Expanding health coverage, controlling healthcare costs, and modernizing the healthcare delivery system are the three main objectives of which healthcare legislation?<div><br></div><div>A. American Healthcare Act</div><div>B. Patient Protection and Affordable Care Act (ACA)</div><div>C. Health Innovations Expansion Law</div><div>D. Accountable Care Organization</div>B. Patient Protection and Affordable Care Act (ACA)
Which of the following are key trends in healthcare reform?<div>I. Focus on fraud and abuse</div><div>II. Shift from acute care to prevention and wellness</div><div>III. Care delivery expanding beyond the traditional physician office</div><div>IV. Coordination of Care</div><div><br></div><div>A. I and III</div><div>B. I and II</div><div>C. I, II and III</div><div>D. I, II, III and IV</div>D. I, II, III and IV
<div>What are Retail Clinics, internet-based visits and remote patient monitoring are all examples of?</div> <div>A. care beyond the traditional physician office</div> <div>B. patients moving towards home based holistic medicine</div> <div>C. patients moving towards self-care instead of traditional office visits</div> <div>D. care in a hospital or facility</div>A. care beyond the traditional physician office
<div>An Accountable Care Organization (ACOs):</div> <div>I. Relies on a risk adjusted reimbursement methodology called Hierarchical Categories (HCCs)</div> <div>II. Is paid a fixed dollar amount to care for a patient</div> <div>III. Is paid fee for a service</div> <div>IV. Must decide on the most efficient way to allocate treatment resources to mange a patient’s condition(s)</div> <div>V. Must include preventive medicine as the primary goal</div><div><br></div> <div>A. I, III and V</div> <div>B. I, II and V</div> <div>C. I, II and IV</div> <div>D. I, III and IV</div>C. I, II and IV
<div>What is aimed at reducing growth in Medicare spending and developing alternative payment models to promote more efficient use of healthcare resources and higher quality of care?</div> <div>A. Recovery Audit Contractors (RACs)</div> <div>B. Payment Reforms</div> <div>C. Unified Program Integrity Contractors (UPICs)</div> <div>D. OIG compliance guidance</div>B. Payment Reforms
<div>Which one of the following is NOT measured in a hospital that is paid based on performance?</div> <div>A. Volume</div> <div>B. Efficiency</div> <div>C. Patient Satisfaction</div> D. Quality of CareA. Volume
<div>Which of the following is NOT an example of program initiatives created to reduce waste, fraud and abuse?</div> <div>A. Mandatory repayment of overpayments within 60 days</div> <div>B. Enforce violations of the Anti-Kickback statute as also violations of the False Claims Act</div> <div>C. Decrease the number of RACs and UPICs</div> D. Establish compliance and ethics programs for Medicare and Medicaid providersC. Decrease the number of RACs and UPICs
<div>Which statement is TRUE regarding APMs?</div> <div>A. All APMs must submit MIPS data</div> <div>B. MIPS APMs are APMs that are not considered advanced and therefore must submit MIPS data</div> <div>C. APMs have to meet CEHRT requirement but do not have quality measures to meet</div> D. CEHRT requirements to not apply to APMsB. MIPS APMs are APMs that are not considered advanced and therefore must submit MIPS data
<div>The role of physicians will be changing with healthcare reform. Which of the following are TRUE of changes to come?</div> <div>I. The roles and scope of services for non-physician providers will be expanded due to increased demand for healthcare</div> <div>II. Physicians will focus primarily on preventive care</div> <div>III. Non-physician providers will play a larger role in care for routine problems</div> <div>IV. Pharmacists will play a great role in providing comprehensive care</div> <div>V. Chronic conditions will be monitored by home visits.</div> <div>&nbsp;</div> <div>A. II and III</div> <div>B. I, III and V</div> <div>C. II, III and V</div> D. I, III and IVD. I, III and IV
<div>Mobile technology is rapidly being integrated into healthcare to monitor patients, improve outcomes and reduce the need for face-to-face visits. The amount of data and real-time patient information that will become available will _________.</div> <div>A. increase</div> <div>B. decrease</div> <div>C. remain the same</div> <div>D. initially increase and then decrease</div>A. increase
<div>For a visit to qualify as an incident-to-service, which of the following is NOT required?</div> <div>A. Services must be part of a patient’s normal course of treatment.</div> <div>B. The NPP must provide services that are an integral part of the physician’s own involvement.</div> <div>C. The supervising physician must be physically present in the room with the patient and the NPP provider.</div> D. The physician must have personally performed an initial service.<div>C. The supervising physician must be physically present in the room with the patient and the NPP provider.</div><br>
<div>A successful practice requires a team of dedicated employees who work to achieve defined outcomes. When management creates staff accountability, it creates a shared desire for what in the workplace?</div><div><br></div> <div>A. Assist in continuous improvement</div> <div>B. Only focus on individual goals rather than company goals</div> <div>C. Perform the job the quickest way possible to meet the employee’s deadlines, even if the outcome is substandard</div> D. Expect the employee to perform job without clear expectation<div>A. Assist in continuous improvement</div><br>
<div>There are differences between a manager and a leader. Which one of the following sets of characteristics is more representative of a manager?</div><div><br></div> <div>A. Focuses on the long-term vs the short-term</div> <div>B. Sets direction instead of plans details</div> <div>C. Leads people instead of managing work</div> D. Focuses on day-to-day tasksD. Focuses on day-to-day tasks
<div>All of the following providers can write prescriptions for medications, except who?</div> <div>A. Nurse Practitioner</div> <div>B. Physician Assistant</div> <div>C. Registered Nurse</div> D. Physician<div>C. Registered Nurse</div><br>
<div>An efficient patient check-in process includes:</div> <div>A. Verification of patient’s insurance and patient completes/updates forms</div> <div>B. Collection of co-payment and the patient’s insurance card is copied/scanned</div> <div>C. Verification of patient’s insurance, have patient complete/update forms, and the patient’s insurance card is copied/scanned</div> D. Verification of patient’s insurance, collection of a co-payment, have patient complete/update forms, and the patient’s insurance card is copied/scannedD. Verification of patient’s insurance, collection of a co-payment, have patient complete/update forms, and the patient’s insurance card is copied/scanned
<div>Body language can help ensure effective communication. What gesture(s) should you avoid?</div> <div>A. Watching the clock</div> <div>B. Looking the person in the eyes and crossing your arms</div> <div>C. Fiddling, watching the clock, and crossing your arms</div> D. Fiddling, watching the clock, looking the person in the eyes and crossing your arms<div>C. Fiddling, watching the clock, and crossing your arms</div><br>
<div>Which of the following are ways that stereotyping affects our communication?</div> <div>A. Power Differential/Class and Cultural Competence/Ethnicity-Race</div> <div>B. Cultural Competence/Ethnicity-race, and Gender</div> <div>C. Power Differential/Class and Gender</div> D. Power Differential/Class, Cultural Competence/Ethnicity-Race, and GenderD. Power Differential/Class, Cultural Competence/Ethnicity-Race, and Gender
<div>In the practice that you manage, a nurse comes to you complaining of the way that the physician verbally abuses her when she makes a mistake. You express your concern and promise to talk with the doctor. Because you know that initiating difficult conversations in the past has not gone well, you decide to do the following to ensure that the meeting goes as good as possible:</div> <div>A. Ask if this is a good time to talk and sympathize</div> <div>B. Be direct and speak quickly</div> <div>C. Be direct, sympathize, and speak quickly</div> D. Ask if this is a good time to talk, be direct, and sympathizeD. Ask if this is a good time to talk, be direct, and sympathize
<div>Which of the following is NOT part of a practice manager’s duties?</div> <div>A. Collecting copays at check-in from the patient</div> <div>B. Implementing strategies to reduce expenses</div> <div>C. Implementing a process to increase more referrals</div> D. Selecting and reviewing reports and tools in the revenue-cycle process to make decisions quicklyA. Collecting copays at check-in from the patient
<div>Which of the following are barriers to effective communication?</div> <div>A. Me-too-ism and arguing or disagreeing with the speaker</div> <div>B. Me-too-ism, giving unsolicited advice, and arguing or disagreeing with the speaker</div> <div>C. Me-too-ism, arguing or disagreeing with the speaker, and moralizing</div> D. Me-too-ism, giving unsolicited advice, arguing or disagreeing with the speaker, and moralizingD. Me-too-ism, giving unsolicited advice, arguing or disagreeing with the speaker, and moralizing
<div>As the practice manager, you have been asked to develop a brand that defines who the practice is and makes the practice stand out to patient. To establish a marketing brand, you must complete these steps EXCEPT which of the following?</div><div><br></div> <div>A. Distinguish your practice with a strong graphical reference such as a logo, tagline, or slogan.</div> <div>B. Perform a business analysis, such as SWOT, to define what your business will be, who your audience will be.</div> <div>C. Search the internet for competitors’ brand and make your practice fit their brand.</div> <div>D. Be consistent with using your brand with every aspect of your business, including stationary, print ads, etc.</div><div>C. Search the internet for competitors’ brand and make your practice fit their brand.</div><br>
<div>Which marketing strategy is responsible for over 70 percent of new business for primary care offices?</div><div><br></div> <div>A. Practice website</div> <div>B. Insurance panels</div> <div>C. Patient word of mouth</div> <div>D. Direct mailers</div><div>C. Patient word of mouth</div><br>
<div>To increase your practice’s website visibility when internet users are searching for related medical topics, you should consider using _________.</div><div><br></div> <div>A. Search engine organization (SEO)</div> <div>B. Search engine optimization (SEO)</div> <div>C. Search everywhere optimization (SEO)</div> D. Strategic engine organization (SEO)<div>B. Search engine optimization (SEO)</div><br>
<div>Patient satisfaction surveys provide you with necessary information to make improvements in your practice. All of the following represent best practices for patient satisfaction surveys EXCEPT which of the following?</div><div><br></div> <div>A. Limit your sample size to a small number of patients</div> <div>B. For surveys handed out in the office, make every effort to remove potential bias.</div> <div>C. When using an online survey, use a dependable online gathering tool.</div> D. When surveys are mailed to patients, you should include a stamped returned envelope.<div>A. Limit your sample size to a small number of patients</div><br>
<div>When is the best time to implement a strong marketing plan?</div><div><br></div> <div>A. Immediately</div> <div>B. After the practice has verified it has the right people and culture in place</div> <div>C. After making sure that good processes and systems are in place and quality services are being provided</div> D. Both B and CD. Both B and C
<div>What is an effective way to market to your existing patients?</div><div><br></div> <div>A. Sales calls from your office staff</div> <div>B. Healthcare maintenance reminders</div> <div>C. Billboard sign</div> <div>D. Health fairs</div><div>B. Healthcare maintenance reminders</div><br>
<div>One of the most effective ways that medical practices are able to shop and receive discounted prices on their purchases is ___________.</div><div><br></div> <div>A. Shopping at a big retail store such as Wal-Mart</div> <div>B. Looking at the sales sheets in the Sunday paper</div> <div>C. Joining a Group Purchasing Organization (GPOs)</div> D. Buying all products from one vendor<div>C. Joining a Group Purchasing Organization (GPOs)</div><br>
<div>Dr. Jones would like to increase revenue for the practice and has approached you regarding the possibility of adding some internal radiology services, which are currently being sent out. Your job as the practice manager is to decide if it is a feasible idea. Which of the following is NOT done when considering new ancillary services to be provided in your practice?</div><div><br></div> <div>A. Identify current volumes that are currently being ordered so that a good financial analysis can be performed to determine profitability</div> <div>B. Research the price of equipment</div> <div>C. Determine how the Stark and Anti-kickback laws may apply</div> D. Order the radiology equipment immediately. Research is not necessary.D. Order the radiology equipment immediately. Research is not necessary.
<div>In reviewing the most recent insurance payer analysis for your surgery practice, you recognize that the number of patient visits of one of your best commercial payers continues to decrease. What should you do first?</div><div><br></div> <div>A. Send out a direct mailer to the surrounding area to try to bring in more patients</div> <div>B. Check the insurance panel for that payer and make sure that your physicians are listed</div> <div>C. Put up new signage around town</div> D. Go visit the local primary care providers and ask them to send you more of that payer’s patients and give them a referral fee for every patient they send<div>B. Check the insurance panel for that payer and make sure that your physicians are listed</div><br>
<div>Which of the following should the staff do to obtain the best sample of patient feedback when surveys are handed out in the clinic?</div><div><br></div> <div>A. Give only to the happy patients</div> <div>B. Pick a specific time period and give survey to every patient who has an appointment during that time</div> <div>C. Give only to the dissatisfied patients</div> <div>D. Put in a box in the waiting room for patients to fill out while they wait to be seen</div><div>B. Pick a specific time period and give survey to every patient who has an appointment during that time</div><br>
SWOTSWOT Analysis - Strengths, Weaknesses, Opportunities, and Threats
Brand DevelopmentCreating a service and image defining who you are to stand out in the minds of your patients
Focus GroupBring a group of people together to ask about their perceptions, opinion, and attitudes toward a product or service
GPOsGroup Purchasing Organizations
NPPNon-physician Practitioner: PA, NP, CNS (clinical nurse specialist), CNM (certified nurse midwife)
RA noticeRemittance Advice notice
EOBExplanation of Benefits
CMS-1500Standard claim form for billing physician services
ACAPatient Protection and Affordable Care Act
CBOCongressional Budget Office
ACOAccountable Care Organizations
RPMRemote Patient Monitoring
DMEDurable Medical Equipment
RACsRecovery Audit Contractors
UPICsUnified Program Integrity Contractors
HCCsHierarchical Condition Categories
MIPSMerit-Based Incentive Payment System
Advanced APMsAdvanced Alternative Payment Models
CEHRT 2015Certified Electronic Health Record Technology - 2015 Edition
SAFER GuidesSafety Assurance Factors for EHR Resilience Guides
<div>The practice has received complaints from patients because they are not able to get same day appointments due to full schedules. Which scheduling type could help accommodate those patients?</div> <div>&nbsp;</div> <div>A. Block scheduling</div> <div>B. Individual time slots</div> <div>C. Open access scheduling</div> <div>D. Business scheduling</div><div>C. Open access scheduling</div><br>
<div>Triage refers to prioritizing treatment based on urgency of condition, but it can also refer to directing a patient to the right person or the right place during the patient’s visit or during a phone call. Triage can be made easier if the practice establishes _________.</div> <div>&nbsp;</div> <div>A. Protocols</div> <div>B. Phone directories</div> <div>C. Business workflow</div> D. Automated phone system<div><b>A. Protocols</b></div><br>
<div>When constructing new exam rooms, how is confidentiality in the exam room best accomplished?</div> <div>&nbsp;</div> <div>A. Music over the loudspeaker</div> <div>B. Whispering when talking to patients</div> <div>C. Insulation to dampen noise transfer between rooms</div> D. Curtains to protect privacy when exam room doors are opened<div><div>C. Insulation to dampen noise transfer between rooms</div><br></div>
<div>Transitioning to an EHR has left many boxes of paper charts that are no longer being used. Where is the best place to keep those records?</div> <div>&nbsp;</div> <div>A. Extra exam room at the practice</div> <div>B. Stored off site</div> <div>C. Hospital HIM Department</div> D. Practice basement<div>B. Stored off site</div><br>
<div>Which of the following is NOT an example of workflow within a clinic?</div> <div>&nbsp;</div> <div>A. Check-in process</div> <div>B. Scheduling of patients and gathering of demographic information</div> <div>C. Management of sample prescriptions</div> D. Credentialing of the physiciansD. Credentialing of the physicians
<div>Efficient medical practices will locate the physician’s offices close to ______.</div> <div>&nbsp;</div> <div>A. The check-in desk</div> <div>B. The exam rooms</div> <div>C. Near the kitchen</div> <div>D. Near the back door</div><div>B. The exam rooms</div><br>
<div>The physicians have come to you complaining about pharmaceutical representatives always being at their workstations trying to talk to them about their products and leaving drug samples all around their workstations. What are some examples of processes you could implement to help solve these problems?</div> <div>I. Establish times that pharmaceutical representatives are allowed to meet with the physicians</div> <div>II. Establish processes of how the representatives are required to check in</div> <div>III. Require pharmaceutical representatives log and leave all samples in a designated area</div> <div>IV. Set up designated areas where the pharmaceutical representatives are allowed to go in the clinic</div> <div>V. Set up a deal with the pharmaceutical representatives giving the best access to those who provide the best lunches</div> <div>&nbsp;</div> <div>A. I, II and V</div> <div>B. I, II and III</div> <div>C. III, IV and V</div> D. I, II, III and IVD. I, II, III and IV
<div>A type of scheduling that allows several patients to be scheduled at the same time and are seen in the order they arrive is called _______ scheduling.</div> <div>&nbsp;</div> <div>A. Individual time slot scheduling</div> <div>B. Open access scheduling</div> <div>C. Block scheduling</div> D. Group scheduling<div>C. Block scheduling</div><br>
<div>When scheduling patients, the scheduler should obtain as much information as possible prior to the visit for all the reasons EXCEPT which of the following?</div> <div>&nbsp;</div> <div>A. Faster check-in for the patients</div> <div>B. Opportunity to verify insurance prior to the visit</div> <div>C. Ability to remind patient about past balances and copays that are due</div> <div>D. Ensure that all patients are seen at their appointment time</div>D. Ensure that all patients are seen at their appointment time
<div>An effective patient encounter workflow allows all EXCEPT which of the following?</div> <div>&nbsp;</div> <div>A. Physicians providing all services including vitals and injections</div> <div>B. Nursing staff provide all services that they are qualified to do</div> <div>C. Properly stocked exam room to provide care without delay</div> <div>D. Reserving tasks for the physicians that require his or her skills</div><div>A. Physicians providing all services including vitals and injections</div><br>
ADAAmerican with Disabilities Act 1990
OSHAOccupational Safety and Health Administration
ORTOperation Restore Trust&nbsp;
HHSDepartment of Health and Human Services
Three agencies were involved in ORT (Operation Restore Trust)OIG: Office of Inspector General&nbsp;<div><br></div><div>HCFA, now CMS: Healthcare Financing Administration, now Centers for Medicare &amp; Medicaid</div><div><br></div><div>AoA: Administration on Aging</div>
OIGOffice of Inspector General
HCFA, now CMSHealthcare Financing Administration
AoAAdministration on Aging
SMPSenior Medicare Patrol
What does HHS, CMS, and the OIG work with AoA to combat?fraud and abuse
What does the Stark Law govern?Physician self-referral for Medicare and Medicaid patients
The Anti-Dumping LawEMTALA (Emergency Medical Treatment and Active Labor Act)
EMTALAEmergency Medical Treatment and Active Labor Act
ASH ActOccupational Safety and Health Act of 1970
CFRCode of Federal Regulations
ECPExposure Control Plan
ETSEmergency Temporary Standard
CLIAClinical Laboratory Improvement Amendments
PPMProvider-performed microscopy
COWCertificate of Waiver&nbsp;
COACertificate of Accreditation
COCCertificate of Compliance
The 2015 ActThe Federal Civil Penalties Inflation Adjustment Improvements Act of 2015
CMPsCivil Monetary Penalties
IFRinterim final rulemaking
OMBThe Office of Management and Budget
CPI-UConsumer Price Index for All Urban Consumers
CDCCenters for Disease Control
MSDSmaterial safety data sheets
SSASocial Security Administration
CIACorporate Integrity Agreement
LEIEList of Excluded Individuals/ Entities
<div>Patient volumes have decreased in your orthopedic practice over the last year and one of your doctors approaches you about an idea that he has to increase patient visits. He suggests that the practice begin paying the local primary care physicians a fee for every patient that they refer to your practice. What law would prohibit this? </div><div><br></div> <div>A. Stark Law </div> <div>B. False Claims Act </div> <div>C. Anti-Kickback Law<br></div> D. EMTALA&nbsp;<div>C. Anti-Kickback Law</div><br>
<div>Which of the following is NOT an OSHA requirement for a Bloodborne Pathogen Exposure Control Plan? </div><div><br></div> <div>A. Vaccination policy for Hepatitis C </div> <div>B. Occupational exposure determination </div> <div>C. Communication of hazards to employees </div> D. Use of universal precautions<div>A. Vaccination policy for Hepatitis C</div><br>
<div>Which type of laboratory performs tests that require multiple and/or significant steps in preparation, processing, and interpretation? </div><div><br></div> <div>A. CLIA waived lab </div> <div>B. High-level complexity lab </div> <div>C. Moderate-level complexity lab </div> D. Simple-level lab<div>B. High-level complexity lab</div><br>
<div>Billing for tests not performed, performing unnecessary procedures, unbundling CPT codes, or submitting fake diagnosis codes to get Medicare to pay a claim are all examples of what? </div><div><br></div> <div>A. Waste </div> <div>B. Abuse </div> <div>C. Qui tam </div> D. Fraud&nbsp;D. Fraud&nbsp;
<div>What law requires that any individual that presents to the ER and requests treatment must have an appropriate medical screening and cannot be turned away? </div> <div><br></div><div>A. EMTALA </div> <div>B. Qui tam </div> <div>C. Stark Law </div> D. OIG CIA&nbsp;<div>A. EMTALA</div><br>
"Does a physician's office have to follow EMTALA regulations? Why?"No. Because EMTALA is specific to hospitals with an operating ER.
<div>As the practice manager, you have been instructed to develop and implement a compliance plan for your practice. Your first step is completing a baseline audit which examines the claim from the initial documentation to the submission. After the baseline audit, how often should audits be performed? </div><div><br></div> <div>A. Annually </div> <div>B. Every 6 months </div> <div>C. Every 2 years </div> D. Every 5 years<div>A. Annually</div><br>
<div>Under the federal False Claims Act, what statute allows a private individual with knowledge of past or present fraudulent claims to sue on behalf of the federal government to recover civil penalties and damages? </div><div><br></div> <div>A. Stark </div> <div>B. OSHA </div> <div>C. EMTALA </div> D. Qui tamD. Qui tam
<div>Many federal and state government laws and regulations aim to prevent fraud, waste, and abuse and to protect consumers and government healthcare programs. Failure to comply may result in all, EXCEPT which of the following? </div><div><br></div> <div>A. Civil penalties </div> <div>B. Criminal penalties </div> <div>C. Exclusion from all insurance programs </div> D. Exclusion from Medicare and Medicaid programs<div>C. Exclusion from all insurance programs&nbsp;</div><br>
<div>Once a practice has been identified as being non-compliant, the OIG often negotiates compliance obligations as part of the settlement of the federal healthcare program investigation. These are referred to as Corporate Integrity Agreements (CIA) and generally last up to _______year(s). </div> <div><br></div><div>A. 10 years </div> <div>B. 5 years </div> <div>C. 2 years </div> D. 1 year 10B. 5 years
<div>Risk management in the medical practice is a process of protecting the assets of the organization. The medical office must have a comprehensive risk management plan that ensures the safety of patients, staff, and visitors. Careful investigation and analysis of the risk management process helps ensure risk reduction. The four steps involved in a risk investigation include all, EXCEPT which of the following? </div><div><br></div> <div>A. Identifying your risk exposure</div> <div>B. Evaluating loss control techniques </div> <div>C. Choosing the best technique with the information you have </div> D. Continue to use same techniques for risk management for consistencyD. Continue to use same techniques for risk management for consistency
The <span class=cloze>[...]</span> prohibits anyone (a person or corporate entity) from intentionally soliciting or receiving payment directly or indirectly, to get patient referrals and/or additional business reimbursed under federal healthcare programs like Medicare and Medicaid.The <span class=cloze>federal anti-kickback law</span> prohibits anyone (a person or corporate entity) from intentionally soliciting or receiving payment directly or indirectly, to get patient referrals and/or additional business reimbursed under federal healthcare programs like Medicare and Medicaid.<br> The federal anti-kickback law prohibits anyone (a person or corporate entity) from <span class=cloze>[...]</span> soliciting or receiving payment <span class=cloze>[...]</span> or <span class=cloze>[...]</span>, to get patient <span class=cloze>[...]</span> and/or <span class=cloze>[...]</span> under federal healthcare programs like Medicare and Medicaid.The federal anti-kickback law prohibits anyone (a person or corporate entity) from <span class=cloze>intentionally</span> soliciting or receiving payment <span class=cloze>directly</span> or <span class=cloze>indirectly</span>, to get patient <span class=cloze>referrals</span> and/or <span class=cloze>additional business reimbursed</span> under federal healthcare programs like Medicare and Medicaid.<br> The <span class=cloze>[...]</span> imposes criminal penalties of up to $25,000 in fines, imprisonment up to five years, or both, for knowingly and willfully paying, soliciting, or receiving remuneration in return for referring a person for services paid by Medicare or Medicaid.&nbsp;The <span class=cloze>federal anti-kickback law</span> imposes criminal penalties of up to $25,000 in fines, imprisonment up to five years, or both, for knowingly and willfully paying, soliciting, or receiving remuneration in return for referring a person for services paid by Medicare or Medicaid.&nbsp;<br> The federal anti-kickback law imposes criminal penalties of up to <span class=cloze>[...]</span> in fines, imprisonment up to <span class=cloze>[...]</span> years, or <span class=cloze>[...]</span>, for knowingly and willfully paying, soliciting, or receiving remuneration in return for referring a person for services paid by Medicare or Medicaid.&nbsp;The federal anti-kickback law imposes criminal penalties of up to <span class=cloze>$25,000</span> in fines, imprisonment up to <span class=cloze>five</span> years, or <span class=cloze>both</span>, for knowingly and willfully paying, soliciting, or receiving remuneration in return for referring a person for services paid by Medicare or Medicaid.&nbsp;<br> According to the federal anti-kickback law, improper payments can come in many different forms, including:&nbsp;<div><span class=cloze>[...]</span> fees;&nbsp;</div><div><span class=cloze>[...]</span> fees;&nbsp;</div><div><span class=cloze>[...]</span> bonuses;&nbsp;</div><div><span class=cloze>[...]</span> leases;&nbsp;</div><div><span class=cloze>[...]</span> equipment rentals;&nbsp;</div><div><span class=cloze>[...]</span> grants;&nbsp;</div><div><span class=cloze>[...]</span> fees;&nbsp;</div><div><span class=cloze>[...]</span> compensation; and&nbsp;</div><div><span class=cloze>[...]</span> travel or entertainment.</div>"According to the federal anti-kickback law, improper payments can come in many different forms, including:&nbsp;<div><span class=cloze>referral</span> fees;&nbsp;</div><div><span class=cloze>finder's</span> fees;&nbsp;</div><div><span class=cloze>productivity</span> bonuses;&nbsp;</div><div><span class=cloze>discounted</span> leases;&nbsp;</div><div><span class=cloze>discounted</span> equipment rentals;&nbsp;</div><div><span class=cloze>research</span> grants;&nbsp;</div><div><span class=cloze>speaker's</span> fees;&nbsp;</div><div><span class=cloze>excessive</span> compensation; and&nbsp;</div><div><span class=cloze>free or discounted</span> travel or entertainment.</div><br> "
