mix Index (CMI)

Question 60

This is an example of what kind of code: 45382

Accepted Answer

CPT

Question 61

Cost that generally varies with the level of activity, but which tends to be incurred at certain discrete points

Accepted Answer

Step Variable Cost

Question 62

Allocates the cost of some service departments to other service departments in a sequential process

Accepted Answer

Step Down Allocation

Question 63

A method in which providers are paid for each service performed.

Accepted Answer

Fee for Service

Question 64

not linked to reimbursement and are used to track specific information about their patients, such as tobacco use.

Accepted Answer

CPT II

664 Class 1-8 Review

Questions 75

664 Class 1-8 Review

Questions 75