Question 22 (1 point)

There are 3 parties in healthcare reimbursement. Who is the first party?

Question 22 options:

A)	patient or guarantor
B)	provider of care or services
C)	payer
D)	society

Question 23 (1 point)

Which type of compliance guidance is used by Medicare to communicate policies and procedures for the specific prospective payment systems' manuals?

Question 23 options:

A)	CMS transmittals
B)	national coverage determinations
C)	Medicare claims processing manual
D)	national correct coding initiative

Question 24 (1 point)

All of the following are cost-sharing provisions EXCEPT:

Question 24 options:

A)	benefit
B)	deductible
C)	copayment
D)	coinsurance

Question 25 (1 point)

CHAMPVA is available for:

Question 25 options:

A)	veterans of the armed forces
B)	spouse of widow(er) of a veteran meeting specific criteria
C)	children of a veteran meeting specific criteria
D)	any spouse, widow(er) or children of a veteran
E)	B and C

Question 26 (1 point)

All of the following are true of state Medicaid programs EXCEPT:

Question 26 options:

A)	federal funds allocated to each state are based on the average income per person for that state
B)	the program must cover infants born to Medicaid-eligible pregnant women
C)	states may offer a manged care option
D)	services offered to beneficiaries are the same in each state

Question 27 (1 point)

All of the following are examples of abuse EXCEPT:

Question 27 options:

A)	misinterpreting coding guidance for a diagnosis code
B)	inadvertently reporting component codes instead of a single comprehensive code
C)	accidentally billing for a service nor provided at the level billed
D)	knowingly billing for a service that the provider did not furnish

Question 28 (1 point)

Which of the following measures improper payments in various settings for Medicare?

Question 28 options:

A)	CERT program
B)	UPIC
C)	A/B MAC medical review
D)	RAC

Question 29 (1 point)

In a typical acute care setting, patient education of payment policies is located in which revenue cycle area?

Question 29 options:

A)	front end
B)	middle
C)	back end
D)	all three components

Question 30 (1 point)

Many electronic health record systems allow patients to send and receive information with a provider electronically through___________

Question 30 options:

A)	webpage
B)	patient portal
C)	interface
D)	email account

Question 31 (1 point)

Which of the following helps confirm the patient's insurance eligibility and coverage for the service to be provided?

Question 31 options:

A)	patient financial responsibility agreement
B)	prior authorization
C)	ABN
D)	insurance card

Question 32 (1 point)

Which of the following is not considered a part of patient financial counseling?

Question 32 options:

A)	medical necessity review
B)	offer of payment plan
C)	information about healthcare loans
D)	information about drug copay cards