To comply with Bloodborne Pathogens Standard, a practice must have a written Bloodborne Pathogen Exposure Control Plan (ECP). The ECP identifies those <span class=cloze>[...]</span> in which hazards to occupational exposure may occur and outlines the <span class=cloze>[...]</span> the practice will use to protect <span class=cloze>[...]</span> and comply with OSHA standards.&nbsp;To comply with Bloodborne Pathogens Standard, a practice must have a written Bloodborne Pathogen Exposure Control Plan (ECP). The ECP identifies those <span class=cloze>employees</span> in which hazards to occupational exposure may occur and outlines the <span class=cloze>methods</span> the practice will use to protect <span class=cloze>them</span> and comply with OSHA standards.&nbsp;<br> To comply with Bloodborne Pathogens Standard, a practice must have a <span class=cloze>[...]</span> Bloodborne Pathogen <span class=cloze>[...]</span>. The <span class=cloze>[...]</span> identifies those employees in which hazards to occupational exposure may occur and outlines the methods the practice will use to protect them and comply with <span class=cloze>[...]</span>.&nbsp;To comply with Bloodborne Pathogens Standard, a practice must have a <span class=cloze>written</span> Bloodborne Pathogen <span class=cloze>Exposure Control Plan (ECP)</span>. The <span class=cloze>ECP</span> identifies those employees in which hazards to occupational exposure may occur and outlines the methods the practice will use to protect them and comply with <span class=cloze>OSHA standards</span>.&nbsp;<br> To comply with Bloodborne Pathogens Standard, a practice must have a written Bloodborne Pathogen Exposure Control Plan (ECP). The ECP <span class=cloze>[...]</span> those employees in which hazards to occupational exposure may occur and <span class=cloze>[...]</span> the methods the practice will use to <span class=cloze>[...]</span> them and <span class=cloze>[...]</span> with OSHA standards.&nbsp;To comply with Bloodborne Pathogens Standard, a practice must have a written Bloodborne Pathogen Exposure Control Plan (ECP). The ECP <span class=cloze>identifies</span> those employees in which hazards to occupational exposure may occur and <span class=cloze>outlines</span> the methods the practice will use to <span class=cloze>protect</span> them and <span class=cloze>comply</span> with OSHA standards.&nbsp;<br> <div>The Exposure Control Plan (ECP) must contain, at minimum, the following:</div><div><br></div> • Occupational exposure <span class=cloze>[...]</span>&nbsp;<div>• Use of <span class=cloze>[...]</span>&nbsp;</div><div>• Use of <span class=cloze>[...]</span> and <span class=cloze>[...]</span> controls&nbsp;</div><div>• Use of <span class=cloze>[...]</span> equipment&nbsp;</div><div>• Vaccination policy for <span class=cloze>[...]</span>&nbsp;</div><div>• Evaluation for use of safe <span class=cloze>[...]</span> and <span class=cloze>[...]</span></div><div>• <span class=cloze>[...]</span> evaluation and follow up&nbsp;</div><div>• Containment of <span class=cloze>[...]</span>.</div><div>• Communication of <span class=cloze>[...]</span> to <span class=cloze>[...]</span></div><div>The Exposure Control Plan (ECP) must contain, at minimum, the following:</div><div><br></div> • Occupational exposure <span class=cloze>determination</span>&nbsp;<div>• Use of <span class=cloze>universal precautions</span>&nbsp;</div><div>• Use of <span class=cloze>engineering</span> and <span class=cloze>work-practice</span> controls&nbsp;</div><div>• Use of <span class=cloze>personal protective</span> equipment&nbsp;</div><div>• Vaccination policy for <span class=cloze>Hepatitis B</span>&nbsp;</div><div>• Evaluation for use of safe <span class=cloze>needles</span> and <span class=cloze>sharps&nbsp;</span></div><div>• <span class=cloze>Post exposure</span> evaluation and follow up&nbsp;</div><div>• Containment of <span class=cloze>regulated waste</span>.</div><div>• Communication of <span class=cloze>hazards</span> to <span class=cloze>employees</span></div><br> <div>The <span class=cloze>[...]</span> must contain, at minimum, the following:</div><div><br></div> • Occupational exposure determination&nbsp;<div>• Use of universal precautions&nbsp;</div><div>• Use of engineering and work-practice controls&nbsp;</div><div>• Use of personal protective equipment&nbsp;</div><div>• Vaccination policy for Hepatitis B&nbsp;</div><div>• Evaluation for use of safe needles and sharps&nbsp;</div><div>• Post exposure evaluation and follow up&nbsp;</div><div>• Containment of regulated waste.</div><div>• Communication of hazards to employees</div><div>The <span class=cloze>Exposure Control Plan (ECP)</span> must contain, at minimum, the following:</div><div><br></div> • Occupational exposure determination&nbsp;<div>• Use of universal precautions&nbsp;</div><div>• Use of engineering and work-practice controls&nbsp;</div><div>• Use of personal protective equipment&nbsp;</div><div>• Vaccination policy for Hepatitis B&nbsp;</div><div>• Evaluation for use of safe needles and sharps&nbsp;</div><div>• Post exposure evaluation and follow up&nbsp;</div><div>• Containment of regulated waste.</div><div>• Communication of hazards to employees</div><br> A <span class=cloze>[...]</span> performs tests that require multiple and/or significant steps in preparation, processing, and interpretation. A <span class=cloze>[...]</span> requires the oversight of a <span class=cloze>[...]</span> with specific credentials to perform highly complex tests. This level of lab also must perform proficiency testing in <span class=cloze>[...]</span> to maintain lab certification.A <span class=cloze>highly complex lab</span> performs tests that require multiple and/or significant steps in preparation, processing, and interpretation. A <span class=cloze>highly complex lab</span> requires the oversight of a <span class=cloze>Lab Director</span> with specific credentials to perform highly complex tests. This level of lab also must perform proficiency testing in <span class=cloze>good standing</span> to maintain lab certification.<br> The <span class=cloze>[...]</span> prohibits any person from knowingly presenting or causing to be presented a false claim to the government.&nbsp;The <span class=cloze>False Claims Act</span> prohibits any person from knowingly presenting or causing to be presented a false claim to the government.&nbsp;<br> Under the False Claims Act a person or entity may not:<br><div>• submit a <span class=cloze>[...]</span> for payment or approval,&nbsp;</div><div>• submit a <span class=cloze>[...]</span> record or statement to get a <span class=cloze>[...]</span> paid,&nbsp;</div><div>• conspire to <span class=cloze>[...]</span> the government by getting a <span class=cloze>[...]</span> claim paid, or&nbsp;</div><div>• knowingly make a <span class=cloze>[...]</span> statement to conceal <span class=cloze>[...]</span> by the government.&nbsp;</div>Under the False Claims Act a person or entity may not:<br><div>• submit a <span class=cloze>false claim</span> for payment or approval,&nbsp;</div><div>• submit a <span class=cloze>false</span> record or statement to get a <span class=cloze>false claim</span> paid,&nbsp;</div><div>• conspire to <span class=cloze>defraud</span> the government by getting a <span class=cloze>false/ fraudulent</span> claim paid, or&nbsp;</div><div>• knowingly make a <span class=cloze>false</span> statement to conceal <span class=cloze>overpayment</span> by the government.&nbsp;</div><br> Under the False Claims Act, to avoid liability, when overpayment has been discovered, <span class=cloze>[...]</span> to remedy the overpayment. Recent health reform imposes an explicit duty on <span class=cloze>[...]</span> to return known overpayments to the government within <span class=cloze>[...]</span> days of <span class=cloze>[...]</span>.Under the False Claims Act, to avoid liability, when overpayment has been discovered, <span class=cloze>the government must be notified in a timely manner</span> to remedy the overpayment. Recent health reform imposes an explicit duty on <span class=cloze>physicians</span> to return known overpayments to the government within <span class=cloze>60</span> days of <span class=cloze>discovering an error</span>.<br> <div>Examples of fraud under the False Claims Act include:</div> <div>• Billing for tests <span class=cloze>[...]</span> </div> <div>• Performing <span class=cloze>[...]</span> procedures </div> <div>• Charging for equipment or supplies <span class=cloze>[...]</span> or <span class=cloze>[...]</span></div> <div>• Billing for <span class=cloze>[...]</span> equipment but providing <span class=cloze>[...]</span> equipment </div> <div>• Labs submitting <span class=cloze>[...]</span> diagnosis codes to get Medicare to pay the claim </div> <div>• Purposefully <span class=cloze>[...]</span> when coding guidelines do not permit it </div> <div>• <span class=cloze>[...]</span> billing or charging <span class=cloze>[...]</span> for the <span class=cloze>[...]</span> service </div> <div>• <span class=cloze>[...]</span> by submitting CPT or diagnosis codes that report services or conditions were <span class=cloze>[...]</span> than they actually were </div> <div>• <span class=cloze>[...]</span> waiving <span class=cloze>[...]</span>&nbsp;</div>"<div>Examples of fraud under the False Claims Act include:</div> <div>• Billing for tests <span class=cloze>not performed</span> </div> <div>• Performing <span class=cloze>unnecessary</span> procedures </div> <div>• Charging for equipment or supplies <span class=cloze>never ordered</span> or <span class=cloze>used</span></div> <div>• Billing for <span class=cloze>expensive</span> equipment but providing <span class=cloze>cheap</span> equipment </div> <div>• Labs submitting <span class=cloze>fake</span> diagnosis codes to get Medicare to pay the claim </div> <div>• Purposefully <span class=cloze>""unbundling"" CPT codes</span> when coding guidelines do not permit it </div> <div>• <span class=cloze>Double</span> billing or charging <span class=cloze>more than once</span> for the <span class=cloze>same</span> service </div> <div>• <span class=cloze>Upcoding</span> by submitting CPT or diagnosis codes that report services or conditions were <span class=cloze>more serious</span> than they actually were </div> <div>• <span class=cloze>Routinely</span> waiving <span class=cloze>co-payments</span>&nbsp;</div><br> "
"<div>Examples of fraud under the <span class=cloze>[...]</span> include:</div> <div>• Billing for tests not performed </div> <div>• Performing unnecessary procedures </div> <div>• Charging for equipment or supplies never ordered or used</div> <div>• Billing for expensive equipment but providing cheap equipment </div> <div>• Labs submitting fake diagnosis codes to get Medicare to pay the claim </div> <div>• Purposefully ""unbundling"" CPT codes when coding guidelines do not permit it </div> <div>• Double billing or charging more than once for the same service </div> <div>• Upcoding by submitting CPT or diagnosis codes that report services or conditions were more serious than they actually were </div> <div>• Routinely waiving co-payments&nbsp;</div>""<div>Examples of fraud under the <span class=cloze>False Claims Act</span> include:</div> <div>• Billing for tests not performed </div> <div>• Performing unnecessary procedures </div> <div>• Charging for equipment or supplies never ordered or used</div> <div>• Billing for expensive equipment but providing cheap equipment </div> <div>• Labs submitting fake diagnosis codes to get Medicare to pay the claim </div> <div>• Purposefully ""unbundling"" CPT codes when coding guidelines do not permit it </div> <div>• Double billing or charging more than once for the same service </div> <div>• Upcoding by submitting CPT or diagnosis codes that report services or conditions were more serious than they actually were </div> <div>• Routinely waiving co-payments&nbsp;</div><br> "
"The federal <span class=cloze>[...]</span>, commonly known as the ""anti- dumping statute,"" applies to any hospital with an operating emergency room (ER) participating in a federal health program (like Medicare or Medicaid).&nbsp;""The federal <span class=cloze>Emergency Medical Treatment and Active Labor Act (EMTALA)</span>, commonly known as the ""anti- dumping statute,"" applies to any hospital with an operating emergency room (ER) participating in a federal health program (like Medicare or Medicaid).&nbsp;<br> "
"The federal Emergency Medical Treatment and Active Labor Act (EMTALA), commonly known as the ""<span class=cloze>[...]</span>,"" applies to any hospital with an <span class=cloze>[...]</span> participating in a federal health program (like Medicare or Medicaid).&nbsp;""The federal Emergency Medical Treatment and Active Labor Act (EMTALA), commonly known as the ""<span class=cloze>anti- dumping statute</span>,"" applies to any hospital with an <span class=cloze>operating emergency room (ER)</span> participating in a federal health program (like Medicare or Medicaid).&nbsp;<br> "
"Under EMTALA, if any individual comes to the ER and requests treatment, the hospital must perform an appropriate <span class=cloze>[...]</span> without <span class=cloze>[...]</span> to determine whether the patient has an <span class=cloze>[...]</span>.&nbsp;<div>If the patient is found to have an <span class=cloze>[...]</span>, the hospital must <span class=cloze>[...]</span> the patient. This screening and treatment must be provided by the hospital regardless of the patient's <span class=cloze>[...]</span> or <span class=cloze>[...]</span>.&nbsp;</div>""Under EMTALA, if any individual comes to the ER and requests treatment, the hospital must perform an appropriate <span class=cloze>medical screening</span> without <span class=cloze>delay</span> to determine whether the patient has an <span class=cloze>emergency medical condition</span>.&nbsp;<div>If the patient is found to have an <span class=cloze>emergent medical condition</span>, the hospital must <span class=cloze>stabilize</span> the patient. This screening and treatment must be provided by the hospital regardless of the patient's <span class=cloze>insurance status</span> or <span class=cloze>ability to pay for the service</span>.&nbsp;</div><br> "
"Under <span class=cloze>[...]</span>, if any individual comes to the ER and requests treatment, the hospital must perform an appropriate medical screening without delay to determine whether the patient has an emergency medical condition.&nbsp;<div>If the patient is found to have an emergent medical condition, the hospital must stabilize the patient. This screening and treatment must be provided by the hospital regardless of the patient's insurance status or ability to pay for the service.&nbsp;</div>""Under <span class=cloze>EMTALA</span>, if any individual comes to the ER and requests treatment, the hospital must perform an appropriate medical screening without delay to determine whether the patient has an emergency medical condition.&nbsp;<div>If the patient is found to have an emergent medical condition, the hospital must stabilize the patient. This screening and treatment must be provided by the hospital regardless of the patient's insurance status or ability to pay for the service.&nbsp;</div><br> "
A successful compliance plan must <span class=cloze>[...]</span> improve compliance. Initially, determine what <span class=cloze>[...]</span> and <span class=cloze>[...]</span> apply to the practice. The <span class=cloze>[...]</span> recommends a <span class=cloze>[...]</span> as a benchmark. A <span class=cloze>[...]</span> examines the claim from the <span class=cloze>[...]</span> to the <span class=cloze>[...]</span>. Following the <span class=cloze>[...]</span>, conduct <span class=cloze>[...]</span> audits to determine compliance issues that need to be addressed. If areas of concern are discovered during the <span class=cloze>[...]</span> or <span class=cloze>[...]</span> audits, a more <span class=cloze>[...]</span> audit should be conducted and <span class=cloze>[...]</span> provided.A successful compliance plan must <span class=cloze>demonstrably</span> improve compliance. Initially, determine what <span class=cloze>standards</span> and <span class=cloze>procedures</span> apply to the practice. The <span class=cloze>OIG</span> recommends a <span class=cloze>baseline audit</span> as a benchmark. A <span class=cloze>baseline audit</span> examines the claim from the <span class=cloze>initial documentation</span> to the <span class=cloze>submission</span>. Following the <span class=cloze>baseline audit</span>, conduct <span class=cloze>annual</span> audits to determine compliance issues that need to be addressed. If areas of concern are discovered during the <span class=cloze>baseline</span> or <span class=cloze>annual</span> audits, a more <span class=cloze>focused</span> audit should be conducted and <span class=cloze>training</span> provided.<br> "Under the federal False Claims Act, the ""<span class=cloze>[...]</span>,"" allows a private individual or ""whistle blower"" with knowledge of past or present fraudulent claims to the federal government to sue on behalf of the government to recover civil penalties and damages.&nbsp;""Under the federal False Claims Act, the ""<span class=cloze>qui tam statute</span>,"" allows a private individual or ""whistle blower"" with knowledge of past or present fraudulent claims to the federal government to sue on behalf of the government to recover civil penalties and damages.&nbsp;<br> "
"Under the <span class=cloze>[...]</span>, the ""qui tam statute,"" allows a <span class=cloze>[...]</span> or ""<span class=cloze>[...]</span>"" with knowledge of <span class=cloze>[...]</span> or <span class=cloze>[...]</span> fraudulent claims to the federal government to <span class=cloze>[...]</span> on behalf of the government to recover civil <span class=cloze>[...]</span> and <span class=cloze>[...]</span>.&nbsp;""Under the <span class=cloze>federal False Claims Act</span>, the ""qui tam statute,"" allows a <span class=cloze>private individual</span> or ""<span class=cloze>whistle blower</span>"" with knowledge of <span class=cloze>past</span> or <span class=cloze>present</span> fraudulent claims to the federal government to <span class=cloze>sue</span> on behalf of the government to recover civil <span class=cloze>penalties</span> and <span class=cloze>damages</span>.&nbsp;<br> "
"An example of the ""<span class=cloze>[...]</span>""&nbsp;would be a nurse in a clinic becoming aware of fraudulent billing being performed and then filing a suit against the physician or physicians submitting fraudulent claims.""An example of the ""<span class=cloze>qui tam statute</span>""&nbsp;would be a nurse in a clinic becoming aware of fraudulent billing being performed and then filing a suit against the physician or physicians submitting fraudulent claims.<br> "
"Under the federal False Claims Act - the ""qui tam statute,"" if the whistleblower's suit is successful, he or she may receive from <span class=cloze>[...]</span> percent of the government's total recovery.&nbsp;<div>The whistleblower is provided with protection against <span class=cloze>[...]</span>. If <span class=cloze>[...]</span> occurs, the person may be awarded ""all relief necessary to make the employee whole,"" including reinstatement, back pay, two times the amount of back pay, litigation costs, and attorney fees.</div>""Under the federal False Claims Act - the ""qui tam statute,"" if the whistleblower's suit is successful, he or she may receive from <span class=cloze>15-30</span> percent of the government's total recovery.&nbsp;<div>The whistleblower is provided with protection against <span class=cloze>retaliation</span>. If <span class=cloze>retaliation</span> occurs, the person may be awarded ""all relief necessary to make the employee whole,"" including reinstatement, back pay, two times the amount of back pay, litigation costs, and attorney fees.</div><br> "
"Under the federal False Claims Act - the ""<span class=cloze>[...]</span>,"" if the whistleblower's suit is successful, he or she may receive from 15-30 percent of the government's total recovery.&nbsp;<div>The whistleblower is provided with protection against retaliation. If retaliation occurs, the person may be awarded ""all relief necessary to make the employee whole,"" including reinstatement, back pay, two times the amount of back pay, litigation costs, and attorney fees.</div>""Under the federal False Claims Act - the ""<span class=cloze>qui tam statute</span>,"" if the whistleblower's suit is successful, he or she may receive from 15-30 percent of the government's total recovery.&nbsp;<div>The whistleblower is provided with protection against retaliation. If retaliation occurs, the person may be awarded ""all relief necessary to make the employee whole,"" including reinstatement, back pay, two times the amount of back pay, litigation costs, and attorney fees.</div><br> "
Many federal and state government laws and regulations aim to prevent fraud, waste, and abuse, and to protect consumers and government healthcare programs. Failure to comply may result in <span class=cloze>[...]</span> and <span class=cloze>[...]</span> liability of both the company and the individual acting in noncompliance. If an offense is found in the case of Medicare, the CMS may <span class=cloze>[...]</span> for every <span class=cloze>[...]</span> that a facility ever <span class=cloze>[...]</span> for <span class=cloze>[...]</span> determined by Medicare to be <span class=cloze>[...]</span>. If Medicare published a rule, you cannot plead that <span class=cloze>[...]</span>. The <span class=cloze>[...]</span> may also exclude a provider from Medicare or Medicaid.Many federal and state government laws and regulations aim to prevent fraud, waste, and abuse, and to protect consumers and government healthcare programs. Failure to comply may result in <span class=cloze>civil</span> and <span class=cloze>criminal</span> liability of both the company and the individual acting in noncompliance. If an offense is found in the case of Medicare, the CMS may <span class=cloze>take back monies</span> for every <span class=cloze>code</span> that a facility ever <span class=cloze>billed</span> for <span class=cloze>a period of years</span> determined by Medicare to be <span class=cloze>misrepresented</span>. If Medicare published a rule, you cannot plead that <span class=cloze>you did not know</span>. The <span class=cloze>Office of Inspector General (OIG)</span> may also exclude a provider from Medicare or Medicaid.<br> "The <span class=cloze>[...]</span> often negotiates compliance obligations with healthcare providers and other entities as part of the settlement of federal healthcare program investigations arising under a variety of civil false claims statutes.&nbsp;<div><br></div><div>The imposition of a <span class=cloze>[...]</span> from the <span class=cloze>[...]</span> on any provider participating in one of the federal healthcare programs creates significant risk and compliance overhead.&nbsp;</div><div><br></div><div><span class=cloze>[...]</span> generally last for five years and include specific compliance stipulations that must be enacted within specified time frames (often as short as 90 days). These stipulations frequently include verifiable code of conduct attestations and training certifications from all ""covered persons"" (employees and all contractors and vendors), as well as verifiable distribution of relevant policies and procedures to all appropriate covered persons.&nbsp;</div><div><br></div><div><span class=cloze>[...]</span> may mandate specific claims review and audit criteria, reporting of the findings, and the establishment of processes for managing and reporting on ""reportable events"" that might be criminal or fraudulent in nature.</div>""The <span class=cloze>Office of Inspector General (OIG)</span> often negotiates compliance obligations with healthcare providers and other entities as part of the settlement of federal healthcare program investigations arising under a variety of civil false claims statutes.&nbsp;<div><br></div><div>The imposition of a <span class=cloze>Corporate Integrity Agreement (CIA)</span> from the <span class=cloze>OIG</span> on any provider participating in one of the federal healthcare programs creates significant risk and compliance overhead.&nbsp;</div><div><br></div><div><span class=cloze>CIAs</span> generally last for five years and include specific compliance stipulations that must be enacted within specified time frames (often as short as 90 days). These stipulations frequently include verifiable code of conduct attestations and training certifications from all ""covered persons"" (employees and all contractors and vendors), as well as verifiable distribution of relevant policies and procedures to all appropriate covered persons.&nbsp;</div><div><br></div><div><span class=cloze>CIAs</span> may mandate specific claims review and audit criteria, reporting of the findings, and the establishment of processes for managing and reporting on ""reportable events"" that might be criminal or fraudulent in nature.</div><br> "
"The Office of Inspector General (OIG) often negotiates <span class=cloze>[...]</span> with healthcare providers and other entities as part of the <span class=cloze>[...]</span> of federal healthcare program <span class=cloze>[...]</span> arising under a variety of civil false claims statutes.&nbsp;<div><br></div><div>The imposition of a Corporate Integrity Agreement (CIA) from the OIG on any provider participating in one of the federal healthcare programs creates significant risk and compliance <span class=cloze>[...]</span>.&nbsp;</div><div><br></div><div>CIAs generally last for <span class=cloze>[...]</span> years and include specific <span class=cloze>[...]</span> that must be enacted within specified time frames (often as short as <span class=cloze>[...]</span> days). These <span class=cloze>[...]</span> frequently include verifiable code of conduct <span class=cloze>[...]</span> and training <span class=cloze>[...]</span> from all ""covered persons"" (employees and all contractors and vendors), as well as verifiable distribution of relevant <span class=cloze>[...]</span> and <span class=cloze>[...]</span> to all appropriate covered persons.&nbsp;</div><div><br></div><div>CIAs may mandate specific claims <span class=cloze>[...]</span> and <span class=cloze>[...]</span>, reporting of the <span class=cloze>[...]</span>, and the establishment of processes for managing and reporting on ""<span class=cloze>[...]</span>"" that might be <span class=cloze>[...]</span> or <span class=cloze>[...]</span> in nature.</div>""The Office of Inspector General (OIG) often negotiates <span class=cloze>compliance obligations</span> with healthcare providers and other entities as part of the <span class=cloze>settlement</span> of federal healthcare program <span class=cloze>investigations</span> arising under a variety of civil false claims statutes.&nbsp;<div><br></div><div>The imposition of a Corporate Integrity Agreement (CIA) from the OIG on any provider participating in one of the federal healthcare programs creates significant risk and compliance <span class=cloze>overhead</span>.&nbsp;</div><div><br></div><div>CIAs generally last for <span class=cloze>five</span> years and include specific <span class=cloze>compliance stipulations</span> that must be enacted within specified time frames (often as short as <span class=cloze>90</span> days). These <span class=cloze>stipulations</span> frequently include verifiable code of conduct <span class=cloze>attestations</span> and training <span class=cloze>certifications</span> from all ""covered persons"" (employees and all contractors and vendors), as well as verifiable distribution of relevant <span class=cloze>policies</span> and <span class=cloze>procedures</span> to all appropriate covered persons.&nbsp;</div><div><br></div><div>CIAs may mandate specific claims <span class=cloze>review</span> and <span class=cloze>audit criteria</span>, reporting of the <span class=cloze>findings</span>, and the establishment of processes for managing and reporting on ""<span class=cloze>reportable events</span>"" that might be <span class=cloze>criminal</span> or <span class=cloze>fraudulent</span> in nature.</div><br> "
<div>Careful investigation and analysis of the risk management process helps ensure risk reduction.&nbsp;</div><div><br></div><div>The four steps involved in a risk investigation include: </div> <div>• Identifying your <span class=cloze>[...]</span>; </div> <div>• Evaluating <span class=cloze>[...]</span>; </div> <div>• Choosing the best <span class=cloze>[...]</span> with the <span class=cloze>[...]</span>; </div> <div>• Monitoring, improving, and refining the <span class=cloze>[...]</span> for risk management programs.</div><div>Careful investigation and analysis of the risk management process helps ensure risk reduction.&nbsp;</div><div><br></div><div>The four steps involved in a risk investigation include: </div> <div>• Identifying your <span class=cloze>risk exposure</span>; </div> <div>• Evaluating <span class=cloze>loss control techniques</span>; </div> <div>• Choosing the best <span class=cloze>technique</span> with the <span class=cloze>information you have</span>; </div> <div>• Monitoring, improving, and refining the <span class=cloze>techniques</span> for risk management programs.</div><br> <div>Careful investigation and analysis of the risk management process helps ensure risk reduction.&nbsp;</div><div><br></div><div>The four steps involved in a risk investigation include: </div> <div>• <span class=cloze>[...]</span> your risk exposure; </div> <div>• <span class=cloze>[...]</span> loss control techniques; </div> <div>• <span class=cloze>[...]</span> the best technique with the information you have; </div> <div>• <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, and <span class=cloze>[...]</span> the techniques for risk management programs.</div><div>Careful investigation and analysis of the risk management process helps ensure risk reduction.&nbsp;</div><div><br></div><div>The four steps involved in a risk investigation include: </div> <div>• <span class=cloze>Identifying</span> your risk exposure; </div> <div>• <span class=cloze>Evaluating</span> loss control techniques; </div> <div>• <span class=cloze>Choosing</span> the best technique with the information you have; </div> <div>• <span class=cloze>Monitoring</span>, <span class=cloze>improving</span>, and <span class=cloze>refining</span> the techniques for risk management programs.</div><br> <div>Which of these is NOT an advantage of leasing equipment for a medical clinic? </div> <div>A. Leasing equipment allows a clinic to acquire equipment with little up-front expenditure. </div> <div>B. You can deduct lease payments as a tax expense. </div> <div>C. At the end of the lease, the equipment returns to the lessor with no value to you.</div><div>D. At the end of the lease, you are able to lease newer equipment.&nbsp;<br></div><div><br></div>C. At the end of the lease, the equipment returns to the lessor with no value to you.
<div>Which of the following choices describes the two primary accounting methods? </div> <div>A. Income statement and balance sheet </div> <div>B. Cash based accounting and accrual based </div> <div>C. Activity Based Costing (ABC) and accrual based </div> D. None of the above<div>B. Cash based accounting and accrual based</div><br>
<div>What type of corporate structure is the most formal and may offer stock with or without voting rights to as many shareholders as desired? </div> <div>A. Sole Proprietorship </div> <div>B. S Corporation </div> <div>C. C Corporation </div> D. Limited Liability CorporationC. C Corporation
"<img src=""paste-57c73b6e43829b4b0629827c485ceab6f2ae5162.jpg"">"D. 3556
<div>Which type of accounting method is useful for performance improvement efforts and defines costs by processes or activities? </div> <div>A. Accounting by category </div> <div>B. Activity based costing </div> <div>C. Accounting by charting </div> D. None of the above&nbsp;<div>B. Activity based costing</div><br>
<div>What is one way to protect the business against amateur counterfeiting? </div> <div>A. Use checks with void pantographs. </div> <div>B. Have the same person write the checks that balances the checking account. </div> <div>C. Have a return receipt sent for all checks sent through the postal service. </div> D. There are no measures that can be taken to reduce amateur counterfeiting.&nbsp;<div>A. Use checks with void pantographs.</div><br>
<div>Which of the following is a listing of all potential accounts for which financial information will be gathered in the general ledger? </div> <div>A. Balance Sheet </div> <div>B. Chart of Accounts </div> <div>C. Income Statement </div> D. Facility Expense Report&nbsp;<div>B. Chart of Accounts</div><br>
<div>When a practice is trying to reduce expenses, what is one of the best options to implement? </div> <div>A. Cut the number of employees and make others absorb the extra work </div> <div>B. Reduce salaries immediately </div> <div>C. Include the staff and brainstorm to come up with ideas to reduce expenses </div> D. Begin using cheaper, generic suppliesC. Include the staff and brainstorm to come up with ideas to reduce expenses
<div>The accrual method of accounting records revenues when they are earned and expenses when they have been incurred. Why would this be beneficial? </div> <div>A. This method more accurately reflects your financial position. </div> <div>B. This method more accurately reflects your financial position and produces more accurate financial statements. </div> <div>C. This method produces more accurate financial statements and projects your balance over a longer period of time. </div> D. This method more accurately reflects your financial position, produces more accurate financial statements, and projects your balance over a longer period of time.B. This method more accurately reflects your financial position and produces more accurate financial statements.
<div>Effective use of a budget enables a manager to do which of the following? </div> <div>A. Maintain focus on goals for the clinic and what it will take to get there, assess the productivity of the practice by comparing budgeted goals to results, and make timely changes to operations to keep track for yearly goals. </div> <div>B. Assess the productivity of the practice by comparing budgeted goals to results, foster accountability in department managers, and manage growth opportunities while sustaining the current business. </div> <div>C. Maintain focus on goals for the clinic and what it will take to get there, make timely changes to operations to keep track for yearly goals, and manage growth opportunities while sustaining the current business. </div> D. Maintain focus on goals for the clinic and what it will take to get there, assess the productivity of the practice by comparing budgeted goals to results, Foster accountability in department managers, Analyze variances in production or costs of running the practice, Make timely changes to operations to keep track for yearly goals, and Manage growth opportunities while sustaining the current business.D. Maintain focus on goals for the clinic and what it will take to get there, assess the productivity of the practice by comparing budgeted goals to results, Foster accountability in department managers, Analyze variances in production or costs of running the practice, Make timely changes to operations to keep track for yearly goals, and Manage growth opportunities while sustaining the current business.
