Module 3 Assignment 3 (M3A3) Principles of Finance (White) Chapter 6: Third-Party Contract Analysis Review Questions (5 points each) 1. Since providers are not able to negotiate with government payers, how can they afford to treat patients covered by those plans when the payment does not cover the cost of care? 2. What are the potential negative ramifications of decreases in Medicare's payments to physicians? 3. What is the key difference between Medicare's IPPS and OPPS payment systems? 4. If a facility's average length of stay for joint replacement patients is 5 days and the average charge per patient is $25,000, which of the following contractual arrangements is most favorable? a) A case rate of $10,000 b) 65% of charges c) A per diem rate of $3,000 5. All Medicare beneficiaries are required to pay a premium for which of the Medicare Parts? a) Part A b) Part B c) Medicare beneficiaries do not pay a premium d) Only high income beneficiaries pay Medicare premiums 6. In a prospective payment system, payment for services is determined: a) At time of service b) By the level of charges incurred c) Prior to services rendered d) Based on ability of patient to pay 7. If an insurance company does not have a contractual agreement with a provider, then they are obligated to pay what amount on behalf of their beneficiary? a) Total charge b) Cost of care c) $0 d) Medicare rates