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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: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

QUESTION NO:10

In which act, federal legislation designed to tighten accounting standards in financial

reporting and that holds top executives personally liable as to the accuracy and fairness of

their financial statements?

A. Sarbanes-Oxley Act

B. Insurance accountability Act

C. Financial statement Act

D. Portability and Accountability Standardized Act

Answer: A

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:8

A set of federal compliance regulations to ensure standardization of billing, privacy and

reporting as institutions convert to electronic systems is called:

A. Health Insurance standard Act

B. Reimbursement Insurance Act

C. Medicare Reporting Act

D. Health Insurance portability and Accountability Act

Answer: D

QUESTION NO:22

A process that specifies in advance the preferred treatment regimen for patients with

particular diagnoses is called:

A. Retail health care

B. Diagnosis care

C. Complementary medicine

D. Care mapping

Answer: D

QUESTION NO:20

Which organizations are the third party entities that contract with multiple hospitals to

offer cost savings in the purchase of supplies and equipment by negotiating large-volume

discounted contract with vendors?

A. Cost saving organizations

B. Global payment organizations

C. Group purchasing organizations

D. Cost-accounting organizations

Answer: C

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:19

A system to pay providers whereby the fees for all providers are included in a single

negotiated amount is called:

A. Single member per month payment

B. Global payment

C. Revolutionary payment

D. Ambulatory payment

Answer: B

QUESTION NO:1

The key factors that have contributed to the higher cost of health care include:

A. Technology, aging population, chronic disease and litigation

B. Aging population, chronic disease, performance payment and litigation

C. Technology, performance payment and litigation

D. All of the above

Answer: A

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