Advantages - Leasing equipment<br><ul><li>Allows a clinic to acquire equipment with <span class=cloze>[...]</span> up-front expenditure, which is helpful if the cash flow or credit is <span class=cloze>[...]</span>.&nbsp;</li><li>Generally, you can deduct lease payments as a <span class=cloze>[...]</span>.&nbsp;</li><li>Also, the burden of the <span class=cloze>[...]</span> item falls to the lessor, and you are free to lease <span class=cloze>[...]</span> equipment.&nbsp;</li></ul>Advantages - Leasing equipment<br><ul><li>Allows a clinic to acquire equipment with <span class=cloze>little</span> up-front expenditure, which is helpful if the cash flow or credit is <span class=cloze>weak</span>.&nbsp;</li><li>Generally, you can deduct lease payments as a <span class=cloze>tax expense</span>.&nbsp;</li><li>Also, the burden of the <span class=cloze>devalued</span> item falls to the lessor, and you are free to lease <span class=cloze>newer, up-to-date</span> equipment.&nbsp;</li></ul><br> Disadvantages - Leasing equipment<br><ul><li>Because you do not own leased equipment, you will build no <span class=cloze>[...]</span>. At the end of the lease the equipment returns to the lessor with <span class=cloze>[...]</span> to you.&nbsp;</li><li>Leasing usually is <span class=cloze>[...]</span>, overall, and you may be <span class=cloze>[...]</span> to the lease even if you decide to not use the equipment.</li></ul>Disadvantages - Leasing equipment<br><ul><li>Because you do not own leased equipment, you will build no <span class=cloze>equity</span>. At the end of the lease the equipment returns to the lessor with <span class=cloze>no value</span> to you.&nbsp;</li><li>Leasing usually is <span class=cloze>more expensive</span>, overall, and you may be <span class=cloze>tied</span> to the lease even if you decide to not use the equipment.</li></ul><br> The two primary accounting methods for financial management and reporting are the <span class=cloze>[...]</span> method and the <span class=cloze>[...]</span> methodThe two primary accounting methods for financial management and reporting are the <span class=cloze>cash-based</span> method and the <span class=cloze>accrual-based</span> method<br> The two primary <span class=cloze>[...]</span> for financial <span class=cloze>[...]</span> are the cash-based method and the accrual-based methodThe two primary <span class=cloze>accounting methods</span> for financial <span class=cloze>management and reporting</span> are the cash-based method and the accrual-based method<br> <div>Smaller practices widely use <span class=cloze>[...]</span> accounting because it is the simpler of the <span class=cloze>[...]</span> accounting methods. <br><br><span class=cloze>[...]</span> accounting recognizes revenues only when <span class=cloze>[...]</span> (or check or credit card) is <span class=cloze>[...]</span> and recognizes expenses only when <span class=cloze>[...]</span> (or check or credit card) is <span class=cloze>[...]</span>. <br><br>Revenue is not recorded in the accounting system until <span class=cloze>[...]</span> is <span class=cloze>[...]</span>, which could be months after the service was provided; and, <br>Expenses are not recorded until <span class=cloze>[...]</span> is <span class=cloze>[...]</span>.&nbsp;</div><div>Smaller practices widely use <span class=cloze>cash-based</span> accounting because it is the simpler of the <span class=cloze>two</span> accounting methods. <br><br><span class=cloze>Cash based</span> accounting recognizes revenues only when <span class=cloze>cash</span> (or check or credit card) is <span class=cloze>collected</span> and recognizes expenses only when <span class=cloze>cash</span> (or check or credit card) is <span class=cloze>paid</span>. <br><br>Revenue is not recorded in the accounting system until <span class=cloze>money</span> is <span class=cloze>received</span>, which could be months after the service was provided; and, <br>Expenses are not recorded until <span class=cloze>money</span> is <span class=cloze>paid</span>.&nbsp;</div><br> <div>Smaller practices widely use cash-based accounting because it is the simpler of the two accounting methods. <br><br>Cash based accounting recognizes <span class=cloze>[...]</span> only when cash (or check or credit card) is collected and recognizes <span class=cloze>[...]</span> only when cash (or check or credit card) is paid. <br><br><span class=cloze>[...]</span> is not recorded in the accounting system until money is received, which could be <span class=cloze>[...]</span> after the service was provided; and, <br><span class=cloze>[...]</span> are not recorded until money is paid.&nbsp;</div><div>Smaller practices widely use cash-based accounting because it is the simpler of the two accounting methods. <br><br>Cash based accounting recognizes <span class=cloze>revenues</span> only when cash (or check or credit card) is collected and recognizes <span class=cloze>expenses</span> only when cash (or check or credit card) is paid. <br><br><span class=cloze>Revenue</span> is not recorded in the accounting system until money is received, which could be <span class=cloze>months</span> after the service was provided; and, <br><span class=cloze>Expenses</span> are not recorded until money is paid.&nbsp;</div><br> The <span class=cloze>[...]</span> method of accounting records <span class=cloze>[...]</span> when they are earned and <span class=cloze>[...]</span> when they have been incurred. <br><br>In other words, <span class=cloze>[...]</span> are recorded on the books when billed to patients, insurance companies, and other third-party payers.<br><br><span class=cloze>[...]</span> are recorded when incurred and there is an obligation to pay. <br><br>This method more accurately reflects your financial position.&nbsp;The <span class=cloze>accrual</span> method of accounting records <span class=cloze>revenues</span> when they are earned and <span class=cloze>expenses</span> when they have been incurred. <br><br>In other words, <span class=cloze>revenues</span> are recorded on the books when billed to patients, insurance companies, and other third-party payers.<br><br><span class=cloze>Expenses</span> are recorded when incurred and there is an obligation to pay. <br><br>This method more accurately reflects your financial position.&nbsp;<br> The accrual method of accounting records revenues when they are <span class=cloze>[...]</span> and expenses when they have been <span class=cloze>[...]</span>. <br><br>In other words, revenues are recorded on the books when <span class=cloze>[...]</span> to patients, insurance companies, and other third-party payers.<br><br>Expenses are recorded when <span class=cloze>[...]</span> and there is an <span class=cloze>[...]</span> to pay. <br><br>This method more accurately reflects your <span class=cloze>[...]</span>.&nbsp;The accrual method of accounting records revenues when they are <span class=cloze>earned</span> and expenses when they have been <span class=cloze>incurred</span>. <br><br>In other words, revenues are recorded on the books when <span class=cloze>billed</span> to patients, insurance companies, and other third-party payers.<br><br>Expenses are recorded when <span class=cloze>incurred</span> and there is an <span class=cloze>obligation</span> to pay. <br><br>This method more accurately reflects your <span class=cloze>financial position</span>.&nbsp;<br> Under the accrual method, if you see a patient on November 15 and provide immunizations paid for on October 30, your financial report will show <span class=cloze>[...]</span> for <span class=cloze>[...]</span>.<br><br>Under the cash method, your immunization <span class=cloze>[...]</span> would be accounted for in <span class=cloze>[...]</span> (when you paid for it), and it is likely your <span class=cloze>[...]</span> will not show until <span class=cloze>[...]</span>.Under the accrual method, if you see a patient on November 15 and provide immunizations paid for on October 30, your financial report will show <span class=cloze>both revenue and expenses</span> for <span class=cloze>November</span>.<br><br>Under the cash method, your immunization <span class=cloze>expense</span> would be accounted for in <span class=cloze>October</span> (when you paid for it), and it is likely your <span class=cloze>revenue</span> will not show until <span class=cloze>payment is received from the payer</span>.<br> Under the <span class=cloze>[...]</span> method, if you see a patient on November 15 and provide immunizations paid for on October 30, your financial report will show both revenue and expenses for November.<br><br>Under the <span class=cloze>[...]</span> method, your immunization expense would be accounted for in October (when you paid for it), and it is likely your revenue will not show until payment is received from the payer.Under the <span class=cloze>accrual</span> method, if you see a patient on November 15 and provide immunizations paid for on October 30, your financial report will show both revenue and expenses for November.<br><br>Under the <span class=cloze>cash</span> method, your immunization expense would be accounted for in October (when you paid for it), and it is likely your revenue will not show until payment is received from the payer.<br> <span class=cloze>[...]</span> are the most formal business corporations and may offer stock with or without voting rights to as many shareholders as desired. This structure works well for an entity interested in providing ownership of the business to physicians as they join the practice. <br><br>The downside is that <span class=cloze>[...]</span> are taxed on net income both at the federal and state level.&nbsp;<span class=cloze>C corporations</span> are the most formal business corporations and may offer stock with or without voting rights to as many shareholders as desired. This structure works well for an entity interested in providing ownership of the business to physicians as they join the practice. <br><br>The downside is that <span class=cloze>C corporations</span> are taxed on net income both at the federal and state level.&nbsp;<br> C corporations are the most formal business corporations and may offer stock <span class=cloze>[...]</span> voting rights to <span class=cloze>[...]</span>. This structure works well for an entity interested in providing <span class=cloze>[...]</span> of the business to physicians as they join the practice. <br><br>The downside is that C corporations are taxed on <span class=cloze>[...]</span> income <span class=cloze>[...]</span> level.&nbsp;C corporations are the most formal business corporations and may offer stock <span class=cloze>with or without</span> voting rights to <span class=cloze>as many shareholders as desired</span>. This structure works well for an entity interested in providing <span class=cloze>ownership</span> of the business to physicians as they join the practice. <br><br>The downside is that C corporations are taxed on <span class=cloze>net</span> income <span class=cloze>both at the federal and state</span> level.&nbsp;<br> "S corporations are similar to C corporations&nbsp;in that they can issue stock <span class=cloze>[...]</span> in the number of shareholders. <br><br>All <span class=cloze>[...]</span> (after salaries to the physicians) must be distributed in proportion to ownership percentage. <br><br>A major benefit of an S corporation is that net income <span class=cloze>[...]</span> at the entity level but flows through the physician's personal income tax return.&nbsp;""S corporations are similar to C corporations&nbsp;in that they can issue stock <span class=cloze>but are limited</span> in the number of shareholders. <br><br>All <span class=cloze>profit</span> (after salaries to the physicians) must be distributed in proportion to ownership percentage. <br><br>A major benefit of an S corporation is that net income <span class=cloze>is not taxed</span> at the entity level but flows through the physician's personal income tax return.&nbsp;<br> "
"<span class=cloze>[...]</span> are similar to <span class=cloze>[...]</span>&nbsp;in that they can issue stock but are limited in the number of shareholders. <br><br>All profit (after salaries to the physicians) must be distributed in proportion to <span class=cloze>[...]</span>. <br><br>A major benefit of an <span class=cloze>[...]</span> is that net income is not taxed at the entity level but flows through the physician's <span class=cloze>[...]</span> income tax return.&nbsp;""<span class=cloze>S corporations</span> are similar to <span class=cloze>C corporations</span>&nbsp;in that they can issue stock but are limited in the number of shareholders. <br><br>All profit (after salaries to the physicians) must be distributed in proportion to <span class=cloze>ownership percentage</span>. <br><br>A major benefit of an <span class=cloze>S corporation</span> is that net income is not taxed at the entity level but flows through the physician's <span class=cloze>personal</span> income tax return.&nbsp;<br> "
"<div>With sole proprietorships, the physician/owner and the practice are treated as a <span class=cloze>[...]</span> entity, for <span class=cloze>[...]</span> purposes. The practice's profits are reported on the Schedule C of the physician's personal 1040 Form. This type of structure provides virtually <span class=cloze>[...]</span> for the physician.&nbsp;</div>""<div>With sole proprietorships, the physician/owner and the practice are treated as a <span class=cloze>single</span> entity, for <span class=cloze>tax</span> purposes. The practice's profits are reported on the Schedule C of the physician's personal 1040 Form. This type of structure provides virtually <span class=cloze>no liability protection</span> for the physician.&nbsp;</div><br> "
"<div>With <span class=cloze>[...]</span>, the physician/owner and the practice are treated as a single entity, for tax purposes. The practice's profits are reported on the Schedule C of the physician's personal 1040 Form. This type of structure provides virtually no liability protection for the physician.&nbsp;</div>""<div>With <span class=cloze>sole proprietorships</span>, the physician/owner and the practice are treated as a single entity, for tax purposes. The practice's profits are reported on the Schedule C of the physician's personal 1040 Form. This type of structure provides virtually no liability protection for the physician.&nbsp;</div><br> "
"<table> <tbody><tr> <td> <div>&nbsp;</div> </td> <td> <div>Fixed cost + Annual unit (equipment) cost</div> </td> </tr> <tr> <td> <div><span class=cloze>[...]</span></span><span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);"">&nbsp;&nbsp;=</span></div> </td> <td> <div>__________________________________ </div> </td> </tr> <tr> <td> <div>&nbsp;</div> </td> <td> <div>&nbsp;</div> <div>Revenue per unit – Variable cost per unit</div> </td> </tr></tbody></table>""<table> <tbody><tr> <td> <div>&nbsp;</div> </td> <td> <div>Fixed cost + Annual unit (equipment) cost</div> </td> </tr> <tr> <td> <div><span class=cloze>Annual Break-even in units<span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);""></span></span><span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);"">&nbsp;&nbsp;=</span></div> </td> <td> <div>__________________________________ </div> </td> </tr> <tr> <td> <div>&nbsp;</div> </td> <td> <div>&nbsp;</div> <div>Revenue per unit – Variable cost per unit</div> </td> </tr></tbody></table><br> "
"<table> <tbody><tr> <td> <div>&nbsp;</div> </td> <td> <div><span class=cloze>[...]</span> + <span class=cloze>[...]</span></div> </td> </tr> <tr> <td> <div>Annual Break-even in units<span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);""></span><span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);"">&nbsp;&nbsp;=</span></div> </td> <td> <div>__________________________________ </div> </td> </tr> <tr> <td> <div>&nbsp;</div> </td> <td> <div>&nbsp;</div> <div>Revenue per unit – Variable cost per unit</div> </td> </tr></tbody></table>""<table> <tbody><tr> <td> <div>&nbsp;</div> </td> <td> <div><span class=cloze>Fixed cost</span> + <span class=cloze>Annual unit (equipment) cost</span></div> </td> </tr> <tr> <td> <div>Annual Break-even in units<span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);""></span><span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);"">&nbsp;&nbsp;=</span></div> </td> <td> <div>__________________________________ </div> </td> </tr> <tr> <td> <div>&nbsp;</div> </td> <td> <div>&nbsp;</div> <div>Revenue per unit – Variable cost per unit</div> </td> </tr></tbody></table><br> "
"<table> <tbody><tr> <td> <div>&nbsp;</div> </td> <td> <div>Fixed cost + Annual unit (equipment) cost</div> </td> </tr> <tr> <td> <div>Annual Break-even in units<span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);""></span><span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);"">&nbsp;&nbsp;=</span></div> </td> <td> <div>__________________________________ </div> </td> </tr> <tr> <td> <div>&nbsp;</div> </td> <td> <div>&nbsp;</div> <div><span class=cloze>[...]</span> – <span class=cloze>[...]</span></div> </td> </tr></tbody></table>""<table> <tbody><tr> <td> <div>&nbsp;</div> </td> <td> <div>Fixed cost + Annual unit (equipment) cost</div> </td> </tr> <tr> <td> <div>Annual Break-even in units<span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);""></span><span style=""color: var(--field-fg); font-family: -apple-system-body; background: var(--field-bg);"">&nbsp;&nbsp;=</span></div> </td> <td> <div>__________________________________ </div> </td> </tr> <tr> <td> <div>&nbsp;</div> </td> <td> <div>&nbsp;</div> <div><span class=cloze>Revenue per unit</span> – <span class=cloze>Variable cost per unit</span></div> </td> </tr></tbody></table><br> "
"<div>Activity based costing (ABC) defines costs by <span class=cloze>[...]</span> or <span class=cloze>[...]</span>.&nbsp;</div> <div>This type of accounting is useful for performance improvement efforts. Rather than applying ""overhead"" costs to <span class=cloze>[...]</span>, ABC accounting attempts to apply costs to <span class=cloze>[...]</span>, providing a much more accurate measure of <span class=cloze>[...]</span>.&nbsp;</div>""<div>Activity based costing (ABC) defines costs by <span class=cloze>processes</span> or <span class=cloze>activities</span>.&nbsp;</div> <div>This type of accounting is useful for performance improvement efforts. Rather than applying ""overhead"" costs to <span class=cloze>every activity evenly</span>, ABC accounting attempts to apply costs to <span class=cloze>each activity</span>, providing a much more accurate measure of <span class=cloze>cost and benefit</span>.&nbsp;</div><br> "
"<div><span class=cloze>[...]</span> defines costs by processes or activities.&nbsp;</div> <div>This type of accounting is useful for <span class=cloze>[...]</span>. Rather than applying ""overhead"" costs to every activity evenly, <span class=cloze>[...]</span> accounting attempts to apply costs to each activity, providing a much more accurate measure of cost and benefit.&nbsp;</div>""<div><span class=cloze>Activity based costing (ABC)</span> defines costs by processes or activities.&nbsp;</div> <div>This type of accounting is useful for <span class=cloze>performance improvement efforts</span>. Rather than applying ""overhead"" costs to every activity evenly, <span class=cloze>ABC</span> accounting attempts to apply costs to each activity, providing a much more accurate measure of cost and benefit.&nbsp;</div><br> "
<span class=cloze>[...]</span> defines costs by processes or activities. For example, a practice with an in-house lab that uses <span class=cloze>[...]</span> accounting would identify staff time, cost of the equipment, cost of the space, and any supplies needed for the in-house lab activities. Using this information, a practice can identify the <span class=cloze>[...]</span> needed to make this activity or service profitable.<span class=cloze>Activity based costing (ABC)</span> defines costs by processes or activities. For example, a practice with an in-house lab that uses <span class=cloze>ABC</span> accounting would identify staff time, cost of the equipment, cost of the space, and any supplies needed for the in-house lab activities. Using this information, a practice can identify the <span class=cloze>revenue</span> needed to make this activity or service profitable.<br> "Businesses must protect against amateur counterfeiting. Use checks with&nbsp;<span class=cloze>[...]</span>&nbsp;to limit the risk of fraud. When photocopied by a color copier, the word ""<span class=cloze>[...]</span>"" appears on the document.""Businesses must protect against amateur counterfeiting. Use checks with&nbsp;<span class=cloze>void pantographs</span>&nbsp;to limit the risk of fraud. When photocopied by a color copier, the word ""<span class=cloze>VOID</span>"" appears on the document.<br> <img src=""main-qimg-478e0eda543477ca023d41e187721c09"">"
<ul><li>The <span class=cloze>[...]</span> is a listing of all potential accounts for which <span class=cloze>[...]</span> will be gathered (for example, revenue, supply expenses, staff payroll expenses, rent, utilities, supplies, etc.) and reported.</li><li>A <span class=cloze>[...]</span> can vary from general expenses to specific line item designations. For example, in a <span class=cloze>[...]</span>, all payroll expenses could be <span class=cloze>[...]</span>. Or, could be <span class=cloze>[...]</span> into specific categories such as staff payroll, physician payroll, midlevel provider payroll, bonus payments, overtime pay, etc.</li></ul><br><ul><li>The <span class=cloze>chart of accounts</span> is a listing of all potential accounts for which <span class=cloze>financial information</span> will be gathered (for example, revenue, supply expenses, staff payroll expenses, rent, utilities, supplies, etc.) and reported.</li><li>A <span class=cloze>chart of accounts</span> can vary from general expenses to specific line item designations. For example, in a <span class=cloze>chart of accounts</span>, all payroll expenses could be <span class=cloze>grouped</span>. Or, could be <span class=cloze>separated</span> into specific categories such as staff payroll, physician payroll, midlevel provider payroll, bonus payments, overtime pay, etc.</li></ul><br><br> The first step in designing your chart of accounts is to identify the financial information important to <span class=cloze>[...]</span> and <span class=cloze>[...]</span>. This information is used to manage your business and for tax purposes, so you should consult an accountant during this process. The more detail tracked (<span class=cloze>[...]</span>), the greater ability you have to mine data for <span class=cloze>[...]</span> exercises. It can be useful to allocate <span class=cloze>[...]</span>.&nbsp;The first step in designing your chart of accounts is to identify the financial information important to <span class=cloze>track</span> and <span class=cloze>report</span>. This information is used to manage your business and for tax purposes, so you should consult an accountant during this process. The more detail tracked (<span class=cloze>greater number of chart of accounts</span>), the greater ability you have to mine data for <span class=cloze>operational and budgeting</span> exercises. It can be useful to allocate <span class=cloze>separate revenue/cost centers</span>.&nbsp;<br> Most accounting systems provide the opportunity to assign sub-accounts numbers that can be attached to the <span class=cloze>[...]</span> enabling the software to provide the user with departmental financials (whether by specialty, by office, or by physician).Most accounting systems provide the opportunity to assign sub-accounts numbers that can be attached to the <span class=cloze>chart of accounts</span> enabling the software to provide the user with departmental financials (whether by specialty, by office, or by physician).<br> <span class=cloze>[...]</span> should be designed to meet the specific needs of the practice. Consideration should be given to designing the system so that all reports (for example, reports used in determining physician compensation) are produced directly from the accounting software. The use of spreadsheets in reporting should be minimal if the <span class=cloze>[...]</span> is set up correctly.<span class=cloze>Financial reporting</span> should be designed to meet the specific needs of the practice. Consideration should be given to designing the system so that all reports (for example, reports used in determining physician compensation) are produced directly from the accounting software. The use of spreadsheets in reporting should be minimal if the <span class=cloze>accounting system</span> is set up correctly.<br> Financial reporting should be designed to meet <span class=cloze>[...]</span> of the practice. Consideration should be given to designing the system so that all reports (for example, reports used in determining physician compensation) are <span class=cloze>[...]</span>. The use of spreadsheets in reporting should be <span class=cloze>[...]</span> if the accounting system is set up correctly.Financial reporting should be designed to meet <span class=cloze>the specific needs</span> of the practice. Consideration should be given to designing the system so that all reports (for example, reports used in determining physician compensation) are <span class=cloze>produced directly from the accounting software</span>. The use of spreadsheets in reporting should be <span class=cloze>minimal</span> if the accounting system is set up correctly.<br> <ul><li>To increase net income, a practice must either increase <span class=cloze>[...]</span> or decrease <span class=cloze>[...]</span>.&nbsp;</li><li>Controlling overhead expenses is an important part of managing any business. More <span class=cloze>[...]</span> expense information is better when deciding where to reduce expenses.</li></ul><ul><li>To increase net income, a practice must either increase <span class=cloze>revenue</span> or decrease <span class=cloze>costs</span>.&nbsp;</li><li>Controlling overhead expenses is an important part of managing any business. More <span class=cloze>detailed</span> expense information is better when deciding where to reduce expenses.</li></ul><br> <ul><li>To increase <span class=cloze>[...]</span>, a practice must either increase revenue or decrease costs.&nbsp;</li><li>Controlling <span class=cloze>[...]</span> is an important part of managing any business. More detailed <span class=cloze>[...]</span> is better when deciding where to reduce <span class=cloze>[...]</span>.</li></ul><ul><li>To increase <span class=cloze>net income</span>, a practice must either increase revenue or decrease costs.&nbsp;</li><li>Controlling <span class=cloze>overhead expenses</span> is an important part of managing any business. More detailed <span class=cloze>expense information</span> is better when deciding where to reduce <span class=cloze>expenses</span>.</li></ul><br> <ul><li>To increase net income, a practice must either <span class=cloze>[...]</span> revenue or <span class=cloze>[...]</span> costs.&nbsp;</li><li>Controlling overhead expenses is an important part of managing any business. More detailed expense information is better when deciding where to <span class=cloze>[...]</span> expenses.</li></ul><ul><li>To increase net income, a practice must either <span class=cloze>increase</span> revenue or <span class=cloze>decrease</span> costs.&nbsp;</li><li>Controlling overhead expenses is an important part of managing any business. More detailed expense information is better when deciding where to <span class=cloze>reduce</span> expenses.</li></ul><br> <span class=cloze>[...]</span> expense is one of the largest expense items for most practices. But without the detail to determine if an expense is related to payroll, medical benefits, retirement benefits, overtime, education, lunches, etc., it is difficult to know <span class=cloze>[...]</span>. <span class=cloze>[...]</span> may not be the best way to decrease this expense category.<span class=cloze>Staff</span> expense is one of the largest expense items for most practices. But without the detail to determine if an expense is related to payroll, medical benefits, retirement benefits, overtime, education, lunches, etc., it is difficult to know <span class=cloze>where cuts should be made</span>. <span class=cloze>Reduced salaries</span> may not be the best way to decrease this expense category.<br> <ul><li><span class=cloze>[...]</span> and <span class=cloze>[...]</span> when trying to reduce expenses.&nbsp;</li><li>Because <span class=cloze>[...]</span> will not want to reduce salaries, benefits, or jobs, they are motivated to reduce costs, elsewhere.&nbsp;</li><li>But be careful of <span class=cloze>[...]</span>. If you are sure there will have to be salary cuts, do not insinuate that if an employee comes up with other ideas, there will not be cuts. When subsequent cuts are made, <span class=cloze>[...]</span> among your employees will result.</li></ul>"<ul><li><span class=cloze>Include the staff</span> and <span class=cloze>brainstorm</span> when trying to reduce expenses.&nbsp;</li><li>Because <span class=cloze>staff</span> will not want to reduce salaries, benefits, or jobs, they are motivated to reduce costs, elsewhere.&nbsp;</li><li>But be careful of <span class=cloze>asking for suggestions you can't accommodate</span>. If you are sure there will have to be salary cuts, do not insinuate that if an employee comes up with other ideas, there will not be cuts. When subsequent cuts are made, <span class=cloze>mistrust</span> among your employees will result.</li></ul><br> "
"<ul><li>Include the staff and brainstorm when trying to <span class=cloze>[...]</span>.&nbsp;</li><li>Because staff will not want to <span class=cloze>[...]</span> salaries, benefits, or jobs, they are motivated to <span class=cloze>[...]</span>, elsewhere.&nbsp;</li><li>But be careful of asking for suggestions you can't accommodate. If you are sure there will have to be <span class=cloze>[...]</span>, do not insinuate that if an employee comes up with other ideas, there will not be <span class=cloze>[...]</span>. When subsequent <span class=cloze>[...]</span> are made, mistrust among your employees will result.</li></ul>""<ul><li>Include the staff and brainstorm when trying to <span class=cloze>reduce expenses</span>.&nbsp;</li><li>Because staff will not want to <span class=cloze>reduce</span> salaries, benefits, or jobs, they are motivated to <span class=cloze>reduce costs</span>, elsewhere.&nbsp;</li><li>But be careful of asking for suggestions you can't accommodate. If you are sure there will have to be <span class=cloze>salary cuts</span>, do not insinuate that if an employee comes up with other ideas, there will not be <span class=cloze>cuts</span>. When subsequent <span class=cloze>cuts</span> are made, mistrust among your employees will result.</li></ul><br> "
<ul><li>Reducing staff expenses by cutting out a support position may result in <span class=cloze>[...]</span>, which will decrease revenue. </li><li>Many practices hurt themselves by reducing the number of <span class=cloze>[...]</span>, only to find that the physician <span class=cloze>[...]</span> - <span class=cloze>[...]</span> time available for patients and resulting in reduced revenue that surpasses the amount of money saved.</li></ul><ul><li>Reducing staff expenses by cutting out a support position may result in <span class=cloze>decreased productivity</span>, which will decrease revenue. </li><li>Many practices hurt themselves by reducing the number of <span class=cloze>medical assistants</span>, only to find that the physician <span class=cloze>has to do more</span> - <span class=cloze>reducing</span> time available for patients and resulting in reduced revenue that surpasses the amount of money saved.</li></ul><br> <ul><li>Reducing staff expenses by <span class=cloze>[...]</span> may result in decreased productivity, which will decrease revenue. </li><li>Many practices hurt themselves by <span class=cloze>[...]</span> the number of medical assistants, only to find that the physician has to do more - reducing time available for patients and resulting in reduced revenue that surpasses the amount of money saved.</li></ul><ul><li>Reducing staff expenses by <span class=cloze>cutting out a support position</span> may result in decreased productivity, which will decrease revenue. </li><li>Many practices hurt themselves by <span class=cloze>reducing</span> the number of medical assistants, only to find that the physician has to do more - reducing time available for patients and resulting in reduced revenue that surpasses the amount of money saved.</li></ul><br> <ul><li>Reducing staff expenses by cutting out a support position may result in decreased productivity, which will <span class=cloze>[...]</span>. </li><li>Many practices hurt themselves by reducing the number of medical assistants, only to find that the physician has to do more - reducing time available for patients and resulting in <span class=cloze>[...]</span> that surpasses <span class=cloze>[...]</span>.</li></ul><ul><li>Reducing staff expenses by cutting out a support position may result in decreased productivity, which will <span class=cloze>decrease revenue</span>. </li><li>Many practices hurt themselves by reducing the number of medical assistants, only to find that the physician has to do more - reducing time available for patients and resulting in <span class=cloze>reduced revenue</span> that surpasses <span class=cloze>the amount of money saved</span>.</li></ul><br> Another example of ineffective cost control is identifying a new brand of supplies that is much less <span class=cloze>[...]</span> but is also <span class=cloze>[...]</span>.Another example of ineffective cost control is identifying a new brand of supplies that is much less <span class=cloze>expensive</span> but is also <span class=cloze>inferior in quality</span>.<br> Another example of <span class=cloze>[...]</span> is identifying a new brand of supplies that is much less expensive but is also inferior in quality.Another example of <span class=cloze>ineffective cost control</span> is identifying a new brand of supplies that is much less expensive but is also inferior in quality.<br> <ul><li>A budget is a useful tool to monitor and manage the financial activity of a clinic. </li><li>The size and complexity of the <span class=cloze>[...]</span> and the involvement of <span class=cloze>[...]</span> and <span class=cloze>[...]</span> can play a big part into how in-depth a budget might be.&nbsp;</li></ul><ul><li>A budget is a useful tool to monitor and manage the financial activity of a clinic. </li><li>The size and complexity of the <span class=cloze>practice</span> and the involvement of <span class=cloze>physicians</span> and <span class=cloze>accountants</span> can play a big part into how in-depth a budget might be.&nbsp;</li></ul><br> <ul><li>A <span class=cloze>[...]</span> is a useful tool to monitor and manage the financial activity of a clinic. </li><li>The size and complexity of the practice and the involvement of physicians and accountants can play a big part into how in-depth a <span class=cloze>[...]</span> might be.&nbsp;</li></ul><ul><li>A <span class=cloze>budget</span> is a useful tool to monitor and manage the financial activity of a clinic. </li><li>The size and complexity of the practice and the involvement of physicians and accountants can play a big part into how in-depth a <span class=cloze>budget</span> might be.&nbsp;</li></ul><br> <ul><li>A budget is a useful tool to <span class=cloze>[...]</span> and <span class=cloze>[...]</span> the <span class=cloze>[...]</span> of a clinic. </li><li>The <span class=cloze>[...]</span> and <span class=cloze>[...]</span> of the practice and the <span class=cloze>[...]</span> of physicians and accountants can play a big part into how <span class=cloze>[...]</span> a budget might be.&nbsp;</li></ul><ul><li>A budget is a useful tool to <span class=cloze>monitor</span> and <span class=cloze>manage</span> the <span class=cloze>financial activity</span> of a clinic. </li><li>The <span class=cloze>size</span> and <span class=cloze>complexity</span> of the practice and the <span class=cloze>involvement</span> of physicians and accountants can play a big part into how <span class=cloze>in-depth</span> a budget might be.&nbsp;</li></ul><br> "The <span class=cloze>[...]</span> should develop a budget in sufficient detail to provide himself, the physician owners, and other stakeholders information that will be useful in guiding the practice and monitoring results. A common and useful budget format is often based on the clinic's <span class=cloze>[...]</span>.""The <span class=cloze>manager</span> should develop a budget in sufficient detail to provide himself, the physician owners, and other stakeholders information that will be useful in guiding the practice and monitoring results. A common and useful budget format is often based on the clinic's <span class=cloze>income statement</span>.<br> "
"The manager should develop a <span class=cloze>[...]</span> in sufficient detail to provide himself, the physician owners, and other stakeholders information that will be useful in guiding the practice and monitoring results. A common and useful <span class=cloze>[...]</span> is often based on the clinic's income statement.""The manager should develop a <span class=cloze>budget</span> in sufficient detail to provide himself, the physician owners, and other stakeholders information that will be useful in guiding the practice and monitoring results. A common and useful <span class=cloze>budget format</span> is often based on the clinic's income statement.<br> "
<ul><li>Based on <span class=cloze>[...]</span> format, a budget should include projected or budgeted amounts for each line item to facilitate comparison to actual results.&nbsp;</li><li>A <span class=cloze>[...]</span> must determine the budget is made on a quarterly or monthly basis. An effective budgeting tool is compared to actual results to <span class=cloze>[...]</span> and <span class=cloze>[...]</span>, as necessary.</li></ul><ul><li>Based on <span class=cloze>an income statement</span> format, a budget should include projected or budgeted amounts for each line item to facilitate comparison to actual results.&nbsp;</li><li>A <span class=cloze>manager</span> must determine the budget is made on a quarterly or monthly basis. An effective budgeting tool is compared to actual results to <span class=cloze>identify variances</span> and <span class=cloze>adjust</span>, as necessary.</li></ul><br> <ul><li>Based on an income statement format, a budget should include projected or budgeted amounts for each line item to facilitate <span class=cloze>[...]</span>.&nbsp;</li><li>A manager must determine the budget is made on a quarterly or monthly basis. An effective budgeting tool is <span class=cloze>[...]</span> to identify variances and adjust, as necessary.</li></ul><ul><li>Based on an income statement format, a budget should include projected or budgeted amounts for each line item to facilitate <span class=cloze>comparison to actual results</span>.&nbsp;</li><li>A manager must determine the budget is made on a quarterly or monthly basis. An effective budgeting tool is <span class=cloze>compared to actual results</span> to identify variances and adjust, as necessary.</li></ul><br> <ul><li>Based on an income statement format, a budget should include <span class=cloze>[...]</span> or <span class=cloze>[...]</span> amounts for <span class=cloze>[...]</span> to facilitate comparison to actual results.&nbsp;</li><li>A manager must determine the budget is made on a <span class=cloze>[...]</span> or <span class=cloze>[...]</span> basis. An effective budgeting tool is compared to actual results to identify variances and adjust, as necessary.</li></ul><ul><li>Based on an income statement format, a budget should include <span class=cloze>projected</span> or <span class=cloze>budgeted</span> amounts for <span class=cloze>each line item</span> to facilitate comparison to actual results.&nbsp;</li><li>A manager must determine the budget is made on a <span class=cloze>quarterly</span> or <span class=cloze>monthly</span> basis. An effective budgeting tool is compared to actual results to identify variances and adjust, as necessary.</li></ul><br> <div>Effective use of a budget enables a manager to: </div> <div><ul><li><span class=cloze>[...]</span> focus on goals for the clinic, and what it will take to get there.</li><li><span class=cloze>[...]</span> the productivity of the practice by <span class=cloze>[...]</span> budgeted goals to results.</li><li><span class=cloze>[...]</span> accountability in department managers.</li><li><span class=cloze>[...]</span> variances in production or costs of running the practice.</li><li><span class=cloze>[...]</span> to operations to keep on track for yearly goals.</li><li><span class=cloze>[...]</span> growth opportunities while <span class=cloze>[...]</span> the current business.</li></ul></div><div>Effective use of a budget enables a manager to: </div> <div><ul><li><span class=cloze>Maintain</span> focus on goals for the clinic, and what it will take to get there.</li><li><span class=cloze>Assess</span> the productivity of the practice by <span class=cloze>comparing</span> budgeted goals to results.</li><li><span class=cloze>Foster</span> accountability in department managers.</li><li><span class=cloze>Analyze</span> variances in production or costs of running the practice.</li><li><span class=cloze>Make timely changes</span> to operations to keep on track for yearly goals.</li><li><span class=cloze>Manage</span> growth opportunities while <span class=cloze>sustaining</span> the current business.</li></ul></div><br> <div>Effective use of a budget enables a manager to: </div> <div><ul><li>Maintain <span class=cloze>[...]</span> on goals for the clinic, and <span class=cloze>[...]</span>.</li><li>Assess the productivity of the practice by comparing <span class=cloze>[...]</span> to <span class=cloze>[...]</span>.</li><li>Foster accountability in <span class=cloze>[...]</span>.</li><li>Analyze <span class=cloze>[...]</span> in production or costs of running the practice.</li><li>Make timely changes to operations to <span class=cloze>[...]</span> for yearly goals.</li><li>Manage growth opportunities while sustaining the <span class=cloze>[...]</span>.</li></ul></div><div>Effective use of a budget enables a manager to: </div> <div><ul><li>Maintain <span class=cloze>focus</span> on goals for the clinic, and <span class=cloze>what it will take to get there</span>.</li><li>Assess the productivity of the practice by comparing <span class=cloze>budgeted goals</span> to <span class=cloze>results</span>.</li><li>Foster accountability in <span class=cloze>department managers</span>.</li><li>Analyze <span class=cloze>variances</span> in production or costs of running the practice.</li><li>Make timely changes to operations to <span class=cloze>keep on track</span> for yearly goals.</li><li>Manage growth opportunities while sustaining the <span class=cloze>current business</span>.</li></ul></div><br> <div>Effective use of a budget enables a manager to: </div> <div><ul><li>Maintain focus on <span class=cloze>[...]</span> for the clinic, and what it will take to get there.</li><li>Assess the <span class=cloze>[...]</span> of the practice by comparing budgeted goals to results.</li><li>Foster <span class=cloze>[...]</span> in department managers.</li><li>Analyze variances in <span class=cloze>[...]</span> or <span class=cloze>[...]</span> of running the practice.</li><li>Make timely changes to <span class=cloze>[...]</span> to keep on track for <span class=cloze>[...]</span>.</li><li>Manage <span class=cloze>[...]</span> while sustaining the current business.</li></ul></div><div>Effective use of a budget enables a manager to: </div> <div><ul><li>Maintain focus on <span class=cloze>goals</span> for the clinic, and what it will take to get there.</li><li>Assess the <span class=cloze>productivity</span> of the practice by comparing budgeted goals to results.</li><li>Foster <span class=cloze>accountability</span> in department managers.</li><li>Analyze variances in <span class=cloze>production</span> or <span class=cloze>costs</span> of running the practice.</li><li>Make timely changes to <span class=cloze>operations</span> to keep on track for <span class=cloze>yearly goals</span>.</li><li>Manage <span class=cloze>growth opportunities</span> while sustaining the current business.</li></ul></div><br> <div>As the practice manager, you have the responsibility of dealing with employees whose performance is not meeting expectations. What is something that you could do to address the deficiencies? </div> <div>A. Exit interview </div> <div>B. Aptitude test </div> <div>C. Performance Improvement Plan (PIP) </div> D. Personality test&nbsp;C. Performance Improvement Plan (PIP)
<div>You are prohibited from asking certain questions when interviewing a candidate. All the following questions would be acceptable EXCEPT which of the following? </div> <div>A. Have you ever been convicted of a crime? </div> <div>B. What is your religious affiliation? </div> <div>C. What is the highest level of education achieved? </div> D. Are you a citizen of the United States?<div>B. What is your religious affiliation?</div>
"<div>Human resource management requires detailed and accurate record keeping for employees. Which of the following items should NOT be included in an employee's employment file? </div> <div>A. Signed application </div> <div>B. Family and Medical Leave Act forms </div> <div>C. Tax filing status </div> D. Copies of certifications or professional licenses"<div>B. Family and Medical Leave Act forms</div>
<div>Your practice has hired a physician who will be compensated based on 50 percent of her net revenue. For the first year, her net revenue was $450,000. What amount will she be paid based on the percentage of net revenue compensation model? </div> <div>A. $200,000 </div> <div>B. $275,000 </div> <div>C. $225,000 </div> D. $450,000C. $225,000
<div>Which type of retirement plan includes contributions made by both the employer and the employee? </div> <div>A. 401(k) </div> <div>B. Profit Share Plan </div> <div>C. Flex Spending Account </div> D. Educational Savings Account<div>A. 401(k)</div>
<div>Which of the following statements is FALSE regarding mid-level providers? </div> <div>A. Employment arrangements for mid-level providers are generally simpler than physicians. </div> <div>B. Mid-level providers can directly contract with certain payers, but other payers will not allow direct credentialing of mid-level providers. </div> <div>C. Mid-level providers are sometimes paid at a lower rate for their submitted claims than physicians. </div> D. A nurse practitioner can never operate their own clinic because it is against state laws.D. A nurse practitioner can never operate their own clinic because it is against state laws.
