lower payment from CMS? Selected Answer: D. Uncontrolled spike in blood sugar during hospitalization Question 42 1 out of 1 points Which of the following is NOT typically a department participating in the revenue cycle? Selected Answer: C. Material Management Question 43 1 out of 1 points A patient agrees to allow the third-party payer to pay the healthcare provider directly rather than issue payment to the patient. Which term describes this action? Selected Answer: D. Assignment of benefits Question 44 1 out of 1 points A claim is rejected due to missing diagnoses for the surgical services charges on the claim. Which revenue cycle department will need to review the account? Selected Answer: D. HIM/Codin g Question 45 1 out of 1 points Which initiative was implemented to promote correct coding and control improper coding that leads to inappropriate payments? Selected Answer: C. National Correct Coding Question 46
1 out of 1 points Which of the following BEST describes revenue cycle management? Selected Answer: A. Coordination of a series of healthcare administrative and clinical functions related to the capture, management, and collection of revenue Question 47 1 out of 1 points What should a Medicare patient be a given before services are provided if those services are not covered by Medicare? Selected Answer: D. Advance beneficiary notice Question 48 1 out of 1 points Which two financial strategies do hospitals use to improve their bottom line? Selected Answer: A. Increase revenue, decrease cost Question 49 1 out of 1 points Which revenue cycle activity is responsible for ensuring that documentation is accurate, timely, and supports the care provided? Selected Answer: C. Clinical documentation improvement Question 50 1 out of 1 points A patient, staff, or any individual that believes the HIPAA Privacy Rule has been violated can file a complaint with: Selected Answer: B. Office of Civil Rights (OCR) Question 51 1 out of 1 points The UB-04 Hospital Billing Claim has four main sections. Which of the following is NOT one of the sections? Selected Answer: C. Provider information Question 52 1 out of 1 points For patients enrolled in both the Medicare and Medicaid programs, services
covered by Medicare are paid before Medicaid makes payments because Medicaid is considered to be the ________: Selected Answer: B. Payer of last resort Question 53 1 out of 1 points The key field in the charge description master (CDM) is the _______, which is the unique identifier for each charge. Selected Answer: D. Charge code Question 54 1 out of 1 points A determination is made that a patient scheduled for surgery as a hospital inpatient will need to have the surgery in the Ambulatory Surgery Unit. Which revenue cycle department made this decision? Selected Answer: D. Utilization Management Question 55 1 out of 1 points Which term describes a statement issued to the insured and the provider by a third-party payer to explain the services provided, charges, and amount paid? Selected Answer: B. Explanation of benefits
You've reached the end of your free preview.
Want to read all 10 pages?
- Spring '18
- Ruth Berger
- Module 6, Health Insurance Portability and Accountability Act