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QUESTION NO:13
Concurrent review states that:
A. Planning appropriateness and medical necessity of a hospital stay while the patient is
in the hospital and implementing discharge planning.
B. Monitoring appropriateness and medical necessity of a hospital stay while the patient
is not in the hospital and try to implement discharge planning.
C. Planning appropriateness and medical necessity of a hospital stay while the patient is
not in the hospital and try to implement preadmission planning.
D. Monitoring appropriateness and medical necessity of a hospital stay while the patient
is in the hospital and implementing discharge planning.
Answer: D
QUESTION NO:12
Which one of the following is NOT the factor of Uninsured?
A. Health insurance premiums becoming too costly
B. Requiring patients to pay for the part of their own care-up
C. Individuals being screened out of insurance policies
D. Employers feeling they cannot afford to continue to provide health insurance as a
benefit
Answer: B
QUESTION NO:4
The combination of age and technology has increased cost with the passage of time.
A. True
B. False
Answer: A
QUESTION NO:5
Prescription drug coverage for Medicare enrollees, which offsets some of the out-of-
pocket costs for medications, this covers:
A. Medicare Part A
B. Medicare Part B
C. Medicare Part D
D. Medicare Part F
Answer: C
QUESTION NO:9
____________ is the tendency health care practitioners to do more testing and to provide
more care for patients than might otherwise be necessary to protect themselves against
potential litigation.
Answer:
Defensive medicine
QUESTION NO:11
Stark law sates that:
A. Legislation enacted by HIPAA to guard against providers’ ordering self-referrals for
Medicare or Medicaid patients directly to any settings in which they have a vested
financial interest.
B. Legislation enacted by CMS to guard against providers’ ordering self-referrals for
Medicare or Medicaid patients directly to any settings in which they have a vested
financial interest.
C. Legislation enacted by CMS to guard against providers’ ordering self-referrals for
Medicare or Medicaid patients indirectly to any settings in which they have a vested
financial interest.
D. Legislation enacted by HIPAA to guard against providers’ ordering self-referrals for
Medicare or Medicaid patients indirectly to any settings in which they have a vested
financial interest.
Answer: B
QUESTION NO:6
The need to abide by governmental regulations, whether they are for the provision of
care, billing, privacy accounting standards, security or the like refers to:
A. Compliance
B. Chronic Medicare
C. Health proactive standards
D. None of the above
Answer: A
QUESTION NO:7
that providers have to pay insurers to cover the cost of defending against
the lawsuits and paying large jury awards.
A. Ambulatory payment classifications
B. Reimbursement Insurance cost plan
C. Health proactive Insurance standard act
D. Increased insurance premiums
Answer: D
QUESTION NO:17
A system that pays providers a specific amount in advance to care for defined health care
needs of a population over a specific period is called:
A. Health care system
B. Prospective payments system
C. Global payment system
D. Capitation
Answer: D
QUESTION NO:3
when providers try to get one payor to pay for costs that have not been covered by
another payor, this refers to:
A. Cost Capacity
B. Cost capitalization
C. Cost-shifting
D. Prospective cost
Answer: C
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