<div>Licensing and credentialing must be completed for all new physicians. What length of time should the provider wait to see patients once an employment contract is signed? </div> <div>A. 30 days </div> <div>B. 60 days </div> <div>C. 90 days </div> D. 120 days&nbsp;<div>C. 90 days</div>
<div>Which of the following statements is FALSE about employee evaluations? </div> <div>A. Evaluations are easier to administer when they are tied directly compensation. </div> <div>B. Employee performance evaluations allow managers an opportunity to provide feedback on what the employee is doing well. </div> <div>C. Employee performance evaluations allow managers an opportunity to provide feedback on where they have opportunities to improve. </div> <div>D. Employee performance evaluations allow a time for the manager to ask the employee what the employee can do to help the employee develop within the practice.&nbsp;</div><div>A. Evaluations are easier to administer when they are tied directly compensation.</div>
<div>Which of the following is NOT a way to determine that a compensation package is fair to the employee and equitable to the practice? </div> <div>A. Identify a pay range for each job classification. </div> <div>B. Benchmark your current pay ranges to similar positions in similar settings in your industry in your area. </div> <div>C. Figure in benefits to your total compensation package. </div> <div>D. Leave out information regarding potential yearly increases for cost of living inflation.&nbsp;</div>D. Leave out information regarding potential yearly increases for cost of living inflation.&nbsp;
"<div>If there is a perceived need for medical services in your community, what type of organization may be willing to provide an income guarantee to ease the costs of a new physician? </div> <div>A. The local mayor's office </div> <div>B. A local hospital </div> <div>C. The local Chamber of Commerce </div> D. The local state medical society"<div>B. A local hospital</div>
"If an employee's performance is not meeting expectations, the manager should schedule a time to review the concerns and determine a <span class=cloze>[...]</span>""If an employee's performance is not meeting expectations, the manager should schedule a time to review the concerns and determine a <span class=cloze>Performance Improvement Plan (PIP)</span><br> "
"The <span class=cloze>[...]</span>&nbsp;details the employer's expectations of performance improvement and an expected timeline for the improvement (typically 90 days).""The <span class=cloze>Performance Improvement Plan (PIP)</span>&nbsp;details the employer's expectations of performance improvement and an expected timeline for the improvement (typically 90 days).<br> "
"The Performance Improvement Plan (PIP)&nbsp;details the employer's expectations of performance improvement and an expected timeline for the improvement (typically <span class=cloze>[...]</span> days).""The Performance Improvement Plan (PIP)&nbsp;details the employer's expectations of performance improvement and an expected timeline for the improvement (typically <span class=cloze>90</span> days).<br> "
The <span class=cloze>[...]</span> should specify the result if the employee does not meet those expectations. Even with a specific introductory period, it is important to document concerns and follow your company disciplinary process to avoid <span class=cloze>[...]</span>.The <span class=cloze>Performance Improvement Plan (PIP)</span> should specify the result if the employee does not meet those expectations. Even with a specific introductory period, it is important to document concerns and follow your company disciplinary process to avoid <span class=cloze>legal implications</span>.<br> The Performance Improvement Plan (PIP) should specify the <span class=cloze>[...]</span> if the employee does not meet those expectations. Even with a specific introductory period, it is important to document <span class=cloze>[...]</span> and follow your company <span class=cloze>[...]</span> to avoid legal implications.The Performance Improvement Plan (PIP) should specify the <span class=cloze>result</span> if the employee does not meet those expectations. Even with a specific introductory period, it is important to document <span class=cloze>concerns</span> and follow your company <span class=cloze>disciplinary process</span> to avoid legal implications.<br> When interviewing candidates, you should be aware of <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, and <span class=cloze>[...]</span> laws that govern the interview and hiring process. A manager is generally safe asking <span class=cloze>[...]</span> questions regarding <span class=cloze>[...]</span> and <span class=cloze>[...]</span>When interviewing candidates, you should be aware of <span class=cloze>federal</span>, <span class=cloze>state</span>, and <span class=cloze>local</span> laws that govern the interview and hiring process. A manager is generally safe asking <span class=cloze>job related</span> questions regarding <span class=cloze>skills</span> and <span class=cloze>abilities</span><br> <div>When interviewing candidates, some questions that are OK to ask are: </div> <div>• If the person has ever worked under a different <span class=cloze>[...]</span> </div> <div>• If the person has ever been <span class=cloze>[...]</span> of a crime </div> <div>• If the person is a <span class=cloze>[...]</span> of the United States&nbsp;</div> <div>• <span class=cloze>[...]</span> level the person has attained, including <span class=cloze>[...]</span> and <span class=cloze>[...]</span>. </div> <div>• If the person has <span class=cloze>[...]</span> employed by the organization. </div> • Prior <span class=cloze>[...]</span><div>When interviewing candidates, some questions that are OK to ask are: </div> <div>• If the person has ever worked under a different <span class=cloze>name</span> </div> <div>• If the person has ever been <span class=cloze>convicted</span> of a crime </div> <div>• If the person is a <span class=cloze>citizen</span> of the United States&nbsp;</div> <div>• <span class=cloze>Education</span> level the person has attained, including <span class=cloze>degrees</span> and <span class=cloze>certifications</span>. </div> <div>• If the person has <span class=cloze>relatives</span> employed by the organization. </div> • Prior <span class=cloze>employment</span><br> You cannot base employment decisions (hiring or firing) on personal characteristics that are not job related, such as: <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, or <span class=cloze>[...]</span>.You cannot base employment decisions (hiring or firing) on personal characteristics that are not job related, such as: <span class=cloze>age</span>, <span class=cloze>race</span>, <span class=cloze>religion</span>, <span class=cloze>national origin</span>, or <span class=cloze>disabilities</span>.<br> You cannot base employment decisions (<span class=cloze>[...]</span> or <span class=cloze>[...]</span>) on <span class=cloze>[...]</span> that are not <span class=cloze>[...]</span>, such as: age, race, religion, national origin, or disabilities.You cannot base employment decisions (<span class=cloze>hiring</span> or <span class=cloze>firing</span>) on <span class=cloze>personal characteristics</span> that are not <span class=cloze>job related</span>, such as: age, race, religion, national origin, or disabilities.<br> RIFreduction in force
Human Resource management requires detailed and accurate record keeping. Each employee should have a personnel file with:<br><ul><li>a copy of the signed <span class=cloze>[...]</span>, tax filing <span class=cloze>[...]</span>, <span class=cloze>[...]</span> or professional licenses, and <span class=cloze>[...]</span> agreement contracts.&nbsp;</li><li>Performance reviews (<span class=cloze>[...]</span> and <span class=cloze>[...]</span>), awards, recognitions, and <span class=cloze>[...]</span> </li><li>Any anecdotal <span class=cloze>[...]</span> with the employee&nbsp;</li><li>Job description and any <span class=cloze>[...]</span> that were taken during the application process </li><li>Any <span class=cloze>[...]</span> and the reason for <span class=cloze>[...]</span> </li><li>Any <span class=cloze>[...]</span> checks or <span class=cloze>[...]</span> checks </li><li>All <span class=cloze>[...]</span> documentation.&nbsp;</li></ul> Human Resource management requires detailed and accurate record keeping. Each employee should have a personnel file with:<br><ul><li>a copy of the signed <span class=cloze>application</span>, tax filing <span class=cloze>status</span>, <span class=cloze>certifications</span> or professional licenses, and <span class=cloze>employment</span> agreement contracts.&nbsp;</li><li>Performance reviews (<span class=cloze>positive</span> and <span class=cloze>negative</span>), awards, recognitions, and <span class=cloze>disciplinary actions</span> </li><li>Any anecdotal <span class=cloze>conversations</span> with the employee&nbsp;</li><li>Job description and any <span class=cloze>hiring notes</span> that were taken during the application process </li><li>Any <span class=cloze>promotions</span> and the reason for <span class=cloze>promotion</span> </li><li>Any <span class=cloze>background</span> checks or <span class=cloze>reference</span> checks </li><li>All <span class=cloze>reduction in force (RIF)</span> documentation.&nbsp;</li></ul> <br> Policies for benefits should be kept <span class=cloze>[...]</span> and <span class=cloze>[...]</span> so that the current version can be pulled at any time.Policies for benefits should be kept <span class=cloze>up to date</span> and <span class=cloze>filed</span> so that the current version can be pulled at any time.<br> "Forms that have been completed for <span class=cloze>[...]</span> reasonable accommodation, workers' <span class=cloze>[...]</span>, Employment Eligibility forms (<span class=cloze>[...]</span>), <span class=cloze>[...]</span> compliance, and the Family and Medical Leave Act (<span class=cloze>[...]</span>), should be kept in a separate file and in a locked location to protect from unauthorized access.""Forms that have been completed for <span class=cloze>ADA</span> reasonable accommodation, workers' <span class=cloze>compensation</span>, Employment Eligibility forms (<span class=cloze>INS Form I-9</span>), <span class=cloze>OSHA</span> compliance, and the Family and Medical Leave Act (<span class=cloze>FMLA</span>), should be kept in a separate file and in a locked location to protect from unauthorized access.<br> "
"Forms that have been completed for ADA reasonable accommodation, workers' compensation, Employment Eligibility forms (INS Form I-9), OSHA compliance, and the Family and Medical Leave Act (FMLA), should be kept <span class=cloze>[...]</span> and in a <span class=cloze>[...]</span> location to protect from unauthorized access.""Forms that have been completed for ADA reasonable accommodation, workers' compensation, Employment Eligibility forms (INS Form I-9), OSHA compliance, and the Family and Medical Leave Act (FMLA), should be kept <span class=cloze>in a separate file</span> and in a <span class=cloze>locked</span> location to protect from unauthorized access.<br> "
INS Form I-9Employment Eligibility forms&nbsp;
FMLAFamily and Medical Leave Act&nbsp;
The <span class=cloze>[...]</span> model consists of paying compensation based on a certain percent of Net Revenue (collections) earned from the services provided by that physician. In simple terms, it is the amount of <span class=cloze>[...]</span> that is <span class=cloze>[...]</span>.&nbsp;The <span class=cloze>Percent of Net Revenue</span> model consists of paying compensation based on a certain percent of Net Revenue (collections) earned from the services provided by that physician. In simple terms, it is the amount of <span class=cloze>revenue</span> that is <span class=cloze>collectable</span>.&nbsp;<br> A 401(k) plan can include both contributions by the <span class=cloze>[...]</span> and by the <span class=cloze>[...]</span>. It is generally <span class=cloze>[...]</span> for the employer than a <span class=cloze>[...]</span> plan because the employer contributes <span class=cloze>[...]</span>.&nbsp;A 401(k) plan can include both contributions by the <span class=cloze>employer</span> and by the <span class=cloze>employee</span>. It is generally <span class=cloze>less expensive</span> for the employer than a <span class=cloze>profit share</span> plan because the employer contributes <span class=cloze>less</span>.&nbsp;<br> Ways a 401(k) plan can be set up include <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, and <span class=cloze>[...]</span> plansWays a 401(k) plan can be set up include <span class=cloze>traditional</span>, <span class=cloze>simple</span>, and <span class=cloze>safe harbor</span> plans<br> Some physicians who desire to invest higher percentages of their income through a company-sponsored retirement plan will consider a <span class=cloze>[...]</span> plan.Some physicians who desire to invest higher percentages of their income through a company-sponsored retirement plan will consider a <span class=cloze>profit share</span> plan.<br> Both PA and NP are healthcare providers credentialed to provide medical services with <span class=cloze>[...]</span>. In many states, an <span class=cloze>[...]</span> can operate her own clinic without direct supervision.&nbsp;Both PA and NP are healthcare providers credentialed to provide medical services with <span class=cloze>physician supervision</span>. In many states, an <span class=cloze>NP</span> can operate her own clinic without direct supervision.&nbsp;<br> Both PA and NP are healthcare providers credentialed to provide medical services with physician supervision. In many states, an NP can operate her own clinic <span class=cloze>[...]</span>.&nbsp;Both PA and NP are healthcare providers credentialed to provide medical services with physician supervision. In many states, an NP can operate her own clinic <span class=cloze>without direct supervision</span>.&nbsp;<br> Employment arrangements for mid-level providers are generally <span class=cloze>[...]</span> than physicians. A detailed contract is much <span class=cloze>[...]</span> for mid-level providers. Often, an employment agreement similar to other staff that includes the specifics of their <span class=cloze>[...]</span> is sufficient.&nbsp;Employment arrangements for mid-level providers are generally <span class=cloze>simpler</span> than physicians. A detailed contract is much <span class=cloze>less common</span> for mid-level providers. Often, an employment agreement similar to other staff that includes the specifics of their <span class=cloze>compensation structure</span> is sufficient.&nbsp;<br> Mid-level providers can <span class=cloze>[...]</span> contract with certain payers, while some payers will not allow <span class=cloze>[...]</span> but will require <span class=cloze>[...]</span> under the <span class=cloze>[...]</span> physician.&nbsp;Mid-level providers can <span class=cloze>directly</span> contract with certain payers, while some payers will not allow <span class=cloze>direct credentialing</span> but will require <span class=cloze>incident-to billing</span> under the <span class=cloze>supervising</span> physician.&nbsp;<br> When mid-level providers are credentialed and enrolled under <span class=cloze>[...]</span>, insurance payers will sometimes pay a <span class=cloze>[...]</span> reimbursement rate for their submitted claims.&nbsp;When mid-level providers are credentialed and enrolled under <span class=cloze>their own provider number</span>, insurance payers will sometimes pay a <span class=cloze>reduced</span> reimbursement rate for their submitted claims.&nbsp;<br> Make sure to allow enough time from the hire date to start date to complete <span class=cloze>[...]</span> and <span class=cloze>[...]</span>. It is recommended to allow for a minimum of <span class=cloze>[...]</span> days.&nbsp;Make sure to allow enough time from the hire date to start date to complete <span class=cloze>licensing</span> and <span class=cloze>credentialing</span>. It is recommended to allow for a minimum of <span class=cloze>90</span> days.&nbsp;<br> Evaluations are easier to administer when they are not tied directly to <span class=cloze>[...]</span> or other <span class=cloze>[...]</span>, but rather are focused on educational or improvement efforts.Evaluations are easier to administer when they are not tied directly to <span class=cloze>compensation</span> or other <span class=cloze>payment incentives</span>, but rather are focused on educational or improvement efforts.<br> Evaluations are easier to administer when they are not tied directly to compensation or other payment incentives, but rather are focused on <span class=cloze>[...]</span> or <span class=cloze>[...]</span> efforts.Evaluations are easier to administer when they are not tied directly to compensation or other payment incentives, but rather are focused on <span class=cloze>educational</span> or <span class=cloze>improvement</span> efforts.<br> Evaluations are <span class=cloze>[...]</span> to administer when they are not tied <span class=cloze>[...]</span> to compensation or other payment incentives, but rather are focused on educational or improvement efforts.Evaluations are <span class=cloze>easier</span> to administer when they are not tied <span class=cloze>directly</span> to compensation or other payment incentives, but rather are focused on educational or improvement efforts.<br> A good compensation plan should achieve <span class=cloze>[...]</span> by employees. This means that employees feel they are compensated fairly for the <span class=cloze>[...]</span> they do, for the <span class=cloze>[...]</span> or <span class=cloze>[...]</span> they possess, and for the <span class=cloze>[...]</span> and <span class=cloze>[...]</span> where they work.&nbsp;A good compensation plan should achieve <span class=cloze>perceived equity</span> by employees. This means that employees feel they are compensated fairly for the <span class=cloze>work</span> they do, for the <span class=cloze>training</span> or <span class=cloze>education</span> they possess, and for the <span class=cloze>industry</span> and <span class=cloze>environment</span> where they work.&nbsp;<br> "<div>There are basic points to remember in finding equity with employees. </div> <div><ul><li>Identify a <span class=cloze>[...]</span> for each job classification. A <span class=cloze>[...]</span> and a <span class=cloze>[...]</span> should be considered. </li><li>Compare your pay ranges (<span class=cloze>[...]</span>) to similar positions in similar settings in your industry and in your area. Verify they are <span class=cloze>[...]</span> and ""<span class=cloze>[...]</span>.""</li><li>Identify how you will administer <span class=cloze>[...]</span> for things such as years of <span class=cloze>[...]</span>, <span class=cloze>[...]</span> training, <span class=cloze>[...]</span>, and <span class=cloze>[...]</span> evaluations. </li><li>Figure in <span class=cloze>[...]</span> to your total compensation package. A position that pays the same hourly rate as a competing clinic, which offers additional <span class=cloze>[...]</span>, may not be perceived as providing an equitable compensation. </li><li>Identify the potential for <span class=cloze>[...]</span> increases for cost of inflation (cost of living raises). The amount provided each year may differ depending on the <span class=cloze>[...]</span>; however, identifying whether this will be a component of your <span class=cloze>[...]</span> will be valuable.</li></ul></div> ""<div>There are basic points to remember in finding equity with employees. </div> <div><ul><li>Identify a <span class=cloze>pay range</span> for each job classification. A <span class=cloze>low range</span> and a <span class=cloze>high range</span> should be considered. </li><li>Compare your pay ranges (<span class=cloze>benchmark</span>) to similar positions in similar settings in your industry and in your area. Verify they are <span class=cloze>competitive</span> and ""<span class=cloze>fair</span>.""</li><li>Identify how you will administer <span class=cloze>adjustments</span> for things such as years of <span class=cloze>service</span>, <span class=cloze>special</span> training, <span class=cloze>certifications</span>, and <span class=cloze>performance</span> evaluations. </li><li>Figure in <span class=cloze>benefits</span> to your total compensation package. A position that pays the same hourly rate as a competing clinic, which offers additional <span class=cloze>benefits</span>, may not be perceived as providing an equitable compensation. </li><li>Identify the potential for <span class=cloze>yearly</span> increases for cost of inflation (cost of living raises). The amount provided each year may differ depending on the <span class=cloze>economy</span>; however, identifying whether this will be a component of your <span class=cloze>compensation structure</span> will be valuable.</li></ul></div> <br> "
If there is a perceived need for medical services in your community, a local hospital system may be willing to provide an <span class=cloze>[...]</span> to ease the costs of a <span class=cloze>[...]</span>. There will usually be conditions tied to such an agreement that you will need to be familiar and comfortable with.&nbsp;If there is a perceived need for medical services in your community, a local hospital system may be willing to provide an <span class=cloze>income guarantee</span> to ease the costs of a <span class=cloze>new physician</span>. There will usually be conditions tied to such an agreement that you will need to be familiar and comfortable with.&nbsp;<br> MGMA&nbsp;Medical Group Management Association
<div>What is a system to measure the performance of a process, item, or service against a defined standard? </div> <div>A. Quality Assurance </div> <div>B. Quality Control </div> <div>C. Continuous Quality Improvement </div> <div>D. None of the above&nbsp;</div><div>B. Quality Control</div><br>
<div>As the practice manager, you notice that charges are not being coded as quickly as you believe they should. When you speak to the coders, they complain that there are too many doctors and not enough coders to code all the charges in the timeframe you have requested. What resource could you use to find benchmark information to indicate how many coders you should employ in your practice? </div> <div>A. MGMA Annual Survey </div> <div>B. Quality Improvement Organizations </div> <div>C. CMS website </div> D. Ask the practice next door how many coders they have<div>A. MGMA Annual Survey</div><br>
<div>Under MIPS, which of the following is NOT considered an improvement activity? </div> <div>A. Expanding practice access </div> <div>B. Participation in an APM </div> <div>C. Patient Safety and Practice Assessment </div> <div>D. Practice profitability&nbsp;</div>D. Practice profitability&nbsp;
<div>Several patients have presented to the office over the last three weeks complaining they have not received their lab work or received incorrect results. To improve this process, you use the Plan, Do, Check, Act method. Which options below are included in this method? </div> <div>I. Gather a team of the key players together to outline the plan and list steps to achieve the goal. </div> <div>II. Perform small-scale testing to determine if the plan will work. </div> <div>III. Ask other practices if they have this same problem. </div> <div>IV. Check to see if improvements have been made. </div> <div>V. Implement a plan outlined by key players of a team. </div> <div>&nbsp;</div> <div>A. I, II, III, and IV </div> <div>B. I, II, III, and V </div> <div>C. I, II, IV, and V </div> D. II, III, IV, and VC. I, II, IV, and V
<div>All the following are steps to initiate effective benchmarking EXCEPT: </div> <div>A. Identify what you want to measure and improve and how you will obtain measurements </div> <div>B. Decide what improvements can be made to improve your processes </div> <div>C. Only complete process once and then move on </div> D. Repeat-determine if your goals are accomplished and identify continual opportunities for improvementC. Only complete process once and then move on
<div>Which of the following are examples of quality control (QC) processes? </div> <div>I. Comparing processes to other providers in the area </div> <div>II. Calibrating the blood pressure machines </div> <div>III. Testing the fire extinguishers in the clinic </div> <div>IV. Verifying accurate temperatures for the refrigerators containing vaccines </div> <div>V. Turning up the temperature of the refrigerators at night to save cost </div> <div>&nbsp;</div> <div>A. I, II, and V </div> <div>B. I, III, and V </div> <div>C. II, III, and V </div> D. II, III, and IVD. II, III, and IV
<div>What is providing care that is responsive to individual patient preferences, needs, and values and assuring that patient values guide all clinical decisions? </div> <div>A. Equitable care </div> <div>B. Patient-centered care </div> <div>C. Timely care </div> D. Preventive care<div>B. Patient-centered care</div><br>
<div>Which option is FALSE regarding Quality Assurance (QA)? </div> <div>A. It is an integrated system of management involving planning, training, quality control, assessment, data review, reporting and quality improvement to ensure a process, item or service is of expected type and quality. </div> <div>B. Focuses on inspection </div> <div>C. Sets policy and controls to ensure the usability of the product. </div> D. Focuses on prevention of issues.D. Focuses on prevention of issues.
<div>What is a strategy of continuous refinement to improve quality? </div> <div>A. Continuous Quality Improvement </div> <div>B. Quality Outcome Measurements </div> <div>C. Quality Assurance </div> D. Creation of policies and procedures<div>A. Continuous Quality Improvement</div><br>
<div>Which of the following processes will make quality improvement meaningful and reduce medical errors? </div> <div>A. Using a computerized provider order entry (CPOE) of medications (e-prescribing) </div> <div>B. Medication reconciliation </div> <div>C. Using computerization to track, report and measure quality </div> D. All of the above.D. All of the above.
