Reimbursement Methodologies Unit 3 ExamAnswers.docx

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Unformatted text preview: 1. The __________ plans are MA plans that are offered to a society that is limited to only the members of the society. A. B. C. D. Employer Group Health Plan Private Fee-for-Service Plan Medicare Medical Savings Account Plans Religious Fraternal Benefit Plans 2. The Affordable Care Act established __________ that limit enrollment to Continuing Care Retirement Communities residents who are receiving health-related services under an agreement that is in place for a specified period or the life of the enrollee. A. B. C. D. Senior Housing Facility Plans Medicare Medical Savings Accounts Private Fee-for-Service Plans Employer Group Health Plans 3. The NCQA offers __________ that focus on the employers, health plans, patients, and consumers to allow them to make informed healthcare decisions based on quality. A. B. C. D. voluntary surveys patient satisfaction questionnaires recognition programs certification programs 4. Under Medicare Part A, covered items in an inpatient hospital include the following EXCEPT A. B. C. D. room and board. physician services. drugs and biologicals. blood products. 5. Medicare covers beneficiaries who are __________ and have elected to pay a premium for coverage. A. B. C. D. entitled to Social Security entitled to Railroad Retirement disability most persons who have ESRD all of these are correct 6. When practitioners provide services under the Medicare program, they are required to accept assignment for all Medicare claims involving A. the clinical diagnostic laboratory. B. physician lab services. C. physician services to individuals dually entitled to Medicare and Medicaid. D. all of the above 7. For pricing purposes, in the ANSI X12N 837 P (837P) Electronic Claim Form, when the Place of Service (POS) is listed as __________, the pricing will be based on where the beneficiary’s home is located. A. B. C. D. 10 12 24 11 8. In the typical __________ payment structure, a provider will bill for all services rendered to the third-party payer after the services have been provided and then the third-party payer, retrospectively, will pay the provider. A. B. C. D. fee-for-service episode-of-care block payment capitation 9. __________ costs are influenced by volume and can change each month based on changes in volume. A. B. C. D. Direct variable fixed indirect 10. Equipment is considered to be a __________ and because some equipment has a low price, it is up to the individual organization as to how it records the equipment. A. B. C. D. short-term liability long-term liability short-term asset long-term asset 11. The __________ is intended to demonstrate how much money a company is making or losing by subtracting all of the costs of production of goods that have been sold during the period and other expenses of running the company from the revenues generated by sales. A. B. C. D. cost control statement of cash flows balance sheet income statement 12. The structure of a __________ can change with regards to adding consultants, independent contractors, or employees. A. B. C. D. sole proprietorship partnership corporation all of these are correct 13. An organization uses the __________ accounting method to get a better indicator of future cash flows and overall performance than using current cash receipts and disbursements. A. B. C. D. accrual financial cash general 14. The Federal Accounting Standards Advisory Board’s mission is to serve the __________ interest by improving federal financial reporting through issuing federal financial accounting standards. A. B. C. D. private citizen’s federal government’s public’s American business’s ...
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  • Fall '18
  • Monique Johnson
  • Balance Sheet, Health savings account

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