QAQuality Assurance
QCQuality Control
CQIContinuous Quality Improvement
QIQuality Improvement
QIOsQuality Improvement Organizations
JCThe Joint Commission
PDCAPlan, Do, Check, Act
HITHealth Information Technology
CPOEComputerized Provider Order Entry
CCDContinuity of Care Document
PQRSPhysician Quality Reporting System
CPIAClinical practice improvement activities
MPFSMedicare Physician Fee Schedule
EPsEligible Professionals
IAImprovement Activities
RVUs&nbsp;Relative Value Units
GPCIGeographic Practice Cost Index
CF&nbsp;Conversion Factor
RBRVS&nbsp;Resource-based relative value scale
<div>What type of reimbursement is calculated based on RVUs (Relative Value Units), GPCI (Geographic Practice Cost Index) and CF (Conversion Factor)? </div> <div>A. Prospective fee schedule </div> <div>B. Capitation </div> <div>C. RBRVS </div> <div>D. Value-based reimbursement&nbsp;</div><div>C. RBRVS</div>
"<div>Looking at the following denials report, which denial code should you work first? </div> <div><img src=""clip_image002.gif""></div> <div>A. 468 Duplicate Claim </div> <div>B. 487 No Precertification or Prior Authorization </div> <div>C. 522 Time Limit for Filing Expired </div> D. Other&nbsp;"<div>B. 487 No Precertification or Prior Authorization</div><br>
"<div>Looking at the following denials report, which denials could have been reduced/eliminated if the appointment scheduling/ front desk staff had done a better job of collecting demographic and insurance information? </div> <div><img src=""clip_image002.gif""></div> <div>A. 390 - Patient Not Insured by Payer and 444 - Multiple Procedures on Same DOS </div> <div>B. 468 - Duplicate Claim and 390 - Patient Not Insured by Payer </div> <div>C. 468 - Duplicate Claim, 444 - Multiple Procedures on Same DOS, and 597 - Not Primary Payer </div> D. 390 - Patient Not Insured by Payer, 487 - No Precertification or Prior Authorization, and 597 - Not Primary Payer"D. 390 - Patient Not Insured by Payer, 487 - No Precertification or Prior Authorization, and 597 - Not Primary Payer
<div>This measurement refers to how long it takes a business to collect on charges: </div> <div>A. Days in A/R </div> <div>B. Net collection Rate </div> <div>C. Adjustments to Collections Ratio </div> D. A/R Analysis Report<div>A. Days in A/R</div>
"<div>If the total A/R is $150,000 and your average daily charges are $5,500, what is the practice's days in A/R equal? </div> <div>A. 45 </div> <div>B. 25 </div> <div>C. 29 </div> D. 27"D. 27
<div>If the collections for your practice equal $400,000 and your adjustments equal $100,000, what is your adjustments to collections ratio. </div> <div>A. 3.0 </div> <div>B. 0.30 </div> <div>C. 0.25 </div> D. 2.5C. 0.25
<div>When revenue is decreasing, which factors should a practice manager review? </div> <div>A. Staff errors, coding, and billing </div> <div>B. Patient volume, coding, and denials </div> <div>C. Staff errors, insurance delays, and denials </div> D. Patient volume, staff errors, coding, billing, insurance delays, and denials&nbsp;D. Patient volume, staff errors, coding, billing, insurance delays, and denials&nbsp;
<div>Which of the following are essential to have an effective revenue cycle? </div> <div>A. Appointment scheduling and registration (patient intake) </div> <div>B. Appointment scheduling and registration (patient intake) and Denial management and accounts receivable follow up </div> <div>C. Charge capture and billing (claims processing) and Denial management and accounts receivable follow up </div> <div>D. Appointment scheduling and registration (patient intake), Charge capture and billing (claims processing), and Denial management and accounts receivable follow up&nbsp;</div>D. Appointment scheduling and registration (patient intake), Charge capture and billing (claims processing), and Denial management and accounts receivable follow up&nbsp;
<div>Which of the following would NOT be a reason that payers may deny payment for a claim? </div> <div>A. Timely Filing </div> <div>B. Clean claim </div> <div>C. No Precertification or prior authorization </div> <div>D. Patient not insured by payer</div><div>B. Clean claim</div>
<div>If the practice manager finds that the cash receipts look unusually high or low, what should they evaluate? </div> <div>I. Unusual charge activity in the previous or current month </div> <div>II. Timeliness of posted payments </div> <div>III. Unfiled or missing charges </div> <div>IV. Nothing if high, it is an indicator of good collections </div> <div>&nbsp;</div> <div>A. Unusual charge activity in the previous or current month and timeliness of posted payments </div> <div>B. Timeliness of posted payments and unfiled or missing charges </div> <div>C. Unusual charge activity in the previous or current month, timeliness of posted payments, and unfiled or missing charges </div> D. Unusual charge activity in the previous or current month, timeliness of posted payments, unfiled or missing charges, and nothing if high, it is an indicator of good collectionsC. Unusual charge activity in the previous or current month, timeliness of posted payments, and unfiled or missing charges
The most common reimbursement methods from insurance payers are <span class=cloze>[...]</span>, discounted charges, capitation, and resource-based relative value scale (RBRVS) systemsThe most common reimbursement methods from insurance payers are <span class=cloze>prospective fee schedules</span>, discounted charges, capitation, and resource-based relative value scale (RBRVS) systems<br> The most common reimbursement methods from insurance payers are prospective fee schedules, discounted charges, <span class=cloze>[...]</span>, and resource-based relative value scale (RBRVS) systemsThe most common reimbursement methods from insurance payers are prospective fee schedules, discounted charges, <span class=cloze>capitation</span>, and resource-based relative value scale (RBRVS) systems<br> The most common reimbursement methods from insurance payers are prospective fee schedules, discounted charges, capitation, and <span class=cloze>[...]</span>The most common reimbursement methods from insurance payers are prospective fee schedules, discounted charges, capitation, and <span class=cloze>resource-based relative value scale (RBRVS) systems</span><br> The most common reimbursement methods from insurance payers are prospective fee schedules, <span class=cloze>[...]</span>, capitation, and resource-based relative value scale (RBRVS) systemsThe most common reimbursement methods from insurance payers are prospective fee schedules, <span class=cloze>discounted charges</span>, capitation, and resource-based relative value scale (RBRVS) systems<br> "This methodology has become the basis for payment for governmental entities, as well as other managed care plans. Payers can adjust their cost factors to meet their own budgets. Many state Medicaid plans use this methodology and use a conversion factor lower than Medicare's."Resource-based relative value scale (RBRVS)&nbsp;
This measurement that refers to how long it takes a business to collect on chargesDays in A/R&nbsp;
<div>The days in A/R number can be an important tool to identify if your clinic is: </div> <div>• <span class=cloze>[...]</span> properly </div> <div>• <span class=cloze>[...]</span> properly </div> <div>• <span class=cloze>[...]</span> properly </div> <div>• Collecting co-pays and deductibles <span class=cloze>[...]</span> </div> <div>• Billing <span class=cloze>[...]</span> </div> <div>• Properly <span class=cloze>[...]</span> providers. </div> <div>• Working <span class=cloze>[...]</span> on the backend properly </div> • Effectively following-up on <span class=cloze>[...]</span><div>The days in A/R number can be an important tool to identify if your clinic is: </div> <div>• <span class=cloze>Collecting</span> properly </div> <div>• <span class=cloze>Billing</span> properly </div> <div>• <span class=cloze>Coding</span> properly </div> <div>• Collecting co-pays and deductibles <span class=cloze>in a timely manner</span> </div> <div>• Billing <span class=cloze>in a timely manner</span> </div> <div>• Properly <span class=cloze>credentialing</span> providers. </div> <div>• Working <span class=cloze>collections</span> on the backend properly </div> • Effectively following-up on <span class=cloze>insurance denials</span><br> The days in A/R number should be low. Days in A/R is a fraction. The numerator is the total A/R. The denominator is average daily charges. <br><br>Average daily charges are the <span class=cloze>[...]</span> over the last two months (or one month), divided by the <span class=cloze>[...]</span> in those two (or one) months.&nbsp;<div><br></div><div>A good result in A/R should not exceed 45 days. Better performing practices will be around 30 days.</div>The days in A/R number should be low. Days in A/R is a fraction. The numerator is the total A/R. The denominator is average daily charges. <br><br>Average daily charges are the <span class=cloze>total charges</span> over the last two months (or one month), divided by the <span class=cloze>total number of days</span> in those two (or one) months.&nbsp;<div><br></div><div>A good result in A/R should not exceed 45 days. Better performing practices will be around 30 days.</div><br> The days in A/R number should be <span class=cloze>[...]</span>. Days in A/R is a <span class=cloze>[...]</span>. The <span class=cloze>[...]</span> is the total A/R. The <span class=cloze>[...]</span> is average daily charges. <br><br>Average daily charges are the total charges over the last two months (or one month), divided by the total number of days in those two (or one) months.&nbsp;<div><br></div><div>A good result in A/R should not exceed 45 days. Better performing practices will be around 30 days.</div>The days in A/R number should be <span class=cloze>low</span>. Days in A/R is a <span class=cloze>fraction</span>. The <span class=cloze>numerator</span> is the total A/R. The <span class=cloze>denominator</span> is average daily charges. <br><br>Average daily charges are the total charges over the last two months (or one month), divided by the total number of days in those two (or one) months.&nbsp;<div><br></div><div>A good result in A/R should not exceed 45 days. Better performing practices will be around 30 days.</div><br> The days in A/R number should be low. Days in A/R is a fraction. The numerator is the total A/R. The denominator is average daily charges. <br><br>Average daily charges are the total charges over the last two months (or one month), divided by the total number of days in those two (or one) months.&nbsp;<div><br></div><div>A good result in A/R should not exceed <span class=cloze>[...]</span> days. Better performing practices will be around <span class=cloze>[...]</span> days.</div>The days in A/R number should be low. Days in A/R is a fraction. The numerator is the total A/R. The denominator is average daily charges. <br><br>Average daily charges are the total charges over the last two months (or one month), divided by the total number of days in those two (or one) months.&nbsp;<div><br></div><div>A good result in A/R should not exceed <span class=cloze>45</span> days. Better performing practices will be around <span class=cloze>30</span> days.</div><br> Adjustments can affect the net collection rate as well as days in A/R, it is important to monitor the use of adjustment codes, monthly, to verify that money is not being <span class=cloze>[...]</span> unnecessarily.Adjustments can affect the net collection rate as well as days in A/R, it is important to monitor the use of adjustment codes, monthly, to verify that money is not being <span class=cloze>written off</span> unnecessarily.<br> <span class=cloze>[...]</span> can affect the net collection rate as well as days in A/R, it is important to monitor the use of <span class=cloze>[...]</span> codes, monthly, to verify that money is not being written off unnecessarily.<span class=cloze>Adjustments</span> can affect the net collection rate as well as days in A/R, it is important to monitor the use of <span class=cloze>adjustment</span> codes, monthly, to verify that money is not being written off unnecessarily.<br> Total adjustments may fluctuate from month to month as productivity numbers change. Greater <span class=cloze>[...]</span> billed will mean greater adjustments. However, comparing adjustments to <span class=cloze>[...]</span> should create a <span class=cloze>[...]</span>.Total adjustments may fluctuate from month to month as productivity numbers change. Greater <span class=cloze>revenue</span> billed will mean greater adjustments. However, comparing adjustments to <span class=cloze>total collections</span> should create a <span class=cloze>consistent ratio</span>.<br> Adjustments should also be monitored by category, such as contractual <span class=cloze>[...]</span>, bad debt <span class=cloze>[...]</span>, and courtesy <span class=cloze>[...]</span>.&nbsp;Adjustments should also be monitored by category, such as contractual <span class=cloze>adjustments</span>, bad debt <span class=cloze>write offs</span>, and courtesy <span class=cloze>discounts</span>.&nbsp;<br> Adjustments should also be monitored by category, such as <span class=cloze>[...]</span> adjustments, <span class=cloze>[...]</span> write offs, and <span class=cloze>[...]</span> discounts.&nbsp;Adjustments should also be monitored by category, such as <span class=cloze>contractual</span> adjustments, <span class=cloze>bad debt</span> write offs, and <span class=cloze>courtesy</span> discounts.&nbsp;<br> The factors that affect revenue and should be evaluated by the manager include:<br><ul><li><span class=cloze>[...]</span> volume,&nbsp;</li><li><span class=cloze>[...]</span> errors,&nbsp;</li><li>coding and billing, and&nbsp;</li><li><span class=cloze>[...]</span> delays.</li></ul>The factors that affect revenue and should be evaluated by the manager include:<br><ul><li><span class=cloze>patient</span> volume,&nbsp;</li><li><span class=cloze>staff</span> errors,&nbsp;</li><li>coding and billing, and&nbsp;</li><li><span class=cloze>insurance</span> delays.</li></ul><br> The factors that affect revenue and should be evaluated by the manager include:<br><ul><li>patient <span class=cloze>[...]</span>,&nbsp;</li><li>staff <span class=cloze>[...]</span>,&nbsp;</li><li><span class=cloze>[...]</span> and <span class=cloze>[...]</span>, and&nbsp;</li><li>insurance <span class=cloze>[...]</span>.</li></ul>The factors that affect revenue and should be evaluated by the manager include:<br><ul><li>patient <span class=cloze>volume</span>,&nbsp;</li><li>staff <span class=cloze>errors</span>,&nbsp;</li><li><span class=cloze>coding</span> and <span class=cloze>billing</span>, and&nbsp;</li><li>insurance <span class=cloze>delays</span>.</li></ul><br> The revenue cycle begins when <span class=cloze>[...]</span>.&nbsp;The revenue cycle begins when <span class=cloze>a patient determines the need for services and calls to make an appointment</span>.&nbsp;<br> The revenue cycle does not end until the account balance is <span class=cloze>[...]</span> through <span class=cloze>[...]</span> of insurance payments, contractual adjustments, write offs, and patient payments.The revenue cycle does not end until the account balance is <span class=cloze>resolved</span> through <span class=cloze>reconciliation</span> of insurance payments, contractual adjustments, write offs, and patient payments.<br> The revenue cycle does not end until the account balance is resolved through reconciliation of <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, and <span class=cloze>[...]</span>.The revenue cycle does not end until the account balance is resolved through reconciliation of <span class=cloze>insurance payments</span>, <span class=cloze>contractual adjustments</span>, <span class=cloze>write offs</span>, and <span class=cloze>patient payments</span>.<br> The revenue cycle does not end until the <span class=cloze>[...]</span> is resolved through reconciliation of insurance payments, contractual adjustments, write offs, and patient payments.The revenue cycle does not end until the <span class=cloze>account balance</span> is resolved through reconciliation of insurance payments, contractual adjustments, write offs, and patient payments.<br> <div>Steps for an effective revenue cycle include: </div> <div>• Appointment <span class=cloze>[...]</span> <br>• Registration (<span class=cloze>[...]</span>) </div> <div>• Charge capture for <span class=cloze>[...]</span> </div> <div>• Billing (<span class=cloze>[...]</span>) </div> <div>• Denial <span class=cloze>[...]</span> </div> • Accounts receivable <span class=cloze>[...]</span><div>Steps for an effective revenue cycle include: </div> <div>• Appointment <span class=cloze>scheduling</span> <br>• Registration (<span class=cloze>patient intake</span>) </div> <div>• Charge capture for <span class=cloze>services</span> </div> <div>• Billing (<span class=cloze>claims processing</span>) </div> <div>• Denial <span class=cloze>management</span> </div> • Accounts receivable <span class=cloze>follow-up</span><br> <div>Steps for an effective revenue cycle include: </div> <div>• <span class=cloze>[...]</span> scheduling <br>• <span class=cloze>[...]</span> (patient intake) </div> <div>• <span class=cloze>[...]</span> for services </div> <div>• <span class=cloze>[...]</span> (claims processing) </div> <div>• <span class=cloze>[...]</span> management </div> • <span class=cloze>[...]</span> follow-up<div>Steps for an effective revenue cycle include: </div> <div>• <span class=cloze>Appointment</span> scheduling <br>• <span class=cloze>Registration</span> (patient intake) </div> <div>• <span class=cloze>Charge capture</span> for services </div> <div>• <span class=cloze>Billing</span> (claims processing) </div> <div>• <span class=cloze>Denial</span> management </div> • <span class=cloze>Accounts receivable</span> follow-up<br> <div>Steps for an effective <span class=cloze>[...]</span> include: </div> <div>• Appointment scheduling <br>• Registration (patient intake) </div> <div>• Charge capture for services </div> <div>• Billing (claims processing) </div> <div>• Denial management </div> • Accounts receivable follow-up<div>Steps for an effective <span class=cloze>revenue cycle</span> include: </div> <div>• Appointment scheduling <br>• Registration (patient intake) </div> <div>• Charge capture for services </div> <div>• Billing (claims processing) </div> <div>• Denial management </div> • Accounts receivable follow-up<br> If cash receipts look unusually high or low, look for:<br><ul><li>unusual charge activity in the <span class=cloze>[...]</span> month,&nbsp;</li><li>payments <span class=cloze>[...]</span>,&nbsp;</li><li><span class=cloze>[...]</span> claims, or&nbsp;</li><li>an adjudication issue with a <span class=cloze>[...]</span>.&nbsp;</li></ul>If cash receipts look unusually high or low, look for:<br><ul><li>unusual charge activity in the <span class=cloze>previous or current</span> month,&nbsp;</li><li>payments <span class=cloze>not posted regularly</span>,&nbsp;</li><li><span class=cloze>unfiled or lost</span> claims, or&nbsp;</li><li>an adjudication issue with a <span class=cloze>payer</span>.&nbsp;</li></ul><br> If cash receipts look unusually high or low, look for:<br><ul><li>unusual <span class=cloze>[...]</span> in the previous or current month,&nbsp;</li><li><span class=cloze>[...]</span> not posted regularly,&nbsp;</li><li>unfiled or lost <span class=cloze>[...]</span>, or&nbsp;</li><li>an <span class=cloze>[...]</span> issue with a payer.&nbsp;</li></ul>If cash receipts look unusually high or low, look for:<br><ul><li>unusual <span class=cloze>charge activity</span> in the previous or current month,&nbsp;</li><li><span class=cloze>payments</span> not posted regularly,&nbsp;</li><li>unfiled or lost <span class=cloze>claims</span>, or&nbsp;</li><li>an <span class=cloze>adjudication</span> issue with a payer.&nbsp;</li></ul><br> EDIElectronic Data Interchange
ERAelectronic remittance advice
EFTelectronic funds transfer
UPINunique physician identification number
CHIPChildren Health Insurance Program&nbsp;
<div>MCO</div>Managed Care Organization
PPOPreferred Provider Organization&nbsp;
HMOHealth Maintenance Organization&nbsp;
DRGDiagnosis Related Groups&nbsp;
APCAmbulatory Payment Classification&nbsp;
FFSFee for Service&nbsp;
<div>Which code set represents procedures performed at inpatient hospital facilities? </div> <div>A. ICD-10 CM codes </div> <div>B. CPT codes </div> <div>C. HCPCS Level II codes </div> D. ICD-10 PCS codesD. ICD-10 PCS codes
<div>A Medicare patient is in the hospital. Which Medicare plan will be billed for the facility charges? </div> <div>A. Part A </div> <div>B. Part B </div> <div>C. Part C </div> <div>D. Part D</div><div>A. Part A</div><br>
"<div>Medicare is considered a secondary payer in which of the following scenarios? </div> <div>A. Workers' Compensation claims </div> <div>B. Automobile accidents </div> <div>C. End-stage renal disease (ESRD) during the first 18-30 months of the beneficiary's entitlement to ESRD benefits </div> <div>D. All of the above&nbsp;</div>"D. All of the above&nbsp;
<div>Services that are reported with E/M codes include: </div> <div>I. Office visits </div> <div>II. Hospital visits </div> <div>III. Nursing home visits </div> <div>IV. Surgical procedures </div> <div>&nbsp;</div> <div>A. I only </div> <div>B. I and II only </div> <div>C. I, II, and III </div> <div>D. I, II, III, and IV&nbsp;</div><div>C. I, II, and III</div><br>
<div>Which of the following places of service is reimbursed at a higher level to cover expenses such as rent, staff, and supplies? </div> <div>A. Inpatient Hospital POS (21) </div> <div>B. Office POS (11) </div> <div>C. Ambulatory Surgical Center POS (24) </div> <div>D. Skilled Nursing Facility POS (32)&nbsp;</div><div>B. Office POS (11)</div><br>
"<div>Which of the following is NOT a common billing error? </div> <div>A. The patient cannot be identified as a Medicare patient </div> <div>B. E/M procedure codes and the place of service do not match </div> <div>C. Diagnosis codes are specific and valid </div> <div>D. The referring or ordering physician's name and UPIN are not present on the claim.&nbsp;</div>"<div>C. Diagnosis codes are specific and valid</div><br>
<div>Which of the following is NOT an example of a private health plan? </div> <div>A. Children Health Insurance Program (CHIP) </div> <div>B. Managed Care Organization (MCO) </div> <div>C. Preferred Provider Organization (PPO) </div> D. Health Maintenance Organization (HMO)&nbsp;<div>A. Children Health Insurance Program (CHIP)</div><br>
<div>What type of reimbursement does a facility receive when patients are receiving hospital services, but have not been admitted to the hospital? </div> <div>A. Inpatient-Diagnosis Related Groups (DRG) </div> <div>B. Hospital Outpatient-Ambulatory Payment Classification (APC) </div> <div>C. Outpatient Physician - Fee for Service (FFS) </div> <div>D. None of the above</div><div>B. Hospital Outpatient-Ambulatory Payment Classification (APC)</div><br>
"<div>Which of the following is the most important guideline to meet in the selection of a physician's evaluation and management code? </div> <div>A. Medical Decision Making </div> <div>B. Medical Necessity </div> <div>C. The amount of time spent with the patient </div> D. Amount of history and exam documented&nbsp;"<div>B. Medical Necessity</div><br>
<div>Which one of the following is a history component in evaluation and management coding with 1995 or 1997 E/M Documentation Guidelines? </div> <div>I. Chief complaint </div> <div>II. History of Present Illness </div> <div>III. Review of Systems </div> <div>&nbsp;</div> <div>A. I only </div> <div>B. II only </div> <div>C. II and III only </div> D. I, II, and IIID. I, II, and III
ICD-10-PCS codes represent&nbsp;procedures performed at inpatient facilities
<span class=cloze>[...]</span> are not reported with ICD-10-PCS codes<span class=cloze>Professional services</span> are not reported with ICD-10-PCS codes<br> CPT codes represent procedures performed and billed by <span class=cloze>[...]</span> and <span class=cloze>[...]</span>CPT codes represent procedures performed and billed by <span class=cloze>physicians</span> and <span class=cloze>non-physician practitioners (NPP)</span><br> ICD-10-CM codes represent&nbsp;the diagnosis/reason a procedure is done
HCPCS Level II codes represent&nbsp;healthcare equipment, supplies and services
Hospital insurance (<span class=cloze>[...]</span>) helps pay for <span class=cloze>[...]</span> in a hospital or skilled nursing facility (following a hospital stay), some <span class=cloze>[...]</span> and <span class=cloze>[...]</span>Hospital insurance (<span class=cloze>Part A</span>) helps pay for <span class=cloze>inpatient care</span> in a hospital or skilled nursing facility (following a hospital stay), some <span class=cloze>home healthcare</span> and <span class=cloze>hospice care</span><br> <span class=cloze>[...]</span> insurance (Part A) helps pay for inpatient care in a <span class=cloze>[...]</span> or <span class=cloze>[...]</span> (following a <span class=cloze>[...]</span> stay), some home healthcare and hospice care<span class=cloze>Hospital</span> insurance (Part A) helps pay for inpatient care in a <span class=cloze>hospital</span> or <span class=cloze>skilled nursing facility</span> (following a <span class=cloze>hospital</span> stay), some home healthcare and hospice care<br> "<span class=cloze>[...]</span> insurance (Part B) helps pay for doctors' services and many other medical services and supplies that are not covered by <span class=cloze>[...]</span> insurance.""<span class=cloze>Medical</span> insurance (Part B) helps pay for doctors' services and many other medical services and supplies that are not covered by <span class=cloze>hospital</span> insurance.<br> "
"Medical insurance (Part B) helps pay for doctors' <span class=cloze>[...]</span> and many other medical services and supplies that are not covered by hospital insurance.""Medical insurance (Part B) helps pay for doctors' <span class=cloze>services</span> and many other medical services and supplies that are not covered by hospital insurance.<br> "
"Medical insurance (<span class=cloze>[...]</span>) helps pay for doctors' services and many other medical <span class=cloze>[...]</span> that are not covered by hospital insurance.""Medical insurance (<span class=cloze>Part B</span>) helps pay for doctors' services and many other medical <span class=cloze>services and supplies</span> that are not covered by hospital insurance.<br> "
<span class=cloze>[...]</span> (Part C) plans are available in many areas. People with Medicare Parts A and B can choose to receive <span class=cloze>[...]</span> through one of these provider organizations under Part C.&nbsp;<span class=cloze>Medicare Advantage</span> (Part C) plans are available in many areas. People with Medicare Parts A and B can choose to receive <span class=cloze>all of their healthcare services</span> through one of these provider organizations under Part C.&nbsp;<br> Medicare Advantage (<span class=cloze>[...]</span>) plans are available in many areas. People with Medicare <span class=cloze>[...]</span> and <span class=cloze>[...]</span> can choose to receive all of their healthcare services through one of these provider organizations under <span class=cloze>[...]</span>.&nbsp;Medicare Advantage (<span class=cloze>Part C</span>) plans are available in many areas. People with Medicare <span class=cloze>Parts A</span> and <span class=cloze>B</span> can choose to receive all of their healthcare services through one of these provider organizations under <span class=cloze>Part C</span>.&nbsp;<br> <span class=cloze>[...]</span> coverage (Part D) helps pay for doctor <span class=cloze>[...]</span> necessary for treatment.<span class=cloze>Prescription drug</span> coverage (Part D) helps pay for doctor <span class=cloze>prescribed medications</span> necessary for treatment.<br> Prescription drug coverage (<span class=cloze>[...]</span>) helps pay for doctor prescribed medications necessary for treatment.Prescription drug coverage (<span class=cloze>Part D</span>) helps pay for doctor prescribed medications necessary for treatment.<br> "Medicare is <span class=cloze>[...]</span> to <br><ul><li>Workers' Compensation,&nbsp;</li><li>Automobile, medical no-fault and liability insurance,</li><li>Employer Group Health Plans (EGHP), and&nbsp;</li><li>Certain employer health plans covering aged and disabled beneficiaries</li></ul>""Medicare is <span class=cloze>secondary</span> to <br><ul><li>Workers' Compensation,&nbsp;</li><li>Automobile, medical no-fault and liability insurance,</li><li>Employer Group Health Plans (EGHP), and&nbsp;</li><li>Certain employer health plans covering aged and disabled beneficiaries</li></ul><br> "
"Medicare is secondary to <br><ul><li>Workers' Compensation,&nbsp;</li><li><span class=cloze>[...]</span>, <span class=cloze>[...]</span> and <span class=cloze>[...]</span> insurance,</li><li>Employer Group Health Plans (EGHP), and&nbsp;</li><li>Certain employer health plans covering <span class=cloze>[...]</span> beneficiaries</li></ul>""Medicare is secondary to <br><ul><li>Workers' Compensation,&nbsp;</li><li><span class=cloze>Automobile</span>, <span class=cloze>medical no-fault</span> and <span class=cloze>liability</span> insurance,</li><li>Employer Group Health Plans (EGHP), and&nbsp;</li><li>Certain employer health plans covering <span class=cloze>aged and disabled</span> beneficiaries</li></ul><br> "
Medicare is secondary to <br><ul><li><span class=cloze>[...]</span>,&nbsp;</li><li>Automobile, medical no-fault and liability insurance,</li><li><span class=cloze>[...]</span> (EGHP), and&nbsp;</li><li>Certain employer health plans covering aged and disabled beneficiaries</li></ul>"Medicare is secondary to <br><ul><li><span class=cloze>Workers' Compensation</span>,&nbsp;</li><li>Automobile, medical no-fault and liability insurance,</li><li><span class=cloze>Employer Group Health Plans</span> (EGHP), and&nbsp;</li><li>Certain employer health plans covering aged and disabled beneficiaries</li></ul><br> "
EGHPEmployer Group Health Plans&nbsp;
ESRDend-stage renal disease&nbsp;
"For end-stage renal disease (ESRD) beneficiaries, Medicare is the <span class=cloze>[...]</span> payer during the <span class=cloze>[...]</span> months of the beneficiary's entitlement to ESRD benefits""For end-stage renal disease (ESRD) beneficiaries, Medicare is the <span class=cloze>secondary</span> payer during the <span class=cloze>first 18-30</span> months of the beneficiary's entitlement to ESRD benefits<br> "
"For <span class=cloze>[...]</span> beneficiaries, Medicare is the secondary payer during the first 18-30 months of the beneficiary's entitlement to <span class=cloze>[...]</span> benefits""For <span class=cloze>end-stage renal disease (ESRD)</span> beneficiaries, Medicare is the secondary payer during the first 18-30 months of the beneficiary's entitlement to <span class=cloze>ESRD</span> benefits<br> "
E/M services are reported for visits made by physicians or other qualified healthcare providers in the <span class=cloze>[...]</span>E/M services are reported for visits made by physicians or other qualified healthcare providers in the <span class=cloze>office, hospital, and nursing home.&nbsp;</span><br> <span class=cloze>[...]</span> services are reported for visits made by physicians or other qualified healthcare providers in the office, hospital, and nursing home.&nbsp;<span class=cloze>E/M</span> services are reported for visits made by physicians or other qualified healthcare providers in the office, hospital, and nursing home.&nbsp;<br> "Physician reimbursement for services provided in a facility (for example, hospital or ASC) is <span class=cloze>[...]</span> than when provided in the physician's office because the physician does not have any practice expense (<span class=cloze>[...]</span>) at the facility.""Physician reimbursement for services provided in a facility (for example, hospital or ASC) is <span class=cloze>less</span> than when provided in the physician's office because the physician does not have any practice expense (<span class=cloze>rent, staff, supplies</span>) at the facility.<br> "
Physician reimbursement for services provided in a <span class=cloze>[...]</span> (for example, hospital or ASC) is less than when provided in the <span class=cloze>[...]</span> because the physician does not have any practice expense (rent, staff, supplies) at the <span class=cloze>[...]</span>."Physician reimbursement for services provided in a <span class=cloze>facility</span> (for example, hospital or ASC) is less than when provided in the <span class=cloze>physician's office</span> because the physician does not have any practice expense (rent, staff, supplies) at the <span class=cloze>facility</span>.<br> "
Billing error: The patient cannot be identified as a Medicare patient.&nbsp;<br><br>Solution?Always use the Health Insurance Claim Number.&nbsp;
"Billing error: The referring or ordering physician's name and UPIN are not present on the claim.&nbsp;<br><br>Solution?""Include this information in Item 17 and 17a on all diagnostic services, including consultations. Don't forget the National Provider Identifiers (NPIs).&nbsp;"
"CHIP is a program for children whose families' income is too high to qualify for <span class=cloze>[...]</span>, but who cannot afford private insurance. The program is funded partially by the federal government and is administered by the states. The benefits are the standard Medicaid benefits""CHIP is a program for children whose families' income is too high to qualify for <span class=cloze>Medicaid</span>, but who cannot afford private insurance. The program is funded partially by the federal government and is administered by the states. The benefits are the standard Medicaid benefits<br> "
"<span class=cloze>[...]</span> is a program for children whose families' income is too high to qualify for Medicaid, but who cannot afford <span class=cloze>[...]</span>. The program is funded partially by the federal government and is administered by the states. The benefits are the standard <span class=cloze>[...]</span> benefits""<span class=cloze>CHIP</span> is a program for children whose families' income is too high to qualify for Medicaid, but who cannot afford <span class=cloze>private insurance</span>. The program is funded partially by the federal government and is administered by the states. The benefits are the standard <span class=cloze>Medicaid</span> benefits<br> "
CDHCConsumer-driven healthcare&nbsp;
HRAHealth reimbursement account&nbsp;
Reimbursement by <span class=cloze>[...]</span> includes:<br><ul><li>Inpatient - Diagnosis Related Groups (DRG)&nbsp;<br></li><li>Hospital Outpatient - Ambulatory Payment Classification (APC)&nbsp;<br></li><li>Outpatient Physician Services - Fee for Service (FFS)&nbsp;<br></li></ul>Reimbursement by <span class=cloze>place of service</span> includes:<br><ul><li>Inpatient - Diagnosis Related Groups (DRG)&nbsp;<br></li><li>Hospital Outpatient - Ambulatory Payment Classification (APC)&nbsp;<br></li><li>Outpatient Physician Services - Fee for Service (FFS)&nbsp;<br></li></ul><br> Reimbursement by place of service includes:<br><ul><li>Inpatient - <span class=cloze>[...]</span> (DRG)&nbsp;<br></li><li>Hospital Outpatient - <span class=cloze>[...]</span> (APC)&nbsp;<br></li><li>Outpatient Physician Services - <span class=cloze>[...]</span> (FFS)&nbsp;<br></li></ul>Reimbursement by place of service includes:<br><ul><li>Inpatient - <span class=cloze>Diagnosis Related Groups</span> (DRG)&nbsp;<br></li><li>Hospital Outpatient - <span class=cloze>Ambulatory Payment Classification</span> (APC)&nbsp;<br></li><li>Outpatient Physician Services - <span class=cloze>Fee for Service</span> (FFS)&nbsp;<br></li></ul><br> Reimbursement by place of service includes:<br><ul><li><span class=cloze>[...]</span> - Diagnosis Related Groups (DRG)&nbsp;<br></li><li><span class=cloze>[...]</span> - Ambulatory Payment Classification (APC)&nbsp;<br></li><li><span class=cloze>[...]</span> - Fee for Service (FFS)&nbsp;<br></li></ul>Reimbursement by place of service includes:<br><ul><li><span class=cloze>Inpatient</span> - Diagnosis Related Groups (DRG)&nbsp;<br></li><li><span class=cloze>Hospital Outpatient</span> - Ambulatory Payment Classification (APC)&nbsp;<br></li><li><span class=cloze>Outpatient Physician Services</span> - Fee for Service (FFS)&nbsp;<br></li></ul><br> <span class=cloze>[...]</span> by place of service includes:<br><ul><li>Inpatient - Diagnosis Related Groups (DRG)&nbsp;<br></li><li>Hospital Outpatient - Ambulatory Payment Classification (APC)&nbsp;<br></li><li>Outpatient Physician Services - Fee for Service (FFS)&nbsp;<br></li></ul><span class=cloze>Reimbursement</span> by place of service includes:<br><ul><li>Inpatient - Diagnosis Related Groups (DRG)&nbsp;<br></li><li>Hospital Outpatient - Ambulatory Payment Classification (APC)&nbsp;<br></li><li>Outpatient Physician Services - Fee for Service (FFS)&nbsp;<br></li></ul><br> OPPSOutpatient Prospective Payment System
IPPSInpatient Prospective Payment System
"Although practice managers for physicians will not submit <span class=cloze>[...]</span> claims, they should understand how the services are reimbursed because the physician's <span class=cloze>[...]</span> plays a major role in the proper facility coding.""Although practice managers for physicians will not submit <span class=cloze>inpatient facility</span> claims, they should understand how the services are reimbursed because the physician's <span class=cloze>documentation</span> plays a major role in the proper facility coding.<br> "
Hospitals bill for <span class=cloze>[...]</span> services (charges for the room, time in the OR, meals, supplies, and nursing services) based on a <span class=cloze>[...]</span>Hospitals bill for <span class=cloze>inpatient</span> services (charges for the room, time in the OR, meals, supplies, and nursing services) based on a <span class=cloze>Medicare Severity-Diagnosis Related Group (MS-DRG)</span><br> Physicians treating patients in the facility setting must properly document all <span class=cloze>[...]</span> and <span class=cloze>[...]</span> treated.&nbsp;Physicians treating patients in the facility setting must properly document all <span class=cloze>conditions</span> and <span class=cloze>co-morbidities</span> treated.&nbsp;<br> Physicians treating patients in the <span class=cloze>[...]</span> setting must properly document all conditions and co-morbidities treated.&nbsp;Physicians treating patients in the <span class=cloze>facility</span> setting must properly document all conditions and co-morbidities treated.&nbsp;<br> <span class=cloze>[...]</span> services are paid by Ambulatory Payment Classifications (APCs)<span class=cloze>Outpatient</span> services are paid by Ambulatory Payment Classifications (APCs)<br> Outpatient services are paid by <span class=cloze>[...]</span>Outpatient services are paid by <span class=cloze>Ambulatory Payment Classifications (APCs)</span><br> The APC outpatient prospective payment system (OPPS) categorizes outpatient visits according to clinical characteristics, typical resource use, and costs associated with the <span class=cloze>[...]</span> diagnoses and <span class=cloze>[...]</span> procedures performedThe APC outpatient prospective payment system (OPPS) categorizes outpatient visits according to clinical characteristics, typical resource use, and costs associated with the <span class=cloze>ICD-10-CM</span> diagnoses and <span class=cloze>CPT</span> procedures performed<br> The APC outpatient prospective payment system (OPPS) categorizes <span class=cloze>[...]</span> visits according to clinical characteristics, typical resource use, and costs associated with the ICD-10-CM <span class=cloze>[...]</span> and CPT <span class=cloze>[...]</span> performedThe APC outpatient prospective payment system (OPPS) categorizes <span class=cloze>outpatient</span> visits according to clinical characteristics, typical resource use, and costs associated with the ICD-10-CM <span class=cloze>diagnoses</span> and CPT <span class=cloze>procedures</span> performed<br> Most physicians are paid for the actual service they provide to a patient. In the office, these include services the physician <span class=cloze>[...]</span> or <span class=cloze>[...]</span>, such as office visits and exams, any lab specimens collected and/or studies performed, procedures, medications, and other supplies.&nbsp;Most physicians are paid for the actual service they provide to a patient. In the office, these include services the physician <span class=cloze>performs</span> or <span class=cloze>supervises</span>, such as office visits and exams, any lab specimens collected and/or studies performed, procedures, medications, and other supplies.&nbsp;<br> For services provided at the hospital, the physician bills for his or her hospital visits or surgeries, but not for the <span class=cloze>[...]</span> or <span class=cloze>[...]</span>.&nbsp;For services provided at the hospital, the physician bills for his or her hospital visits or surgeries, but not for the <span class=cloze>supplies used</span> or <span class=cloze>room charges</span>.&nbsp;<br> "Services provided must be <span class=cloze>[...]</span>. For example, repeating a comprehensive history and physical may not be necessary on a two-week follow-up visit to recheck and verify the patient's normal blood pressure. The volume of documentation alone <span class=cloze>[...]</span> support the E/M level billed.""Services provided must be <span class=cloze>medically necessary</span>. For example, repeating a comprehensive history and physical may not be necessary on a two-week follow-up visit to recheck and verify the patient's normal blood pressure. The volume of documentation alone <span class=cloze>does not</span> support the E/M level billed.<br> "
"The components to measure the physician's work in taking a patient's <span class=cloze>[...]</span> are Chief complaint (CC), History of Present Illness (HPI), Review of Systems (ROS), and Past, Family Social History (PFSH).&nbsp;""The components to measure the physician's work in taking a patient's <span class=cloze>medical history</span> are Chief complaint (CC), History of Present Illness (HPI), Review of Systems (ROS), and Past, Family Social History (PFSH).&nbsp;<br> "
"The components to measure the physician's work in taking a patient's medical history are <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, and <span class=cloze>[...]</span>.&nbsp;""The components to measure the physician's work in taking a patient's medical history are <span class=cloze>Chief complaint (CC)</span>, <span class=cloze>History of Present Illness (HPI)</span>, <span class=cloze>Review of Systems (ROS)</span>, and <span class=cloze>Past, Family Social History (PFSH)</span>.&nbsp;<br> "
"The chief complaint is the reason the patient presents for treatment. For each encounter it, should be clear <span class=cloze>[...]</span>. If the visit is for a routine follow up, the provider should indicate the <span class=cloze>[...]</span> that is being followed (eg, ""follow-up visit to manage hypertension"").&nbsp;""The chief complaint is the reason the patient presents for treatment. For each encounter it, should be clear <span class=cloze>why the patient is seeking medical care</span>. If the visit is for a routine follow up, the provider should indicate the <span class=cloze>condition</span> that is being followed (eg, ""follow-up visit to manage hypertension"").&nbsp;<br> "
"The <span class=cloze>[...]</span> is the reason the patient presents for treatment. For each encounter it, should be clear why the patient is seeking medical care. If the visit is for a routine follow up, the provider should indicate the condition that is being followed (eg, ""follow-up visit to manage hypertension"").&nbsp;""The <span class=cloze>chief complaint</span> is the reason the patient presents for treatment. For each encounter it, should be clear why the patient is seeking medical care. If the visit is for a routine follow up, the provider should indicate the condition that is being followed (eg, ""follow-up visit to manage hypertension"").&nbsp;<br> "
"When the reason for the visit is established, the provider will ask the patient questions about the <span class=cloze>[...]</span> problems. The HPI is a <span class=cloze>[...]</span> description of the <span class=cloze>[...]</span> of the patient's present illness, from the first sign and/or symptom, or from the previous encounter, to the present.""When the reason for the visit is established, the provider will ask the patient questions about the <span class=cloze>presenting</span> problems. The HPI is a <span class=cloze>chronological</span> description of the <span class=cloze>development</span> of the patient's present illness, from the first sign and/or symptom, or from the previous encounter, to the present.<br> "
The physician or staff makes review of systems (ROS) query (<span class=cloze>[...]</span> or via <span class=cloze>[...]</span>).&nbsp;The physician or staff makes review of systems (ROS) query (<span class=cloze>verbally</span> or via <span class=cloze>patient intake forms</span>).&nbsp;<br> If a patient presents for follow-up on a chronic condition, both the <span class=cloze>[...]</span> and <span class=cloze>[...]</span> should be considered.If a patient presents for follow-up on a chronic condition, both the <span class=cloze>HPI</span> and <span class=cloze>past medial history</span> should be considered.<br> Kennedy-Kassebaum BillHIPAA
HIPAAHealth Insurance Portability and Accountability Act
OCROffice of Civil Rights
PHIProtected Health Information
TPO reasonstreatment, payment, or healthcare operation reasons
BAABusiness Associates Agreement
COBCoordination of Benefits
EINEmployer Identification Number
HITECHHealth Information Technology for Economic and Clinical Health Act
LANsLocal area networks
WANsWide area networks
VPNVirtual Private Network
DHSDepartment of Homeland Security
CISACybersecurity and Infrastructure Security Agency
MFAMulti-factor authentication
ONCOffice of the National Coordinator for Health Information Technology
NAHITNational Alliance for Health Information Technology
HIOHealth Information Organization
HIEHealth Information Exchange
NISTNational Institute of Standards and Technology
CSRCComputer Security Resource Center
SPsSpecial Publications
<div>HIPAA, also known as the Kennedy Kassebaum bill, was passed in 1996 for all the following reasons EXCEPT which of the following?<br><br></div> <div>A. To improve portability and continuity of health insurance coverage </div> <div>B. To combat fraud, waste, and abuse</div> <div>C. To eliminate the use of medical savings accounts</div> D. To improve access to long-term care services and coverage<div>C. To eliminate the use of medical savings accounts</div><br>
<div>HIPAA applies directly to three groups referred to as covered entities, which includes healthcare providers, health plans, and which of the following?</div> <div>I. Healthcare attorneys</div> <div>II. Healthcare clearinghouses</div> <div>III. Banks who specialize in healthcare</div> <div>IV. Healthcare consultants</div> <div>&nbsp;</div> <div>A. II</div> <div>B. I and ll</div> <div>C. I, II, and III</div> D. I, II, and IVA. II
<div>Which of the following is NOT included in the HIPAA standards for code sets?</div> <div>A. ICD-10-PCS &amp; ICD-10-CM</div> <div>B. HCPCS Level II</div> <div>C. CDT</div> D. HIPAA 5010D. HIPAA 5010
<div>The HIPAA Security Rule is comprised of three levels of safeguards, which include administrative safeguards, physical safeguards, and technical safeguards. Which one of those safeguards addresses business operations?</div> <div>A. Administrative</div> <div>B. Physical</div> <div>C. Technical</div> D. None of the above<div>A. Administrative</div>
"<div>Your practice has a physician who would like to take their laptop home to catch up on their charting over the weekend. What would be the most secure way for the provider to access the patients' electronic medical records from home?</div> <div>A. Free internet at local fast-food restaurant</div> <div>B. Unprotected home internet service</div> <div>C. Virtual private network (VPN)</div> D. Through a company smart phone"C. Virtual private network (VPN)
<div>A new physician is joining your practice. Which HIPAA required number(s) must they have to use in filing and processing healthcare claims and other transactions?</div> <div>I. Employee identification number (EIN)</div> <div>II. National provider identifier (NPI)</div> <div>III. Unique user identifier</div> <div>&nbsp;</div> <div>A. I only</div> <div>B. I and II</div> <div>C. I, II, and III</div> D. None of the aboveB. I and II
"<div>The nurse and doctor are having a conversation at the nurse's station about a patient. Another patient is walking to checkout and overhears part of the conversation. This would be considered which of the following?</div> <div>A. Incidental disclosure, which is permitted, if the covered entity has taken reasonable safeguards to protect PHI</div> <div>B. Privacy breach</div> <div>C. Incidental disclosure even if no safeguards are in place</div> D. A breach that must be reported to the media"<div>A. Incidental disclosure, which is permitted, if the covered entity has taken reasonable safeguards to protect PHI</div><br>
"<div>Under the HIPAA Privacy Rule, covered entities and business associates are allowed to disclose PHI without a signed authorization for all the following EXCEPT?</div> <div>A. Doctors and/or hospitals (covered entities) may share information freely with one another for treatment reasons</div> <div>B. Patients' information may be sent to the insurance companies to receive payment for services provided</div> <div>C. Healthcare operations such as a quality assessment or employee review</div> D. All of the above"D. All of the above
<div>Your physicians have decided to obtain a chart audit by an outside auditor. What must be obtained prior to the exchange of information?</div> <div>A. Medical record authorization signed by the patient</div> <div>B. Business associates agreement</div> <div>C. Notice of privacy practice</div> D. Breach notification<div>B. Business associates agreement</div>
<div>The nurse manager presents to your office and informs you that a potential breach has been reported by a patient. What do you do next?</div> <div>A. Pick up the phone and call the patient immediately</div> <div>B. Determine if notification is necessary by asking two questions: Has a breach occurred and was it a breach of unsecured PHI.</div> <div>C. Nothing. It is not necessary to do anything quickly because as long as the notification is received by 90 days, it will be okay.</div> D. Call the local media to inform them of the breach.<div>B. Determine if notification is necessary by asking two questions: Has a breach occurred and was it a breach of unsecured PHI.</div>
<div>HIPAA (Public Law 104.191, also known as the Kennedy-Kassebaum Bill) was passed in 1996 </div> <div><ul><li>to improve <span class=cloze>[...]</span> and <span class=cloze>[...]</span> of health insurance coverage in the group and individual markets;</li><li>to combat waste, fraud, and abuse in health <span class=cloze>[...]</span> and healthcare <span class=cloze>[...]</span>;<br></li><li>to promote the use of <span class=cloze>[...]</span> savings accounts; </li><li>to improve access to <span class=cloze>[...]</span> services and coverage, and; </li><li>to simplify the <span class=cloze>[...]</span> of health insurance.</li></ul></div> <div>HIPAA (Public Law 104.191, also known as the Kennedy-Kassebaum Bill) was passed in 1996 </div> <div><ul><li>to improve <span class=cloze>portability</span> and <span class=cloze>continuity</span> of health insurance coverage in the group and individual markets;</li><li>to combat waste, fraud, and abuse in health <span class=cloze>insurance</span> and healthcare <span class=cloze>delivery</span>;<br></li><li>to promote the use of <span class=cloze>medical</span> savings accounts; </li><li>to improve access to <span class=cloze>long-term care</span> services and coverage, and; </li><li>to simplify the <span class=cloze>administration</span> of health insurance.</li></ul></div> <br> <div>HIPAA (Public Law 104.191, also known as the Kennedy-Kassebaum Bill) was passed in 1996 </div> <div><ul><li>to <span class=cloze>[...]</span> portability and continuity of health insurance coverage in the group and individual markets;</li><li>to <span class=cloze>[...]</span> waste, fraud, and abuse in health insurance and healthcare delivery;<br></li><li>to <span class=cloze>[...]</span> the use of medical savings accounts; </li><li>to <span class=cloze>[...]</span> access to long-term care services and coverage, and; </li><li>to <span class=cloze>[...]</span> the administration of health insurance.</li></ul></div> <div>HIPAA (Public Law 104.191, also known as the Kennedy-Kassebaum Bill) was passed in 1996 </div> <div><ul><li>to <span class=cloze>improve</span> portability and continuity of health insurance coverage in the group and individual markets;</li><li>to <span class=cloze>combat</span> waste, fraud, and abuse in health insurance and healthcare delivery;<br></li><li>to <span class=cloze>promote</span> the use of medical savings accounts; </li><li>to <span class=cloze>improve</span> access to long-term care services and coverage, and; </li><li>to <span class=cloze>simplify</span> the administration of health insurance.</li></ul></div> <br> <div>HIPAA (Public Law 104.191, also known as the Kennedy-Kassebaum Bill) was passed in 1996 </div> <div><ul><li>to improve portability and continuity of health insurance <span class=cloze>[...]</span> in the group and individual markets;</li><li>to combat <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, and <span class=cloze>[...]</span> in health insurance and healthcare delivery;<br></li><li>to promote the use of medical <span class=cloze>[...]</span>; </li><li>to improve access to long-term care <span class=cloze>[...]</span> and <span class=cloze>[...]</span>, and; </li><li>to simplify the administration of <span class=cloze>[...]</span>.</li></ul></div> <div>HIPAA (Public Law 104.191, also known as the Kennedy-Kassebaum Bill) was passed in 1996 </div> <div><ul><li>to improve portability and continuity of health insurance <span class=cloze>coverage</span> in the group and individual markets;</li><li>to combat <span class=cloze>waste</span>, <span class=cloze>fraud</span>, and <span class=cloze>abuse</span> in health insurance and healthcare delivery;<br></li><li>to promote the use of medical <span class=cloze>savings accounts</span>; </li><li>to improve access to long-term care <span class=cloze>services</span> and <span class=cloze>coverage</span>, and; </li><li>to simplify the administration of <span class=cloze>health insurance</span>.</li></ul></div> <br> "HIPAA applies directly to three groups referred to as ""covered entities,"" including:"<ol><li>Healthcare Providers</li><li>Health Plans</li><li>Healthcare Clearinghouses</li></ol>
The HIPAA standards for code sets include:&nbsp;<br><div><ol><li>International Classification of Disease, Clinical Modification (ICD-10-CM) for <span class=cloze>[...]</span> codes, and ICD-10-PCS for <span class=cloze>[...]</span> codes.</li><li>Current Dental Terminology (CDT) for <span class=cloze>[...]</span> codes</li><li>Healthcare Common Procedure Coding System (HCPCS Level II) for <span class=cloze>[...]</span> codes&nbsp;</li><li>Current Procedure Terminology (CPT) for <span class=cloze>[...]</span> codes</li></ol></div> The HIPAA standards for code sets include:&nbsp;<br><div><ol><li>International Classification of Disease, Clinical Modification (ICD-10-CM) for <span class=cloze>diagnoses</span> codes, and ICD-10-PCS for <span class=cloze>inpatient procedure</span> codes.</li><li>Current Dental Terminology (CDT) for <span class=cloze>dental procedure</span> codes</li><li>Healthcare Common Procedure Coding System (HCPCS Level II) for <span class=cloze>medical procedure and supply</span> codes&nbsp;</li><li>Current Procedure Terminology (CPT) for <span class=cloze>medical procedure</span> codes</li></ol></div> <br> The HIPAA standards for code sets include:&nbsp;<br><div><ol><li>International Classification of Disease, Clinical Modification (<span class=cloze>[...]</span>) for diagnoses codes, and <span class=cloze>[...]</span> for inpatient procedure codes.</li><li>Current Dental Terminology (<span class=cloze>[...]</span>) for dental procedure codes</li><li>Healthcare Common Procedure Coding System (<span class=cloze>[...]</span>) for medical procedure and supply codes&nbsp;</li><li>Current Procedure Terminology (<span class=cloze>[...]</span>) for medical procedure codes</li></ol></div> The HIPAA standards for code sets include:&nbsp;<br><div><ol><li>International Classification of Disease, Clinical Modification (<span class=cloze>ICD-10-CM</span>) for diagnoses codes, and <span class=cloze>ICD-10-PCS</span> for inpatient procedure codes.</li><li>Current Dental Terminology (<span class=cloze>CDT</span>) for dental procedure codes</li><li>Healthcare Common Procedure Coding System (<span class=cloze>HCPCS Level II</span>) for medical procedure and supply codes&nbsp;</li><li>Current Procedure Terminology (<span class=cloze>CPT</span>) for medical procedure codes</li></ol></div> <br> <div>The HIPAA Security Rule is comprised of three levels of safeguards:</div> <div></div><div>1. Administrative safeguards</div><div>2. Physical safeguards</div>3. Technical safeguards
HIPAA - <span class=cloze>[...]</span> safeguards: These safeguards address your operations. They include assigning responsibility to someone for security and having policies and procedures in place to direct your security efforts.HIPAA - <span class=cloze>Administrative</span> safeguards: These safeguards address your operations. They include assigning responsibility to someone for security and having policies and procedures in place to direct your security efforts.<br> HIPAA - Administrative safeguards: These safeguards address your <span class=cloze>[...]</span>. They include assigning responsibility to someone for security and having policies and procedures in place to direct your security efforts.HIPAA - Administrative safeguards: These safeguards address your <span class=cloze>operations</span>. They include assigning responsibility to someone for security and having policies and procedures in place to direct your security efforts.<br> HIPAA - Administrative safeguards: These safeguards address your operations. They include <span class=cloze>[...]</span> for security and <span class=cloze>[...]</span> to direct your security efforts.HIPAA - Administrative safeguards: These safeguards address your operations. They include <span class=cloze>assigning responsibility to someone</span> for security and <span class=cloze>having policies and procedures in place</span> to direct your security efforts.<br> HIPAA - Administrative safeguards: These safeguards address your operations. They include assigning responsibility to someone for <span class=cloze>[...]</span> and having policies and procedures in place to <span class=cloze>[...]</span> your security efforts.HIPAA - Administrative safeguards: These safeguards address your operations. They include assigning responsibility to someone for <span class=cloze>security</span> and having policies and procedures in place to <span class=cloze>direct</span> your security efforts.<br> <div>HIPAA - Physical safeguards: These safeguards include locks and keys, where computers are located, how electronic media are disposed of, and generally <span class=cloze>[...]</span>.</div><div>HIPAA - Physical safeguards: These safeguards include locks and keys, where computers are located, how electronic media are disposed of, and generally <span class=cloze>how to make the environment safe</span>.</div><br> <div>HIPAA - <span class=cloze>[...]</span> safeguards: These safeguards include locks and keys, where computers are located, how electronic media are disposed of, and generally how to make the environment safe.</div><div>HIPAA - <span class=cloze>Physical</span> safeguards: These safeguards include locks and keys, where computers are located, how electronic media are disposed of, and generally how to make the environment safe.</div><br> HIPAA - Technical safeguards: These safeguards are controls directly applied to <span class=cloze>[...]</span>. They identify who may have access to <span class=cloze>[...]</span>, provide access to sets of data and specific functions in systems, audit persons who have used the systems, and protect the systems from malicious software.HIPAA - Technical safeguards: These safeguards are controls directly applied to <span class=cloze>information systems</span>. They identify who may have access to <span class=cloze>information systems</span>, provide access to sets of data and specific functions in systems, audit persons who have used the systems, and protect the systems from malicious software.<br> HIPAA - <span class=cloze>[...]</span> safeguards: These safeguards are controls directly applied to information systems. They identify who may have access to information systems, provide access to sets of data and specific functions in systems, audit persons who have used the systems, and protect the systems from malicious software.HIPAA - <span class=cloze>Technical</span> safeguards: These safeguards are controls directly applied to information systems. They identify who may have access to information systems, provide access to sets of data and specific functions in systems, audit persons who have used the systems, and protect the systems from malicious software.<br> HIPAA - Technical safeguards: These safeguards are controls directly applied to information systems. They identify who may have <span class=cloze>[...]</span> to information systems, provide <span class=cloze>[...]</span> to sets of data and specific functions in systems, <span class=cloze>[...]</span> persons who have used the systems, and <span class=cloze>[...]</span> the systems from malicious software.HIPAA - Technical safeguards: These safeguards are controls directly applied to information systems. They identify who may have <span class=cloze>access</span> to information systems, provide <span class=cloze>access</span> to sets of data and specific functions in systems, <span class=cloze>audit</span> persons who have used the systems, and <span class=cloze>protect</span> the systems from malicious software.<br> <span class=cloze>[...]</span> are responsible for deciding the scope of a VPN, implementing and deploying a VPN, and ongoing monitoring of network traffic across the network firewall<span class=cloze>Network administrators</span> are responsible for deciding the scope of a VPN, implementing and deploying a VPN, and ongoing monitoring of network traffic across the network firewall<br> Network administrators are responsible for deciding the scope of a <span class=cloze>[...]</span>, implementing and deploying a <span class=cloze>[...]</span>, and ongoing monitoring of network traffic across the network firewallNetwork administrators are responsible for deciding the scope of a <span class=cloze>VPN</span>, implementing and deploying a <span class=cloze>VPN</span>, and ongoing monitoring of network traffic across the network firewall<br> The employer identification number (EIN) issued by the <span class=cloze>[...]</span>The employer identification number (EIN) issued by the <span class=cloze>Internal Revenue Service (IRS)</span><br> Healthcare providers who are HIPAA-covered entities must obtain and use <span class=cloze>[...]</span>Healthcare providers who are HIPAA-covered entities must obtain and use <span class=cloze>NPIs</span><br> "Incidental disclosures are uses and disclosures incident to other uses or disclosures permitted or required under the rule. These incidental disclosures are permitted under the rule, but only if the covered entity has taken ""<span class=cloze>[...]</span>"" to protect PHI, and otherwise has implemented the requirements of the minimum necessary rule.&nbsp;""Incidental disclosures are uses and disclosures incident to other uses or disclosures permitted or required under the rule. These incidental disclosures are permitted under the rule, but only if the covered entity has taken ""<span class=cloze>reasonable safeguards</span>"" to protect PHI, and otherwise has implemented the requirements of the minimum necessary rule.&nbsp;<br> "
<div>Any uses or disclosures of PHI for <span class=cloze>[...]</span> are not allowed unless required by state or other law or have been authorized by the patient.</div><div>Any uses or disclosures of PHI for <span class=cloze>non-TPO</span> are not allowed unless required by state or other law or have been authorized by the patient.</div><br> <div>Any uses or disclosures of PHI for non-TPO <span class=cloze>[...]</span> unless required by state or other law or have been authorized by the patient.</div><div>Any uses or disclosures of PHI for non-TPO <span class=cloze>are not allowed</span> unless required by state or other law or have been authorized by the patient.</div><br> Under the HIPAA Privacy Rule, <span class=cloze>[...]</span> and business associates are allowed to disclose PHI without a signed authorization for treatment, payment, or healthcare operations (TPO) reasonsUnder the HIPAA Privacy Rule, <span class=cloze>covered entities</span> and business associates are allowed to disclose PHI without a signed authorization for treatment, payment, or healthcare operations (TPO) reasons<br> Under the HIPAA Privacy Rule, covered entities and <span class=cloze>[...]</span> are allowed to disclose PHI without a signed authorization for treatment, payment, or healthcare operations (TPO) reasonsUnder the HIPAA Privacy Rule, covered entities and <span class=cloze>business associates</span> are allowed to disclose PHI without a signed authorization for treatment, payment, or healthcare operations (TPO) reasons<br> Under the HIPAA Privacy Rule, covered entities and business associates are allowed to disclose PHI without a <span class=cloze>[...]</span> for treatment, payment, or healthcare operations (TPO) reasonsUnder the HIPAA Privacy Rule, covered entities and business associates are allowed to disclose PHI without a <span class=cloze>signed authorization</span> for treatment, payment, or healthcare operations (TPO) reasons<br> Under the HIPAA law, any business associate who performs a function, activity, or service on behalf of a covered entity or organized healthcare arrangement involving the use and disclosure of protected health information, must sign a <span class=cloze>[...]</span>.&nbsp;Under the HIPAA law, any business associate who performs a function, activity, or service on behalf of a covered entity or organized healthcare arrangement involving the use and disclosure of protected health information, must sign a <span class=cloze>business associates agreement (BAA)</span>.&nbsp;<br> HIPAA covered entities <span class=cloze>[...]</span> notify individuals when the unsecured protected health information (PHI) of an individual has been breachedHIPAA covered entities <span class=cloze>must</span> notify individuals when the unsecured protected health information (PHI) of an individual has been breached<br> HIPAA covered entities must notify individuals when the <span class=cloze>[...]</span> protected health information (PHI) of an individual has been breachedHIPAA covered entities must notify individuals when the <span class=cloze>unsecured</span> protected health information (PHI) of an individual has been breached<br> "When an entity or business associate is determining whether notice is required, two questions must be considered. <br><ul><li>First, has a breach occurred according to the definition provided in the regulation?&nbsp;</li><li>Second, was it a breach of <span class=cloze>[...]</span> PHI? Only breaches of ""<span class=cloze>[...]</span>"" PHI trigger the notification requirement.</li></ul>""When an entity or business associate is determining whether notice is required, two questions must be considered. <br><ul><li>First, has a breach occurred according to the definition provided in the regulation?&nbsp;</li><li>Second, was it a breach of <span class=cloze>unsecured</span> PHI? Only breaches of ""<span class=cloze>unsecured</span>"" PHI trigger the notification requirement.</li></ul><br> "
"<span class=cloze>[...]</span> defines a breach as ""the unauthorized acquisition, access, use, or disclosure of protected health information which compromises the security and privacy such that the use of the information poses significant risk of financial, reputational, or other harm to individuals.”""<span class=cloze>HITECH</span> defines a breach as ""the unauthorized acquisition, access, use, or disclosure of protected health information which compromises the security and privacy such that the use of the information poses significant risk of financial, reputational, or other harm to individuals.”<br> "
"HITECH defines a <span class=cloze>[...]</span> as ""the unauthorized acquisition, access, use, or disclosure of protected health information which compromises the security and privacy such that the use of the information poses significant risk of financial, reputational, or other harm to individuals.”""HITECH defines a <span class=cloze>breach</span> as ""the unauthorized acquisition, access, use, or disclosure of protected health information which compromises the security and privacy such that the use of the information poses significant risk of financial, reputational, or other harm to individuals.”<br> "
"<div>What are HITECH's incentives and assistance programs designed to do? </div> <div>A. Replace the Merit-based incentive payment system (MIPS) </div> <div>B. Improve the health outcomes of Americans and the performance of the healthcare system </div> <div>C. To ensure that physicians could continue documenting on paper </div> D. None of the above&nbsp;"<div>B. Improve the health outcomes of Americans and the performance of the healthcare system</div><br>
"<div>The HITECH Act implemented ""meaningful use"" of EHRs to achieve what goals? </div> <div>I. To promote the privacy and security of EHRS </div> <div>II. To limit and/or eliminate public and population health </div> <div>III. To improve care coordination </div> <div>IV. To engage patients and families in their care </div> <div>V. To improve the quality, safety and efficiency of care while reducing disparities </div> <div>&nbsp;</div> <div>A. I, II, V </div> <div>B. I, II, III, V </div> <div>C. I, III, IV, V </div> D. I, II, III, IV, V&nbsp;"C. I, III, IV, V
<div>To enhance the chances of a successful implementation, it is important to identify an implementation team from which of the following employees? </div> <div>A. At least one physician and someone from the medical support team </div> <div>B. Someone from management </div> <div>C. Someone from the IT Department </div> D. All of the aboveD. All of the above
"<div>What is an aggregate electronic record of health-related information on an individual created and gathered cumulatively across more than one healthcare organization and is used in the individual's healthcare? </div> <div>A. Electronic Medical Record (EMR) </div> <div>B. Healthy Lifestyle Record (ELR) </div> <div>C. Electronic Health Record (EHR) </div> D. None of the above"C. Electronic Health Record (EHR)
<div>What version of CEHRT must be used to earn a score in the Promoting Interoperability category under MIPS? </div> <div>A. 2009 </div> <div>B. 2014 </div> <div>C. 2015 </div> D. Any version of CEHRT can be usedC. 2015
<div>Which of the following is a financial implication of implementing an EMR system? </div> <div>A. Hardware maintenance </div> <div>B. Ongoing support and software upgrade costs </div> <div>C. Interfacing with Practice Management software </div> D. All of the aboveD. All of the above
<div>There is a potential for ongoing costs after the purchase and implementation of an EMR. What items might cause ongoing costs? </div> <div>I. Maintenance agreements </div> <div>II. Training </div> <div>III. Upgrade fees </div> IV. Customization<br><br><div>A. I, III, and IV </div> <div>B. II, III, and IV </div> <div>C. I, II, and III </div> D. I, II, III, and IV<br>D. I, II, III, and IV
<div>Medicare Incentive Payment System (MIPS) has four performance categories. Which category replaces the Medicare EHR Incentive Program? </div> <div>A. Quality </div> <div>B. Cost </div> <div>C. Improvement Activities</div> D. Promoting InteroperabilityD. Promoting Interoperability
<div>One way to encourage physicians to invest in using new technology is to prepare a _______</div> <div>A. Flowchart of job responsibilities </div> <div>B. ROI (Return on Investment) </div> <div>C. MUA (Meaningful Use Analysis) </div> D. A and B<div>B. ROI (Return on Investment)</div><br>
<div>When looking to purchase an EMR, a practice should limit consideration to those that are: </div> <div>I. Certified specifically for the Medicare and Medicaid EHR Incentive Programs </div> <div>II. Interfaced system </div> <div>III. New up and coming vendor </div> <div>IV. Scalable for the practice to add physicians or to scale back </div> <div>V. Experienced and known for quality training and implementation assistance </div> <div>&nbsp;</div> <div>A. I, II, III, V </div> <div>B. I, II, IV, V </div> <div>C. III, IV, V </div> D. I, II, III, IV, V<div>B. I, II, IV, V</div><br>
ROIReturn on Investment
AHRQThe Agency for Healthcare Research and Quality
SaaSSoftware as a Service
ASPApplication service provider
PMSPractice Management Software
CHPLCertified Health IT Product List
HISHealth Information System
I/OInput/Output
ISPInternet service provider
PDMPprescription drug monitoring program
"<span class=cloze>[...]</span>'s incentives and assistance programs were designed to improve health outcomes of Americans and the performance of the healthcare system.&nbsp;""<span class=cloze>HITECH</span>'s incentives and assistance programs were designed to improve health outcomes of Americans and the performance of the healthcare system.&nbsp;<br> "
"<div>""Meaningful use"" of EHRs achieving five healthcare goals: </div> <div>• <span class=cloze>[...]</span> the quality, safety, and efficiency of care while <span class=cloze>[...]</span> disparities </div> <div>• <span class=cloze>[...]</span> patients and families in their care </div> <div>• <span class=cloze>[...]</span> public and population health </div> <div>• <span class=cloze>[...]</span> care coordination </div> • <span class=cloze>[...]</span> the privacy and security of EHRs""<div>""Meaningful use"" of EHRs achieving five healthcare goals: </div> <div>• <span class=cloze>Improve</span> the quality, safety, and efficiency of care while <span class=cloze>reducing</span> disparities </div> <div>• <span class=cloze>Engage</span> patients and families in their care </div> <div>• <span class=cloze>Promote</span> public and population health </div> <div>• <span class=cloze>Improve</span> care coordination </div> • <span class=cloze>Promote</span> the privacy and security of EHRs<br> "
"Often, practices invest in an EMR and, due to a <span class=cloze>[...]</span>, it does not function as desired. The providers become less efficient, increased quality is not achieved, and the system becomes frustrating and is ""<span class=cloze>[...]</span>.""""Often, practices invest in an EMR and, due to a <span class=cloze>poor implementation</span>, it does not function as desired. The providers become less efficient, increased quality is not achieved, and the system becomes frustrating and is ""<span class=cloze>shelved</span>.""<br> "
"An <span class=cloze>[...]</span> is an <span class=cloze>[...]</span> with interoperability (as in, integration to other providers' systems), although many people use the terms interchangeably""An <span class=cloze>EHR</span> is an <span class=cloze>EMR</span> with interoperability (as in, integration to other providers' systems), although many people use the terms interchangeably<br> "
"The aggregate electronic record of health-related information on an individual created and gathered cumulatively across more than one healthcare organization, and managed and consulted by licensed clinicians and staff involved in the individual's health and care."EHR
"The electronic record of health-related information on an individual created, gathered, managed, and consulted by licensed clinicians and staff from a single organization who are involved in the individual's health and care."EMR
Providers who want to earn a PI score must report based on <span class=cloze>[...]</span>Providers who want to earn a PI score must report based on <span class=cloze>2015 CEHRT</span><br> An EMR is a major purchase, and implementation will affect physician <span class=cloze>[...]</span>.An EMR is a major purchase, and implementation will affect physician <span class=cloze>productivity</span>.<br> Financial implications of implementing an EMR system in costs associated with <br><ul><li><span class=cloze>[...]</span>,&nbsp;</li><li>software,&nbsp;</li><li><span class=cloze>[...]</span>,&nbsp;</li><li>support costs,&nbsp;</li><li><span class=cloze>[...]</span>,&nbsp;</li><li>interfacing costs to have the EMR integrate with other office systems</li></ul>Financial implications of implementing an EMR system in costs associated with <br><ul><li><span class=cloze>hardware</span>,&nbsp;</li><li>software,&nbsp;</li><li><span class=cloze>training time</span>,&nbsp;</li><li>support costs,&nbsp;</li><li><span class=cloze>software upgrade costs</span>,&nbsp;</li><li>interfacing costs to have the EMR integrate with other office systems</li></ul><br> Financial implications of implementing an EMR system in costs associated with <br><ul><li>hardware,&nbsp;</li><li><span class=cloze>[...]</span>,&nbsp;</li><li>training time,&nbsp;</li><li><span class=cloze>[...]</span>,&nbsp;</li><li>software upgrade costs,&nbsp;</li><li><span class=cloze>[...]</span> to have the EMR integrate with other office systems</li></ul>Financial implications of implementing an EMR system in costs associated with <br><ul><li>hardware,&nbsp;</li><li><span class=cloze>software</span>,&nbsp;</li><li>training time,&nbsp;</li><li><span class=cloze>support costs</span>,&nbsp;</li><li>software upgrade costs,&nbsp;</li><li><span class=cloze>interfacing costs</span> to have the EMR integrate with other office systems</li></ul><br> Most contracts include ongoing <span class=cloze>[...]</span> and <span class=cloze>[...]</span> license maintenance agreements with annual fees. <br><span class=cloze>[...]</span> costs and ongoing <span class=cloze>[...]</span> will continue through the life of the EMR. <br>There may also be additional costs for <span class=cloze>[...]</span> required as new ancillary or other systems are implemented throughout the practice.Most contracts include ongoing <span class=cloze>hardware</span> and <span class=cloze>software</span> license maintenance agreements with annual fees. <br><span class=cloze>Upgrade</span> costs and ongoing <span class=cloze>staff education</span> will continue through the life of the EMR. <br>There may also be additional costs for <span class=cloze>customization</span> required as new ancillary or other systems are implemented throughout the practice.<br> The <span class=cloze>[...]</span> category replaces the Medicare EHR Incentive Program.The <span class=cloze>Advanced Care Information (ACI)</span> category replaces the Medicare EHR Incentive Program.<br> ACIAdvanced Care Information&nbsp;
<div>When looking to purchase an EMR, limit consideration to those that are: </div> <div>• Certified or compliant to all stages of the <span class=cloze>[...]</span> requirements </div> <div>• Certified specifically for the Medicare and Medicaid EHR <span class=cloze>[...]</span> </div> <div>• Backed by financially sound, industry-leading <span class=cloze>[...]</span> </div> <div>• Interfaced <span class=cloze>[...]</span> (operating on a single database for billing, scheduling, and charting) </div> <div>• <span class=cloze>[...]</span>-specific (have developed templates and process flows that work particularly well for your specialty) </div> <div>• <span class=cloze>[...]</span> for the practice to add physicians or to scale back </div> <div>• Poised to provide the <span class=cloze>[...]</span> support the practice needs (training and ongoing maintenance) <br>•&nbsp;Usable and acceptable to the <span class=cloze>[...]</span> (having <span class=cloze>[...]</span> buy in will be vital) </div> <div>• Experienced and known for quality <span class=cloze>[...]</span> and <span class=cloze>[...]</span></div><div>When looking to purchase an EMR, limit consideration to those that are: </div> <div>• Certified or compliant to all stages of the <span class=cloze>meaningful use</span> requirements </div> <div>• Certified specifically for the Medicare and Medicaid EHR <span class=cloze>Incentive Programs</span> </div> <div>• Backed by financially sound, industry-leading <span class=cloze>vendors</span> </div> <div>• Interfaced <span class=cloze>systems</span> (operating on a single database for billing, scheduling, and charting) </div> <div>• <span class=cloze>Specialty</span>-specific (have developed templates and process flows that work particularly well for your specialty) </div> <div>• <span class=cloze>Scalable</span> for the practice to add physicians or to scale back </div> <div>• Poised to provide the <span class=cloze>IT</span> support the practice needs (training and ongoing maintenance) <br>•&nbsp;Usable and acceptable to the <span class=cloze>physicians</span> (having <span class=cloze>physician</span> buy in will be vital) </div> <div>• Experienced and known for quality <span class=cloze>training</span> and <span class=cloze>implementation assistance</span></div><br> <div>Which of the following is NOT a benefit of E-Prescribing? </div> <div>A. Avoiding errors caused by illegible handwriting </div> <div>B. Delayed warnings and alert systems about potential drug-drug, drug-disease, drug-allergy interactions </div> <div>C. Improved monitoring of the use of controlled substances </div> D. Security features, such as electronic signatures to authenticate the user information<div>B. Delayed warnings and alert systems about potential drug-drug, drug-disease, drug-allergy interactions</div><br>
"<div>Advances in technology in the medical office have increased efficiencies and improved quality care. Which of the following is an example? </div> <div>I. Online bill payment</div> <div>II. Card scanner to provide a digital image of insurance cards and drivers' licenses</div> <div>III. Diagnostic tools such as ECGS, Holter monitors and X-ray machines that are directly integrated into an EMR/EHR</div> <div>&nbsp;</div> <div>A. I only </div> <div>B. I and II only </div> <div>C. II and II only </div> D. I, II, and III&nbsp;"D. I, II, and III&nbsp;
<div>Four out of five doctors use smart phones and medical applications in everyday medical practice. To ensure patient data is protected, smart phones should have which of the following security authentication features? </div> <div>A. Device-level authentication only </div> <div>B. Application-level authentication only </div> <div>C. Device-level and Application-level authentication </div> D. Authentication is not requiredC. Device-level and Application-level authentication
<div>What is the name of the site at which the physician or other licenses practitioner delivering the service is located at the time the service is provided via telecommunications system? </div> <div>A. Hub site </div> <div>B. Spoke site </div> <div>C. CDS site </div> D. Clinic siteA. Hub site
<div>What tools provide healthcare providers with patient-specific information to help prevent errors and improve healthcare efficiency? </div> <div>A. Local Coverage Determinations (LCDs) </div> <div>B. Clinical Decision Support (CDS) </div> <div>C. National Coverage Determinations (NCDs) </div> D. Clinical Data Repository (CDR)B. Clinical Decision Support (CDS)
<div>Which of the following examples does telemedicine and telehealth include? </div> <div>A. Videoconferencing, including the evaluation and management of a patient by a healthcare provider </div> <div>B. Telecardiology </div> <div>C. Remote monitoring of vital signs </div> D. All of the Above<b>&nbsp;</b>D. All of the Above
<div>What is the evolving process of moving or sharing HIPAA protected health information (PHI) among organizations? </div> <div>A. EMPI </div> <div>B. HIE </div> <div>C. HUB </div> D. HIO<div>B. HIE</div><br>
<div>Health Information Organizations (HIO) that manage HIEs may be what type of organizations? </div> <div>A. Public </div> <div>B. Private </div> <div>C. Cooperative </div> D. All of the AboveD. All of the Above
<div>The HITECH Act aimed to improve the quality, safety, and efficiency of care while reducing disparities. An example of this objective is achieved via Computerized Physician Order Entry (CPOE) systems. How does CPOE help achieve this goal? </div> <div>A. Transmits the order to the appropriate place, department, or individuals so that it can be carried out </div> <div>B. Reduces errors related to the interpretation of handwritten orders </div> <div>C. Allows for real-time clinical decision support, such as dosage and alternative medication suggestions </div> D. All of the aboveD. All of the above
<div>The Centers for Medicare &amp; Medicaid Services (CMS) has deemed accurate collection and communication of medical data in electronic formats so important to the future of cost efficiency and quality healthcare that it has passed regulations to require implementation regarding data collection. Which of the following is NOT an example of standards necessary in healthcare for interoperability? </div> <div>A. ICD-10-CM </div> <div>B. SNOMED CT </div> <div>C. LCDs<br></div> D. CPTC. LCDs
LCDsLocal Coverage Determinations
CDSClinical Decision Support&nbsp;
NCDsNational Coverage Determinations
CDR<div>Clinical Data Repository&nbsp;</div>
<span class=cloze>[...]</span> electronically transmits a new prescription or renewal authorization to a pharmacy. It can be accomplished as part of an EMR/EHR system or via an application service provider (ASP).<span class=cloze>E-prescribing</span> electronically transmits a new prescription or renewal authorization to a pharmacy. It can be accomplished as part of an EMR/EHR system or via an application service provider (ASP).<br> E-prescribing electronically transmits a new prescription or renewal authorization to a pharmacy. It can be accomplished as part of <span class=cloze>[...]</span> or via <span class=cloze>[...]</span>.E-prescribing electronically transmits a new prescription or renewal authorization to a pharmacy. It can be accomplished as part of <span class=cloze>an EMR/EHR system</span> or via <span class=cloze>an application service provider (ASP)</span>.<br> "By <span class=cloze>[...]</span>, a practice can eliminate patient calls due to having ""lost his or her prescription,"" and increase patient satisfaction.""By <span class=cloze>e-prescribing</span>, a practice can eliminate patient calls due to having ""lost his or her prescription,"" and increase patient satisfaction.<br> "
"By e-prescribing, a practice can eliminate patient calls due to having ""lost his or her prescription,"" and increase <span class=cloze>[...]</span>.""By e-prescribing, a practice can eliminate patient calls due to having ""lost his or her prescription,"" and increase <span class=cloze>patient satisfaction</span>.<br> "
"<div>The benefits of e-prescribing services/functions include: </div> <div>• Avoiding errors caused by illegible handwriting </div> <div>• Avoided telephone miscommunication between the pharmacy and the office </div> <div>• Immediate access to a patient's <span class=cloze>[...]</span> and, in some instances, information related to their general medical condition </div> <div>• Immediate warning and alert systems about potential patient drug-drug, drug-disease, drug-allergy interactions, and dosing errors </div> <div>• Point of care provider access to the patient's payer formulary benefits </div> <div>• Improved monitoring of the use of <span class=cloze>[...]</span> </div> • Security features, such as electronic signatures to authenticate the user information""<div>The benefits of e-prescribing services/functions include: </div> <div>• Avoiding errors caused by illegible handwriting </div> <div>• Avoided telephone miscommunication between the pharmacy and the office </div> <div>• Immediate access to a patient's <span class=cloze>medication history</span> and, in some instances, information related to their general medical condition </div> <div>• Immediate warning and alert systems about potential patient drug-drug, drug-disease, drug-allergy interactions, and dosing errors </div> <div>• Point of care provider access to the patient's payer formulary benefits </div> <div>• Improved monitoring of the use of <span class=cloze>controlled substances</span> </div> • Security features, such as electronic signatures to authenticate the user information<br> "
"<div>The benefits of e-prescribing services/functions include: </div> <div>• Avoiding errors caused by illegible handwriting </div> <div>• Avoided telephone <span class=cloze>[...]</span> between the pharmacy and the office </div> <div>• Immediate access to a patient's medication history and, in some instances, information related to their general medical condition </div> <div>• Immediate warning and alert systems about potential patient drug-drug, drug-disease, drug-allergy interactions, and dosing errors </div> <div>• Point of care provider access to the patient's payer <span class=cloze>[...]</span> benefits </div> <div>• Improved monitoring of the use of controlled substances </div> • Security features, such as electronic signatures to authenticate the user information""<div>The benefits of e-prescribing services/functions include: </div> <div>• Avoiding errors caused by illegible handwriting </div> <div>• Avoided telephone <span class=cloze>miscommunication</span> between the pharmacy and the office </div> <div>• Immediate access to a patient's medication history and, in some instances, information related to their general medical condition </div> <div>• Immediate warning and alert systems about potential patient drug-drug, drug-disease, drug-allergy interactions, and dosing errors </div> <div>• Point of care provider access to the patient's payer <span class=cloze>formulary</span> benefits </div> <div>• Improved monitoring of the use of controlled substances </div> • Security features, such as electronic signatures to authenticate the user information<br> "
"<div>The benefits of e-prescribing services/functions include: </div> <div>• Avoiding errors caused by illegible <span class=cloze>[...]</span> </div> <div>• Avoided telephone miscommunication between the pharmacy and the office </div> <div>• Immediate access to a patient's medication history and, in some instances, information related to their general medical condition </div> <div>• Immediate <span class=cloze>[...]</span> and <span class=cloze>[...]</span> systems about potential patient drug-drug, drug-disease, drug-allergy interactions, and dosing errors </div> <div>• Point of care provider access to the patient's payer formulary benefits </div> <div>• Improved monitoring of the use of controlled substances </div> • <span class=cloze>[...]</span> features, such as electronic signatures to authenticate the user information""<div>The benefits of e-prescribing services/functions include: </div> <div>• Avoiding errors caused by illegible <span class=cloze>handwriting</span> </div> <div>• Avoided telephone miscommunication between the pharmacy and the office </div> <div>• Immediate access to a patient's medication history and, in some instances, information related to their general medical condition </div> <div>• Immediate <span class=cloze>warning</span> and <span class=cloze>alert</span> systems about potential patient drug-drug, drug-disease, drug-allergy interactions, and dosing errors </div> <div>• Point of care provider access to the patient's payer formulary benefits </div> <div>• Improved monitoring of the use of controlled substances </div> • <span class=cloze>Security</span> features, such as electronic signatures to authenticate the user information<br> "
Advances in technology streamline the day-to-day activities for increased efficiencies and improved quality care. <br>Automated solutions for routine tasks eliminate the likelihood of errors, improve turnaround time, and may prove to be more cost effective. <br>Technology improvements should <span class=cloze>[...]</span> the workflow, limit <span class=cloze>[...]</span>, and prevent <span class=cloze>[...]</span>.&nbsp;Advances in technology streamline the day-to-day activities for increased efficiencies and improved quality care. <br>Automated solutions for routine tasks eliminate the likelihood of errors, improve turnaround time, and may prove to be more cost effective. <br>Technology improvements should <span class=cloze>complement</span> the workflow, limit <span class=cloze>bottlenecks</span>, and prevent <span class=cloze>redundancies</span>.&nbsp;<br> Advances in technology streamline the day-to-day activities for increased <span class=cloze>[...]</span> and improved <span class=cloze>[...]</span>. <br>Automated solutions for routine tasks eliminate the likelihood of errors, improve turnaround time, and may prove to be more cost effective. <br>Technology improvements should complement the workflow, limit bottlenecks, and prevent redundancies.&nbsp;Advances in technology streamline the day-to-day activities for increased <span class=cloze>efficiencies</span> and improved <span class=cloze>quality care</span>. <br>Automated solutions for routine tasks eliminate the likelihood of errors, improve turnaround time, and may prove to be more cost effective. <br>Technology improvements should complement the workflow, limit bottlenecks, and prevent redundancies.&nbsp;<br> Advances in technology streamline the day-to-day activities for increased efficiencies and improved quality care. <br>Automated solutions for routine tasks eliminate the likelihood of <span class=cloze>[...]</span>, improve <span class=cloze>[...]</span> time, and may prove to be more <span class=cloze>[...]</span>. <br>Technology improvements should complement the workflow, limit bottlenecks, and prevent redundancies.&nbsp;Advances in technology streamline the day-to-day activities for increased efficiencies and improved quality care. <br>Automated solutions for routine tasks eliminate the likelihood of <span class=cloze>errors</span>, improve <span class=cloze>turnaround</span> time, and may prove to be more <span class=cloze>cost effective</span>. <br>Technology improvements should complement the workflow, limit bottlenecks, and prevent redundancies.&nbsp;<br> "<div>Samples of the technological advances being used by practices today: </div> <div>• Card scanners to provide digital image of insurance cards and driver's licenses </div> <div>• Online registration through <span class=cloze>[...]</span> </div> <div>• Batch demographic eligibility </div> <div>• Appointment reminders via text messaging, email, or automated messaging </div> <div>• <span class=cloze>[...]</span> charge capture systems </div> <div>• Real-time claim adjudication </div> <div>• Online bill payments </div> <div>• <span class=cloze>[...]</span> with scrubber, claim submission, and produces patient statements </div> <div>• Electronic Funds Transfers (EFT) to automatically receive payment from the payers </div> <div>• Electronic Remittance Advice (ERA) provides an electronic version of a payment explanation regarding the details of a claim </div> • Diagnostic tools such as ECGs, Holter monitors, and X-ray machines that are <span class=cloze>[...]</span> into an EMR/EHR""<div>Samples of the technological advances being used by practices today: </div> <div>• Card scanners to provide digital image of insurance cards and driver's licenses </div> <div>• Online registration through <span class=cloze>patient portals</span> </div> <div>• Batch demographic eligibility </div> <div>• Appointment reminders via text messaging, email, or automated messaging </div> <div>• <span class=cloze>Automated</span> charge capture systems </div> <div>• Real-time claim adjudication </div> <div>• Online bill payments </div> <div>• <span class=cloze>Clearinghouse</span> with scrubber, claim submission, and produces patient statements </div> <div>• Electronic Funds Transfers (EFT) to automatically receive payment from the payers </div> <div>• Electronic Remittance Advice (ERA) provides an electronic version of a payment explanation regarding the details of a claim </div> • Diagnostic tools such as ECGs, Holter monitors, and X-ray machines that are <span class=cloze>directly integrated</span> into an EMR/EHR<br> "
"<div>Samples of the technological advances being used by practices today: </div> <div>• <span class=cloze>[...]</span> to provide digital image of insurance cards and driver's licenses </div> <div>• Online registration through patient portals </div> <div>• Batch demographic eligibility </div> <div>• Appointment <span class=cloze>[...]</span> via text messaging, email, or automated messaging </div> <div>• Automated charge capture systems </div> <div>• Real-time claim adjudication </div> <div>• <span class=cloze>[...]</span> bill payments </div> <div>• Clearinghouse with scrubber, claim submission, and produces patient statements </div> <div>• Electronic Funds Transfers (EFT) to automatically receive payment from the payers </div> <div>• <span class=cloze>[...]</span> provides an electronic version of a payment explanation regarding the details of a claim </div> • Diagnostic tools such as ECGs, Holter monitors, and X-ray machines that are directly integrated into an EMR/EHR""<div>Samples of the technological advances being used by practices today: </div> <div>• <span class=cloze>Card scanners</span> to provide digital image of insurance cards and driver's licenses </div> <div>• Online registration through patient portals </div> <div>• Batch demographic eligibility </div> <div>• Appointment <span class=cloze>reminders</span> via text messaging, email, or automated messaging </div> <div>• Automated charge capture systems </div> <div>• Real-time claim adjudication </div> <div>• <span class=cloze>Online</span> bill payments </div> <div>• Clearinghouse with scrubber, claim submission, and produces patient statements </div> <div>• Electronic Funds Transfers (EFT) to automatically receive payment from the payers </div> <div>• <span class=cloze>Electronic Remittance Advice (ERA)</span> provides an electronic version of a payment explanation regarding the details of a claim </div> • Diagnostic tools such as ECGs, Holter monitors, and X-ray machines that are directly integrated into an EMR/EHR<br> "
"<div>Samples of the technological advances being used by practices today: </div> <div>• Card scanners to provide digital image of insurance cards and driver's licenses </div> <div>• Online registration through patient portals </div> <div>• <span class=cloze>[...]</span> demographic eligibility </div> <div>• Appointment reminders via text messaging, email, or automated messaging </div> <div>• Automated charge capture systems </div> <div>• <span class=cloze>[...]</span> claim adjudication </div> <div>• Online bill payments </div> <div>• Clearinghouse with scrubber, claim submission, and produces patient statements </div> <div>• <span class=cloze>[...]</span> to automatically receive payment from the payers </div> <div>• Electronic Remittance Advice (ERA) provides an electronic version of a payment explanation regarding the details of a claim </div> • Diagnostic tools such as ECGs, Holter monitors, and X-ray machines that are directly integrated into an EMR/EHR""<div>Samples of the technological advances being used by practices today: </div> <div>• Card scanners to provide digital image of insurance cards and driver's licenses </div> <div>• Online registration through patient portals </div> <div>• <span class=cloze>Batch</span> demographic eligibility </div> <div>• Appointment reminders via text messaging, email, or automated messaging </div> <div>• Automated charge capture systems </div> <div>• <span class=cloze>Real-time</span> claim adjudication </div> <div>• Online bill payments </div> <div>• Clearinghouse with scrubber, claim submission, and produces patient statements </div> <div>• <span class=cloze>Electronic Funds Transfers (EFT)</span> to automatically receive payment from the payers </div> <div>• Electronic Remittance Advice (ERA) provides an electronic version of a payment explanation regarding the details of a claim </div> • Diagnostic tools such as ECGs, Holter monitors, and X-ray machines that are directly integrated into an EMR/EHR<br> "
<span class=cloze>[...]</span> out of five doctors use smartphones and medical applications in everyday medical practice, according to a report published by physician job recruitment firm Jackson &amp; Coker (www.jacksoncoker.com)<span class=cloze>Four</span> out of five doctors use smartphones and medical applications in everyday medical practice, according to a report published by physician job recruitment firm Jackson &amp; Coker (www.jacksoncoker.com)<br> To ensure patient data is protected, smartphones should have a <span class=cloze>[...]</span> and <span class=cloze>[...]</span> authenticationTo ensure patient data is protected, smartphones should have a <span class=cloze>device-level</span> and <span class=cloze>application-level</span> authentication<br> To ensure patient data is protected, smartphones should have a device-level and application-level <span class=cloze>[...]</span>To ensure patient data is protected, smartphones should have a device-level and application-level <span class=cloze>authentication</span><br> <span class=cloze>[...]</span> or <span class=cloze>[...]</span> Site means the site at which the physician or other licensed practitioner delivering the service is located at the time the service is provided via telecommunications system.<span class=cloze>Distant</span> or <span class=cloze>Hub</span> Site means the site at which the physician or other licensed practitioner delivering the service is located at the time the service is provided via telecommunications system.<br> Distant or Hub Site means the site at which the physician or other licensed practitioner delivering the service is located at the time the service is provided via <span class=cloze>[...]</span> system.Distant or Hub Site means the site at which the physician or other licensed practitioner delivering the service is located at the time the service is provided via <span class=cloze>telecommunications</span> system.<br> <span class=cloze>[...]</span> tools provide healthcare providers with patient specific information to help prevent errors and improve healthcare efficiency.&nbsp;<span class=cloze>Clinical Decision Support (CDS)</span> tools provide healthcare providers with patient specific information to help prevent errors and improve healthcare efficiency.&nbsp;<br> Clinical Decision Support (CDS) tools provide healthcare providers with <span class=cloze>[...]</span> information to help prevent errors and improve healthcare efficiency.&nbsp;Clinical Decision Support (CDS) tools provide healthcare providers with <span class=cloze>patient specific</span> information to help prevent errors and improve healthcare efficiency.&nbsp;<br> "<div><span class=cloze>[...]</span> is a real-time reference that combines comparative, patient specific information (such as the patient's signs and symptoms, allergies, and lab results) with general knowledge about: </div> <div>• Diseases </div> <div>• Diagnoses </div> <div>• Medications </div> <div>• Treatments </div> <div>• Drug Formularies (coverage limitations) </div> <div>• Medical/Clinical Guidelines </div> • Payer Requirements&nbsp;""<div><span class=cloze>Clinical Decision Support (CDS)</span> is a real-time reference that combines comparative, patient specific information (such as the patient's signs and symptoms, allergies, and lab results) with general knowledge about: </div> <div>• Diseases </div> <div>• Diagnoses </div> <div>• Medications </div> <div>• Treatments </div> <div>• Drug Formularies (coverage limitations) </div> <div>• Medical/Clinical Guidelines </div> • Payer Requirements&nbsp;<br> "
<span class=cloze>[...]</span> and <span class=cloze>[...]</span> allow medical care to be provided remotely through electronic media, without a care provider physically present during the evaluation.&nbsp;<span class=cloze>Telemedicine</span> and <span class=cloze>telehealth</span> allow medical care to be provided remotely through electronic media, without a care provider physically present during the evaluation.&nbsp;<br> Although telemedicine/telehealth services are reimbursed by certain insurance payers, each state has rules regulating its practice. Some states require a <span class=cloze>[...]</span> to practice telemedicine in that state.&nbsp;Although telemedicine/telehealth services are reimbursed by certain insurance payers, each state has rules regulating its practice. Some states require a <span class=cloze>separate license</span> to practice telemedicine in that state.&nbsp;<br> <div>Examples of <span class=cloze>[...]</span> and <span class=cloze>[...]</span> include: </div> <div>• Videoconferencing, including the evaluation and management of a patient by a healthcare provider <br>•&nbsp;Image transfers</div> <div>• Remote monitoring of vital signs</div> <div>• Telecardiology </div> <div>• Teledermatology </div> • Medical education <br>•&nbsp;Nursing call centers&nbsp;<div>Examples of <span class=cloze>telemedicine</span> and <span class=cloze>telehealth</span> include: </div> <div>• Videoconferencing, including the evaluation and management of a patient by a healthcare provider <br>•&nbsp;Image transfers</div> <div>• Remote monitoring of vital signs</div> <div>• Telecardiology </div> <div>• Teledermatology </div> • Medical education <br>•&nbsp;Nursing call centers&nbsp;<br> <div>Examples of telemedicine and telehealth include: </div> <div>• Videoconferencing, including the evaluation and management of a patient by a healthcare provider <br>•&nbsp;<span class=cloze>[...]</span> transfers</div> <div>• Remote monitoring of vital signs</div> <div>• <span class=cloze>[...]</span> </div> <div>• Teledermatology </div> • <span class=cloze>[...]</span> education <br>•&nbsp;Nursing call centers&nbsp;<div>Examples of telemedicine and telehealth include: </div> <div>• Videoconferencing, including the evaluation and management of a patient by a healthcare provider <br>•&nbsp;<span class=cloze>Image</span> transfers</div> <div>• Remote monitoring of vital signs</div> <div>• <span class=cloze>Telecardiology</span> </div> <div>• Teledermatology </div> • <span class=cloze>Medical</span> education <br>•&nbsp;Nursing call centers&nbsp;<br> <div>Examples of telemedicine and telehealth include: </div> <div>• <span class=cloze>[...]</span>, including the evaluation and management of a patient by a healthcare provider <br>•&nbsp;Image transfers</div> <div>• Remote monitoring of <span class=cloze>[...]</span></div> <div>• Telecardiology </div> <div>• <span class=cloze>[...]</span> </div> • Medical education <br>•&nbsp;Nursing <span class=cloze>[...]</span><div>Examples of telemedicine and telehealth include: </div> <div>• <span class=cloze>Videoconferencing</span>, including the evaluation and management of a patient by a healthcare provider <br>•&nbsp;Image transfers</div> <div>• Remote monitoring of <span class=cloze>vital signs</span></div> <div>• Telecardiology </div> <div>• <span class=cloze>Teledermatology</span> </div> • Medical education <br>•&nbsp;Nursing <span class=cloze>call centers&nbsp;</span><br> <span class=cloze>[...]</span> is the evolving process of moving or sharing HIPAA protected health information (PHI) among organizations.<span class=cloze>Health Information Exchange (HIE)</span> is the evolving process of moving or sharing HIPAA protected health information (PHI) among organizations.<br> Health Information Exchange (HIE) can happen at the <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, or <span class=cloze>[...]</span> levelHealth Information Exchange (HIE) can happen at the <span class=cloze>community</span>, <span class=cloze>regional</span>, or <span class=cloze>national</span> level<br> <span class=cloze>[...]</span> can happen at the community, regional, or national level<span class=cloze>Health Information Exchange (HIE)</span> can happen at the community, regional, or national level<br> "<div>Examples of Health Information Exchange (HIE) includes:</div> <div>• Ordering lab tests and receiving results </div> <div>• Transmitting prescriptions from physicians to pharmacies </div> <div>• Medication <span class=cloze>[...]</span> </div> <div>• Sharing patient health history between physicians in as documents, structured data, and codified data </div> <div>• Relaying data from patients' home medical devices to physicians. </div> <div>• Giving patients <span class=cloze>[...]</span> to their health information </div> <div>• Distributing clinical documentation from hospitals to ambulatory physicians </div> <div>• Aggregating data from payer systems such as from their beneficiary PHRS </div> • Collecting data for public health initiatives, including compliance with <span class=cloze>[...]</span> tests and research""<div>Examples of Health Information Exchange (HIE) includes:</div> <div>• Ordering lab tests and receiving results </div> <div>• Transmitting prescriptions from physicians to pharmacies </div> <div>• Medication <span class=cloze>reconciliation</span> </div> <div>• Sharing patient health history between physicians in as documents, structured data, and codified data </div> <div>• Relaying data from patients' home medical devices to physicians. </div> <div>• Giving patients <span class=cloze>access</span> to their health information </div> <div>• Distributing clinical documentation from hospitals to ambulatory physicians </div> <div>• Aggregating data from payer systems such as from their beneficiary PHRS </div> • Collecting data for public health initiatives, including compliance with <span class=cloze>recommended</span> tests and research<br> "
"<div>Examples of Health Information Exchange (HIE) includes:</div> <div>• Ordering lab tests and receiving results </div> <div>• Transmitting <span class=cloze>[...]</span> from physicians to pharmacies </div> <div>• Medication reconciliation </div> <div>• Sharing patient health history between physicians in as documents, structured data, and codified data </div> <div>• <span class=cloze>[...]</span> data from patients' home medical devices to physicians. </div> <div>• Giving patients access to their health information </div> <div>• Distributing clinical documentation from hospitals to ambulatory physicians </div> <div>• Aggregating data from <span class=cloze>[...]</span> systems such as from their beneficiary PHRS </div> • Collecting data for public health initiatives, including compliance with recommended tests and research""<div>Examples of Health Information Exchange (HIE) includes:</div> <div>• Ordering lab tests and receiving results </div> <div>• Transmitting <span class=cloze>prescriptions</span> from physicians to pharmacies </div> <div>• Medication reconciliation </div> <div>• Sharing patient health history between physicians in as documents, structured data, and codified data </div> <div>• <span class=cloze>Relaying</span> data from patients' home medical devices to physicians. </div> <div>• Giving patients access to their health information </div> <div>• Distributing clinical documentation from hospitals to ambulatory physicians </div> <div>• Aggregating data from <span class=cloze>payer</span> systems such as from their beneficiary PHRS </div> • Collecting data for public health initiatives, including compliance with recommended tests and research<br> "
"<div>Examples of Health Information Exchange (HIE) includes:</div> <div>• Ordering lab <span class=cloze>[...]</span> and receiving <span class=cloze>[...]</span> </div> <div>• Transmitting prescriptions from physicians to pharmacies </div> <div>• Medication reconciliation </div> <div>• <span class=cloze>[...]</span> patient health history between physicians in as documents, structured data, and codified data </div> <div>• Relaying data from patients' home medical devices to physicians. </div> <div>• Giving patients access to their health information </div> <div>• <span class=cloze>[...]</span> clinical documentation from hospitals to ambulatory physicians </div> <div>• Aggregating data from payer systems such as from their beneficiary PHRS </div> • Collecting data for public health initiatives, including compliance with recommended tests and research""<div>Examples of Health Information Exchange (HIE) includes:</div> <div>• Ordering lab <span class=cloze>tests</span> and receiving <span class=cloze>results</span> </div> <div>• Transmitting prescriptions from physicians to pharmacies </div> <div>• Medication reconciliation </div> <div>• <span class=cloze>Sharing</span> patient health history between physicians in as documents, structured data, and codified data </div> <div>• Relaying data from patients' home medical devices to physicians. </div> <div>• Giving patients access to their health information </div> <div>• <span class=cloze>Distributing</span> clinical documentation from hospitals to ambulatory physicians </div> <div>• Aggregating data from payer systems such as from their beneficiary PHRS </div> • Collecting data for public health initiatives, including compliance with recommended tests and research<br> "
Health Information Organizations (HIO) that manage <span class=cloze>[...]</span> may be public, private, or cooperative. Health Information Organizations (HIO) that manage <span class=cloze>HIEs</span> may be public, private, or cooperative. <br> Health Information Organizations (HIO) that manage HIEs may be <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, or <span class=cloze>[...]</span>. Health Information Organizations (HIO) that manage HIEs may be <span class=cloze>public</span>, <span class=cloze>private</span>, or <span class=cloze>cooperative</span>. <br> <span class=cloze>[...]</span> that manage HIEs may be public, private, or cooperative. <span class=cloze>Health Information Organizations (HIO)</span> that manage HIEs may be public, private, or cooperative. <br> A <span class=cloze>[...]</span> HIE usually belongs to a state agency, or may be semi-independent with some form of government backing.<br><br><span class=cloze>[...]</span> HIEs may be for-profit or non-profit organizations.&nbsp;<br><br>A <span class=cloze>[...]</span> HIE is a consortium of regional providers and hospitals (who may compete, otherwise) coming together to mutually benefit from the exchangeA <span class=cloze>public</span> HIE usually belongs to a state agency, or may be semi-independent with some form of government backing.<br><br><span class=cloze>Private</span> HIEs may be for-profit or non-profit organizations.&nbsp;<br><br>A <span class=cloze>cooperative</span> HIE is a consortium of regional providers and hospitals (who may compete, otherwise) coming together to mutually benefit from the exchange<br> <span class=cloze>[...]</span> is a medical order communicated electronically, as opposed to on paper, and includes any type of order. The system transmits the order to the appropriate place, department, or individuals so it can be carried out<span class=cloze>CPOE</span> is a medical order communicated electronically, as opposed to on paper, and includes any type of order. The system transmits the order to the appropriate place, department, or individuals so it can be carried out<br> <span class=cloze>[...]</span> system transmits the order to the appropriate place, department, or individuals so it can be carried out. This reduces errors related to the interpretation of handwritten orders, (a common cause of mistakes), and allows for real-time clinical decision support, such as dosage and alternative medication suggestions, duplicate therapy warnings, and drug-drug, drug-disease, drug-lab value, and drug- allergy interaction checking.<span class=cloze>CPOE</span> system transmits the order to the appropriate place, department, or individuals so it can be carried out. This reduces errors related to the interpretation of handwritten orders, (a common cause of mistakes), and allows for real-time clinical decision support, such as dosage and alternative medication suggestions, duplicate therapy warnings, and drug-drug, drug-disease, drug-lab value, and drug- allergy interaction checking.<br> CPOE system transmits the order to the appropriate place, department, or individuals so it can be carried out. This reduces errors related to the <span class=cloze>[...]</span> of <span class=cloze>[...]</span> orders, (a common cause of mistakes), and allows for real-time clinical decision support, such as dosage and alternative medication suggestions, duplicate therapy warnings, and drug-drug, drug-disease, drug-lab value, and drug- allergy interaction checking.CPOE system transmits the order to the appropriate place, department, or individuals so it can be carried out. This reduces errors related to the <span class=cloze>interpretation</span> of <span class=cloze>handwritten</span> orders, (a common cause of mistakes), and allows for real-time clinical decision support, such as dosage and alternative medication suggestions, duplicate therapy warnings, and drug-drug, drug-disease, drug-lab value, and drug- allergy interaction checking.<br> CPOE system transmits the order to the appropriate place, department, or individuals so it can be carried out. This reduces errors related to the interpretation of handwritten orders, (a common cause of mistakes), and allows for <span class=cloze>[...]</span> clinical decision support, such as dosage and alternative medication suggestions, duplicate therapy warnings, and drug-drug, drug-disease, drug-lab value, and drug- allergy interaction checking.CPOE system transmits the order to the appropriate place, department, or individuals so it can be carried out. This reduces errors related to the interpretation of handwritten orders, (a common cause of mistakes), and allows for <span class=cloze>real-time</span> clinical decision support, such as dosage and alternative medication suggestions, duplicate therapy warnings, and drug-drug, drug-disease, drug-lab value, and drug- allergy interaction checking.<br> "Barrier to <span class=cloze>[...]</span> include computer systems using varying ""vocabularies""&nbsp;""Barrier to <span class=cloze>interoperability</span> include computer systems using varying ""vocabularies""&nbsp;<br> "
"Barrier to interoperability include computer systems using varying ""<span class=cloze>[...]</span>""&nbsp;""Barrier to interoperability include computer systems using varying ""<span class=cloze>vocabularies</span>""&nbsp;<br> "
<div>Some of the standards for <span class=cloze>[...]</span> in place:</div> <div>• ICD-10-CM </div> <div>• SNOMED CT </div> <div>• ICD-10-PCS </div> <div>• CPT </div> • HCPCS Level II<div>Some of the standards for <span class=cloze>interoperability</span> in place:</div> <div>• ICD-10-CM </div> <div>• SNOMED CT </div> <div>• ICD-10-PCS </div> <div>• CPT </div> • HCPCS Level II<br> EAEnterprise Architechture
CDWClinical Data Warehouse
EMPIEnterprise Master Patient Index
UPSUninterruptible Power Supply
<div>The practice has contracted with an outside disaster recovery company to assist you with disaster preparedness. They have recommended that you implement a system that is a duplicate of the original site of the organization, including full computer systems, as well as backups of user data. What type of site is this called? </div> <div>A. Warm site </div> <div>B. Cold site </div> <div>C. Hot site </div> D. Backup siteC. Hot site
<div>A hot site was far too expensive and not feasible for our practice. Another option presented by the firm was a which provided office space but no equipment and was less expensive. </div> <div>A. Warm site </div> <div>B. Cold site </div> <div>C. Backup site </div> D. There is not an alternative to a hot site<div>B. Cold site</div><br>
<div>What is the first thing that you should consider when establishing a disaster plan for the physician office? </div> <div>A. Office policies </div> <div>B. Physician preferences </div> <div>C. State laws </div> D. Geographical location of the office<div>A. Office policies</div>
"<div>In the case that your practice is severely damaged or destroyed, it would be helpful to a have a post-disaster checklist that included such things as physicians and staff contact information, insurance carrier policy and contact information, etc. Where would be the best location to store this post-disaster checklist? </div> <div>A. Office safe </div> <div>B. Practice Manager's office </div> <div>C. Offsite where it could be easily accessed </div> D. Physician's office&nbsp;"C. Offsite where it could be easily accessed
<div>An attempt to measure the probabilities of various adverse events and the likely extent of losses under certain situations is what type of analysis? </div> <div>A. Qualitative Risk Analysis </div> <div>B. Quantitative Vulnerability Analysis </div> <div>C. Qualitative Impact Analysis </div> D. Quantitative Risk AnalysisD. Quantitative Risk Analysis
<div>Business continuity and disaster planning refer to people and technology. Organizations need business continuity and recovery resources, plans and management to safeguard operations and ensure patient safety. Business continuity planning and disaster recovery planning include all EXCEPT which of the following? </div> <div>A. Preventive measures </div> <div>B. Process measures </div> <div>C. Detective measures </div> D. Corrective measuresB. Process measures
"<div>In reviewing your current insurance policies, you discover that your policy may not actually cover your losses in the event of a disaster. Which of the following statements is FALSE regarding insurance policies? </div> <div>A. You do not need to add additional coverage for flood or earthquakes because all-natural disasters are always covered. </div> <div>B. You need to make sure that you have enough coverage to provide sufficient funds to get your business back in operation. </div> <div>C. You should videotape or inventory the practice's equipment and other assets because it is helpful for insurance purposes in case the equipment is damaged or destroyed. </div> D. You should be aware of whether your coverage provides ""replacement value"" of your assets or just the current value."A. You do not need to add additional coverage for flood or earthquakes because all-natural disasters are always covered.
"<div>For a practice located in California, which of the following is true regarding earthquake insurance? </div> <div>A. General homeowner's insurance generally does not cover earthquakes. </div> <div>B. Losses due to earthquakes are covered in general homeowner policies, so there is no need to purchase earthquake insurance. </div> <div>C. Even though earthquakes can occur in every state, they occur more frequently in California so purchasing earthquake insurance can protect you from devastating losses. </div> D. Both A and B"C. Even though earthquakes can occur in every state, they occur more frequently in California so purchasing earthquake insurance can protect you from devastating losses.
"<div>To cover payroll, business debts and other costs until the practice is operational again, what type of policy or ""rider"" would you purchase? </div> <div>A. Replacement insurance </div> <div>B. Business interruption insurance </div> <div>C. Business asset insurance </div> D. Natural disaster insurance"<div>B. Business interruption insurance</div>
<div>Which of the following actions would NOT be part of a post-disaster checklist? </div> <div>A. Contact the insurance carrier </div> <div>B. Begin the clean-up process immediately by hauling off damaged equipment </div> <div>C. Call a meeting of key employees </div> D. Reroute mail, phone, and fax calls<div>B. Begin the clean-up process immediately by hauling off damaged equipment</div><br>
"A <span class=cloze>[...]</span> is a duplicate of the original site of the organization, with full computer systems, as well as backups of user data. <br><br><span class=cloze>[...]</span> between the two sites may be used to completely ""<span class=cloze>[...]</span>"" the data environment of the original site using wide area network links and specialized software.""A <span class=cloze>hot site</span> is a duplicate of the original site of the organization, with full computer systems, as well as backups of user data. <br><br><span class=cloze>Real time synchronization</span> between the two sites may be used to completely ""<span class=cloze>mirror</span>"" the data environment of the original site using wide area network links and specialized software.<br> "
Following a disruption to the original site, the hot site exists so the organization can relocate with <span class=cloze>[...]</span> losses to normal operations. Ideally, a hot site will be up and running within <span class=cloze>[...]</span>. Following a disruption to the original site, the hot site exists so the organization can relocate with <span class=cloze>minimal</span> losses to normal operations. Ideally, a hot site will be up and running within <span class=cloze>hours</span>. <br> Following a disruption to the original site, the <span class=cloze>[...]</span> exists so the organization can relocate with minimal losses to normal operations. Ideally, a <span class=cloze>[...]</span> will be up and running within hours. Following a disruption to the original site, the <span class=cloze>hot site</span> exists so the organization can relocate with minimal losses to normal operations. Ideally, a <span class=cloze>hot site</span> will be up and running within hours. <br> "Personnel may have to be moved to the <span class=cloze>[...]</span>, so it is possible the <span class=cloze>[...]</span> may be operational from a data processing perspective before staff has relocated. The capacity of the <span class=cloze>[...]</span> may not match the capacity of the original site, depending on the organization's requirements.&nbsp;""Personnel may have to be moved to the <span class=cloze>hot site</span>, so it is possible the <span class=cloze>hot site</span> may be operational from a data processing perspective before staff has relocated. The capacity of the <span class=cloze>hot site</span> may not match the capacity of the original site, depending on the organization's requirements.&nbsp;<br> "
This type of backup site is the most expensive to operate.&nbsp;Hot site
<span class=cloze>[...]</span> are popular with organizations that operate real time processes, such as financial institutions, government agencies, and ecommerce providers.<span class=cloze>Hot sites</span> are popular with organizations that operate real time processes, such as financial institutions, government agencies, and ecommerce providers.<br> Hot sites are popular with organizations that operate <span class=cloze>[...]</span>, such as financial institutions, government agencies, and ecommerce providers.Hot sites are popular with organizations that operate <span class=cloze>real time processes</span>, such as financial institutions, government agencies, and ecommerce providers.<br> A cold site is less expensive. It does not include backed up copies of data and information from the original location of the organization, nor does it include hardware already set up. The lack of <span class=cloze>[...]</span> contributes to the minimal startup costs of the cold site, but it takes <span class=cloze>[...]</span> following a disaster to operate at full capacity.A cold site is less expensive. It does not include backed up copies of data and information from the original location of the organization, nor does it include hardware already set up. The lack of <span class=cloze>hardware</span> contributes to the minimal startup costs of the cold site, but it takes <span class=cloze>longer</span> following a disaster to operate at full capacity.<br> A <span class=cloze>[...]</span> is less expensive. It does not include backed up copies of data and information from the original location of the organization, nor does it include hardware already set up. The lack of hardware contributes to the minimal startup costs of the <span class=cloze>[...]</span>, but it takes longer following a disaster to operate at full capacity.A <span class=cloze>cold site</span> is less expensive. It does not include backed up copies of data and information from the original location of the organization, nor does it include hardware already set up. The lack of hardware contributes to the minimal startup costs of the <span class=cloze>cold site</span>, but it takes longer following a disaster to operate at full capacity.<br> The first thing to consider when establishing a disaster plan for a physician practice is the <span class=cloze>[...]</span> of appropriate policies for the office.The first thing to consider when establishing a disaster plan for a physician practice is the <span class=cloze>implementation</span> of appropriate policies for the office.<br> The first thing to consider when establishing a disaster plan for a physician practice is the implementation of appropriate <span class=cloze>[...]</span> for the office.The first thing to consider when establishing a disaster plan for a physician practice is the implementation of appropriate <span class=cloze>policies</span> for the office.<br> Whether through <span class=cloze>[...]</span> or by <span class=cloze>[...]</span>, employees should be familiar with what they are supposed to do and where they are supposed to go in the event of a disaster.Whether through <span class=cloze>a formal training session</span> or by <span class=cloze>requiring each employee to read the policies</span>, employees should be familiar with what they are supposed to do and where they are supposed to go in the event of a disaster.<br> Whether through a formal training session or by requiring each employee to read the policies, employees should be familiar with <span class=cloze>[...]</span> and <span class=cloze>[...]</span> in the event of a disaster.Whether through a formal training session or by requiring each employee to read the policies, employees should be familiar with <span class=cloze>what they are supposed to do</span> and <span class=cloze>where they are supposed to go</span> in the event of a disaster.<br> The post-disaster checklist should be kept <span class=cloze>[...]</span>, where it would not be damaged and could be easily accessedThe post-disaster checklist should be kept <span class=cloze>off-site</span>, where it would not be damaged and could be easily accessed<br> The <span class=cloze>[...]</span> should be kept off-site, where it would not be damaged and could be easily accessedThe <span class=cloze>post-disaster checklist</span> should be kept off-site, where it would not be damaged and could be easily accessed<br> <span class=cloze>[...]</span> is a process to identify dangers to stakeholders as posed by potential adverse events.<span class=cloze>Risk analysis</span> is a process to identify dangers to stakeholders as posed by potential adverse events.<br> In quantitative risk analysis, an attempt is made to measure the <span class=cloze>[...]</span> of various adverse events and the <span class=cloze>[...]</span> of the losses if a particular event takes place.In quantitative risk analysis, an attempt is made to measure the <span class=cloze>probabilities</span> of various adverse events and the <span class=cloze>likely extent</span> of the losses if a particular event takes place.<br> In <span class=cloze>[...]</span> risk analysis, an attempt is made to measure the probabilities of various adverse events and the likely extent of the losses if a particular event takes place.In <span class=cloze>quantitative</span> risk analysis, an attempt is made to measure the probabilities of various adverse events and the likely extent of the losses if a particular event takes place.<br> <div><span class=cloze>[...]</span> includes a report of the following: </div> <div>• Risk identification </div> <div>• Risk likelihood </div> <div>• Risk impact </div> • Recommendations/Actions<div><span class=cloze>Quantitative risk analysis</span> includes a report of the following: </div> <div>• Risk identification </div> <div>• Risk likelihood </div> <div>• Risk impact </div> • Recommendations/Actions<br> BCMBusiness Continuity Management&nbsp;
<span class=cloze>[...]</span> is a business model used to create, establish, validate, and maintain a logistical business recovery plan.&nbsp;<span class=cloze>Business Continuity Management (BCM)</span> is a business model used to create, establish, validate, and maintain a logistical business recovery plan.&nbsp;<br> <div>Business Continuity Planning and Disaster Recovery Planning include: </div> <div>• <span class=cloze>[...]</span> – Controls aimed at preventing an event from occurring </div> <div>• <span class=cloze>[...]</span> – Controls aimed at detecting or discovering unwanted events </div> <div>• <span class=cloze>[...]</span> – Controls aimed at restoring a system after the disaster or event&nbsp;</div><div>Business Continuity Planning and Disaster Recovery Planning include: </div> <div>• <span class=cloze>Preventive measures</span> – Controls aimed at preventing an event from occurring </div> <div>• <span class=cloze>Detective measures</span> – Controls aimed at detecting or discovering unwanted events </div> <div>• <span class=cloze>Corrective measures</span> – Controls aimed at restoring a system after the disaster or event&nbsp;</div><br> <div>Business Continuity Planning and Disaster Recovery Planning include: </div> <div>• Preventive measures – Controls aimed at <span class=cloze>[...]</span> an event from occurring </div> <div>• Detective measures – Controls aimed at <span class=cloze>[...]</span> or <span class=cloze>[...]</span> unwanted events </div> <div>• Corrective measures – Controls aimed at <span class=cloze>[...]</span> a system after the disaster or event&nbsp;</div><div>Business Continuity Planning and Disaster Recovery Planning include: </div> <div>• Preventive measures – Controls aimed at <span class=cloze>preventing</span> an event from occurring </div> <div>• Detective measures – Controls aimed at <span class=cloze>detecting</span> or <span class=cloze>discovering</span> unwanted events </div> <div>• Corrective measures – Controls aimed at <span class=cloze>restoring</span> a system after the disaster or event&nbsp;</div><br> <div>It is best practice to create and continually update a <span class=cloze>[...]</span> in case the disaster requires any employees to come in when they are not scheduled to work.</div><div>It is best practice to create and continually update a <span class=cloze>disaster call list</span> in case the disaster requires any employees to come in when they are not scheduled to work.</div><br> "The practice must be adequately <span class=cloze>[...]</span> to cover your losses in the event of disaster. Audit your <span class=cloze>[...]</span> periodically to see if your coverage includes:<br><br><div>• Sufficient funds to get your business back in operation.</div> <div>• Does your insurance coverage provide for ""replacement value"" of your assets, or does it provide coverage for the current value of the equipment lost?&nbsp;<br>• Do you need flood insurance, earthquake insurance, or business income and extra expense insurance?&nbsp;<br></div> <div>• Do you need ""business interruption insurance"" to cover payrolls, business debts, and other costs until the practice is operational?</div> <div>• Keeping insurance policies in a safe location that will provide you easy access to them in the event of a disaster.&nbsp;</div> • A list of important information about the insurance policies.<br>•&nbsp;Videotape or inventory the practice's equipment and other assets. Keep an updated list of assets in a safe location, where it can be easily accessed.&nbsp;<br>""The practice must be adequately <span class=cloze>insured</span> to cover your losses in the event of disaster. Audit your <span class=cloze>insurance</span> periodically to see if your coverage includes:<br><br><div>• Sufficient funds to get your business back in operation.</div> <div>• Does your insurance coverage provide for ""replacement value"" of your assets, or does it provide coverage for the current value of the equipment lost?&nbsp;<br>• Do you need flood insurance, earthquake insurance, or business income and extra expense insurance?&nbsp;<br></div> <div>• Do you need ""business interruption insurance"" to cover payrolls, business debts, and other costs until the practice is operational?</div> <div>• Keeping insurance policies in a safe location that will provide you easy access to them in the event of a disaster.&nbsp;</div> • A list of important information about the insurance policies.<br>•&nbsp;Videotape or inventory the practice's equipment and other assets. Keep an updated list of assets in a safe location, where it can be easily accessed.&nbsp;<br><br> "
"The practice must be adequately insured to cover your losses in the event of disaster. Audit your insurance periodically to see if your coverage includes:<br><br><div>• Sufficient <span class=cloze>[...]</span> to get your business back in operation.</div> <div>• Does your insurance coverage provide for ""replacement value"" of your assets, or does it provide coverage for the current value of the equipment lost?&nbsp;<br>• Do you need flood insurance, earthquake insurance, or business income and extra expense insurance?&nbsp;<br></div> <div>• Do you need ""<span class=cloze>[...]</span>"" to cover payrolls, business debts, and other costs until the practice is operational?</div> <div>• Keeping insurance policies in a safe location that will provide you easy access to them in the event of a disaster.&nbsp;</div> • A list of important information about the insurance policies.<br>•&nbsp;Videotape or inventory the practice's equipment and other assets. Keep an updated <span class=cloze>[...]</span> in a safe location, where it can be easily accessed.&nbsp;<br>""The practice must be adequately insured to cover your losses in the event of disaster. Audit your insurance periodically to see if your coverage includes:<br><br><div>• Sufficient <span class=cloze>funds</span> to get your business back in operation.</div> <div>• Does your insurance coverage provide for ""replacement value"" of your assets, or does it provide coverage for the current value of the equipment lost?&nbsp;<br>• Do you need flood insurance, earthquake insurance, or business income and extra expense insurance?&nbsp;<br></div> <div>• Do you need ""<span class=cloze>business interruption insurance</span>"" to cover payrolls, business debts, and other costs until the practice is operational?</div> <div>• Keeping insurance policies in a safe location that will provide you easy access to them in the event of a disaster.&nbsp;</div> • A list of important information about the insurance policies.<br>•&nbsp;Videotape or inventory the practice's equipment and other assets. Keep an updated <span class=cloze>list of assets</span> in a safe location, where it can be easily accessed.&nbsp;<br><br> "
"The practice must be adequately insured to cover your losses in the event of disaster. Audit your insurance periodically to see if your coverage includes:<br><br><div>• Sufficient funds to get your business back in operation.</div> <div>• Does your insurance coverage provide for ""<span class=cloze>[...]</span>"" of your assets, or does it provide coverage for the <span class=cloze>[...]</span> of the equipment lost?&nbsp;<br>• Do you need flood insurance, earthquake insurance, or business income and extra expense insurance?&nbsp;<br></div> <div>• Do you need ""business interruption insurance"" to cover payrolls, business debts, and other costs until the practice is operational?</div> <div>• Keeping insurance policies in <span class=cloze>[...]</span> that will provide you easy access to them in the event of a disaster.&nbsp;</div> • A list of important information about the insurance policies.<br>•&nbsp;Videotape or inventory the practice's equipment and other assets. Keep an updated list of assets in a safe location, where it can be easily accessed.&nbsp;<br>""The practice must be adequately insured to cover your losses in the event of disaster. Audit your insurance periodically to see if your coverage includes:<br><br><div>• Sufficient funds to get your business back in operation.</div> <div>• Does your insurance coverage provide for ""<span class=cloze>replacement value</span>"" of your assets, or does it provide coverage for the <span class=cloze>current value</span> of the equipment lost?&nbsp;<br>• Do you need flood insurance, earthquake insurance, or business income and extra expense insurance?&nbsp;<br></div> <div>• Do you need ""business interruption insurance"" to cover payrolls, business debts, and other costs until the practice is operational?</div> <div>• Keeping insurance policies in <span class=cloze>a safe location</span> that will provide you easy access to them in the event of a disaster.&nbsp;</div> • A list of important information about the insurance policies.<br>•&nbsp;Videotape or inventory the practice's equipment and other assets. Keep an updated list of assets in a safe location, where it can be easily accessed.&nbsp;<br><br> "
"The practice must be adequately insured to cover your losses in the event of disaster. Audit your insurance periodically to see if your coverage includes:<br><br><div>• Sufficient funds to get your business back in operation.</div> <div>• Does your insurance coverage provide for ""replacement value"" of your assets, or does it provide coverage for the current value of the equipment lost?&nbsp;<br>• Do you need <span class=cloze>[...]</span> insurance, <span class=cloze>[...]</span> insurance, or <span class=cloze>[...]</span> insurance?&nbsp;<br></div> <div>• Do you need ""business interruption insurance"" to cover payrolls, business debts, and other costs until the practice is operational?</div> <div>• Keeping insurance policies in a safe location that will provide you easy access to them in the event of a disaster.&nbsp;</div> • A list of important information about the <span class=cloze>[...]</span>.<br>•&nbsp;Videotape or inventory the practice's equipment and other assets. Keep an updated list of assets in a safe location, where it can be easily accessed.&nbsp;<br>""The practice must be adequately insured to cover your losses in the event of disaster. Audit your insurance periodically to see if your coverage includes:<br><br><div>• Sufficient funds to get your business back in operation.</div> <div>• Does your insurance coverage provide for ""replacement value"" of your assets, or does it provide coverage for the current value of the equipment lost?&nbsp;<br>• Do you need <span class=cloze>flood</span> insurance, <span class=cloze>earthquake</span> insurance, or <span class=cloze>business income and extra expense</span> insurance?&nbsp;<br></div> <div>• Do you need ""business interruption insurance"" to cover payrolls, business debts, and other costs until the practice is operational?</div> <div>• Keeping insurance policies in a safe location that will provide you easy access to them in the event of a disaster.&nbsp;</div> • A list of important information about the <span class=cloze>insurance policies</span>.<br>•&nbsp;Videotape or inventory the practice's equipment and other assets. Keep an updated list of assets in a safe location, where it can be easily accessed.&nbsp;<br><br> "
"<span class=cloze>[...]</span> occur more frequently in California than many other states and the chances of loss due to this disaster is higher. Since general homeowner's insurance generally does not cover <span class=cloze>[...]</span>, riders would be necessary to cover the losses.""<span class=cloze>Earthquakes</span> occur more frequently in California than many other states and the chances of loss due to this disaster is higher. Since general homeowner's insurance generally does not cover <span class=cloze>earthquakes</span>, riders would be necessary to cover the losses.<br> "
"Earthquakes occur more frequently in <span class=cloze>[...]</span> than many other states and the chances of loss due to this disaster is higher. Since general homeowner's insurance generally <span class=cloze>[...]</span> cover earthquakes, riders would be <span class=cloze>[...]</span> to cover the losses.""Earthquakes occur more frequently in <span class=cloze>California</span> than many other states and the chances of loss due to this disaster is higher. Since general homeowner's insurance generally <span class=cloze>does not</span> cover earthquakes, riders would be <span class=cloze>necessary</span> to cover the losses.<br> "
"""<span class=cloze>[...]</span>"" will cover payrolls, business debts, and other costs until the practice is operational. In the event of a disaster, it might take days, weeks, or months to get back in operation.""""<span class=cloze>Business interruption insurance</span>"" will cover payrolls, business debts, and other costs until the practice is operational. In the event of a disaster, it might take days, weeks, or months to get back in operation.<br> "
"""Business interruption insurance"" will cover <span class=cloze>[...]</span>, <span class=cloze>[...]</span>, and other costs until the practice is operational. In the event of a disaster, it might take days, weeks, or months to get back in operation.""""Business interruption insurance"" will cover <span class=cloze>payrolls</span>, <span class=cloze>business debts</span>, and other costs until the practice is operational. In the event of a disaster, it might take days, weeks, or months to get back in operation.<br> "
Damaged/destroyed goods should be kept on site until seen by the <span class=cloze>[...]</span>Damaged/destroyed goods should be kept on site until seen by the <span class=cloze>insurance adjuster</span><br> Damaged/destroyed goods should be <span class=cloze>[...]</span> until seen by the insurance adjusterDamaged/destroyed goods should be <span class=cloze>kept on site</span> until seen by the insurance adjuster<br> Post-disaster checklist:<br>1. Contact employees regarding the extent of the disaster and what action employees should take in the short-term.<br>2. Contact <span class=cloze>[...]</span> and, if necessary, the <span class=cloze>[...]</span> for a general assessment of the damage.&nbsp;<br>3. Reroute mail, phone, and fax calls<br>4. Contact insurance carrier<br>5. Keep an accounting of all <span class=cloze>[...]</span><br>6. Conduct salvage operations, but keep damaged goods on site until seen by an insurance adjuster.<br>7. Call a meeting of key employees<br>8. Obtain new <span class=cloze>[...]</span><br>9. Equipment needs for temporary office space<br>10. Contact patientsPost-disaster checklist:<br>1. Contact employees regarding the extent of the disaster and what action employees should take in the short-term.<br>2. Contact <span class=cloze>landlord</span> and, if necessary, the <span class=cloze>fire department</span> for a general assessment of the damage.&nbsp;<br>3. Reroute mail, phone, and fax calls<br>4. Contact insurance carrier<br>5. Keep an accounting of all <span class=cloze>damage-related costs</span><br>6. Conduct salvage operations, but keep damaged goods on site until seen by an insurance adjuster.<br>7. Call a meeting of key employees<br>8. Obtain new <span class=cloze>office space</span><br>9. Equipment needs for temporary office space<br>10. Contact patients<br> Post-disaster checklist:<br>1. Contact employees regarding the extent of the disaster and what action employees should take in the short-term.<br>2. Contact landlord and, if necessary, the fire department for a general assessment of the damage.&nbsp;<br>3. <span class=cloze>[...]</span> mail, phone, and fax calls<br>4. Contact insurance carrier<br>5. Keep an accounting of all damage-related costs<br>6. Conduct <span class=cloze>[...]</span> operations, but keep damaged goods on site until seen by an insurance adjuster.<br>7. Call a meeting of key employees<br>8. Obtain new office space<br>9. <span class=cloze>[...]</span> needs for temporary office space<br>10. Contact patientsPost-disaster checklist:<br>1. Contact employees regarding the extent of the disaster and what action employees should take in the short-term.<br>2. Contact landlord and, if necessary, the fire department for a general assessment of the damage.&nbsp;<br>3. <span class=cloze>Reroute</span> mail, phone, and fax calls<br>4. Contact insurance carrier<br>5. Keep an accounting of all damage-related costs<br>6. Conduct <span class=cloze>salvage</span> operations, but keep damaged goods on site until seen by an insurance adjuster.<br>7. Call a meeting of key employees<br>8. Obtain new office space<br>9. <span class=cloze>Equipment</span> needs for temporary office space<br>10. Contact patients<br> Post-disaster checklist:<br>1. Contact <span class=cloze>[...]</span> regarding the extent of the disaster and what action <span class=cloze>[...]</span> should take in the short-term.<br>2. Contact landlord and, if necessary, the fire department for a general assessment of the damage.&nbsp;<br>3. Reroute mail, phone, and fax calls<br>4. Contact insurance <span class=cloze>[...]</span><br>5. Keep an accounting of all damage-related costs<br>6. Conduct salvage operations, but keep damaged goods on site until seen by an insurance adjuster.<br>7. Call a meeting of <span class=cloze>[...]</span><br>8. Obtain new office space<br>9. Equipment needs for temporary office space<br>10. Contact <span class=cloze>[...]</span>Post-disaster checklist:<br>1. Contact <span class=cloze>employees</span> regarding the extent of the disaster and what action <span class=cloze>employees</span> should take in the short-term.<br>2. Contact landlord and, if necessary, the fire department for a general assessment of the damage.&nbsp;<br>3. Reroute mail, phone, and fax calls<br>4. Contact insurance <span class=cloze>carrier</span><br>5. Keep an accounting of all damage-related costs<br>6. Conduct salvage operations, but keep damaged goods on site until seen by an insurance adjuster.<br>7. Call a meeting of <span class=cloze>key employees</span><br>8. Obtain new office space<br>9. Equipment needs for temporary office space<br>10. Contact <span class=cloze>patients</span><br> <span class=cloze>[...]</span>:<br>1. Contact employees regarding the extent of the disaster and what action employees should take in the short-term.<br>2. Contact landlord and, if necessary, the fire department for a general assessment of the damage.&nbsp;<br>3. Reroute mail, phone, and fax calls<br>4. Contact insurance carrier<br>5. Keep an accounting of all damage-related costs<br>6. Conduct salvage operations, but keep damaged goods on site until seen by an insurance adjuster.<br>7. Call a meeting of key employees<br>8. Obtain new office space<br>9. Equipment needs for temporary office space<br>10. Contact patients<span class=cloze>Post-disaster checklist</span>:<br>1. Contact employees regarding the extent of the disaster and what action employees should take in the short-term.<br>2. Contact landlord and, if necessary, the fire department for a general assessment of the damage.&nbsp;<br>3. Reroute mail, phone, and fax calls<br>4. Contact insurance carrier<br>5. Keep an accounting of all damage-related costs<br>6. Conduct salvage operations, but keep damaged goods on site until seen by an insurance adjuster.<br>7. Call a meeting of key employees<br>8. Obtain new office space<br>9. Equipment needs for temporary office space<br>10. Contact patients<br> <div>Which of the following scenarios is appropriate incident-to billing?</div> <div>A. A nurse practitioner sees patients new to the practice to initiate care and determines the patients’ care plan.</div> <div>B. A physician’s assistant in a cardiology practice sees all patients for their post-operative visit in the hospital.</div> <div>C. A nurse performs methotrexate injections on Wednesday mornings while the physician performs surgeries at a nearby ASC.</div> <div>D. A physician’s assistant at an OB/GYN practice sees patients for their follow up OB appointments while the physician sees new OB patients in the office.</div>D. A physician’s assistant at an OB/GYN practice sees patients for their follow up OB appointments while the physician sees new OB patients in the office.
To be billed as incident-to by an NPP, the service must be <span class=cloze>[...]</span> to the physician’s services and a <span class=cloze>[...]</span> must be in the office suite during the encounter.&nbsp;To be billed as incident-to by an NPP, the service must be <span class=cloze>integral</span> to the physician’s services and a <span class=cloze>physician</span> must be in the office suite during the encounter.&nbsp;<br> Incident-to services <span class=cloze>[...]</span> be billed in the hospital settingIncident-to services <span class=cloze>cannot</span> be billed in the hospital setting<br> Follow-up appointments <span class=cloze>[...]</span> be billed incident to the physician when performed by an NPP and the physician is in the officeFollow-up appointments <span class=cloze>can</span> be billed incident to the physician when performed by an NPP and the physician is in the office<br> <div>In the practice you manage, the medical assistants are responsible for preparing the patients for the physician. The medical assistants place a green folder in the door so the physician knows which patient is next to be seen. The physician refuses to follow the system and determines who he will see next, which is angering the patients because they are waiting too long in the exam room. The medical assistant is extremely upset and close to tears. Which of the following responses is an example of effective communication in this situation?</div> <div>A. “You should not let him get away with that. It is your responsibility to make sure he sees the patients in the correct order.”</div> <div>B. “I understand your frustration. Since this system does not appear to be working, what do you suggest?”</div> <div>C. “I know exactly how you feel. I once worked for a physician who threw charts at me.”</div> D. “I suggest you find a way to work it out because we cannot have angry patients.”<div>B. “I understand your frustration. Since this system does not appear to be working, what do you suggest?”</div>
<div>The goals of effective communication include creating a <span class=cloze>[...]</span> perception, changing <span class=cloze>[...]</span>, and acquiring <span class=cloze>[...]</span>. Do not place <span class=cloze>[...]</span> and avoid “<span class=cloze>[...]</span>.” It is important that you show <span class=cloze>[...]</span> and give away control when possible to find a <span class=cloze>[...]</span>.</div><div>The goals of effective communication include creating a <span class=cloze>common</span> perception, changing <span class=cloze>behaviors</span>, and acquiring <span class=cloze>information</span>. Do not place <span class=cloze>blame</span> and avoid “<span class=cloze>me-too-ism</span>.” It is important that you show <span class=cloze>empathy</span> and give away control when possible to find a <span class=cloze>solution</span>.</div><br> <div>During the typical patient flow for an encounter, when should the copayment be collected?</div> <div>A. When the patient checks in with the front desk prior to the appointment.</div> <div>B. Following the visit with the physician and prior to leaving the office.</div> <div>C. Once the patient’s insurance has been billed and the copayment amount is determined.</div> <div>D. Prior to scheduling the next visit for follow up services.</div><div>A. When the patient checks in with the front desk prior to the appointment.</div>
<div>It is best practice to collect the copayment when the patient <span class=cloze>[...]</span> for the appointment. The copayment is a set amount that can be determined when verifying the patient’s insurance prior to the appointment. It is recommended to <span class=cloze>[...]</span> when he or she checks in for the appointment and collect any <span class=cloze>[...]</span> or <span class=cloze>[...]</span> amounts.</div><div>It is best practice to collect the copayment when the patient <span class=cloze>arrives</span> for the appointment. The copayment is a set amount that can be determined when verifying the patient’s insurance prior to the appointment. It is recommended to <span class=cloze>review the patient’s account</span> when he or she checks in for the appointment and collect any <span class=cloze>unpaid balances</span> or <span class=cloze>copayment</span> amounts.</div><br> <div>Which of the following is NOT a typical duty of a practice manager?<br></div> <div>A. Developing a strategy to increase patient referrals.</div> <div>B. Inventory control for vaccines needed for school physicals.</div> <div>C. Processing prior authorizations for minor surgeries performed in the office.</div> D. Implement strategies to reduce the days in A/R.C. Processing prior authorizations for minor surgeries performed in the office.
A <span class=cloze>[...]</span> would make sure prior authorizations are obtained but would not be the staff member responsible for performing the task. Prior authorizations are usually obtained by the <span class=cloze>[...]</span> staff.A <span class=cloze>practice manager</span> would make sure prior authorizations are obtained but would not be the staff member responsible for performing the task. Prior authorizations are usually obtained by the <span class=cloze>medical or billing</span> staff.<br> <div>Which statement regarding insurance reform is TRUE?</div> <div>A. A requirement to permit adult children to stay on family policies until age 26.</div> <div>B. Require pre-authorizations for only emergency department services.</div> <div>C. Limit the lifetime limits on the dollar amount of the coverage for which insurers will pay.</div> <div>D. Insurers must limit any waiting periods for coverage to 30 days.</div><div>A. A requirement to permit adult children to stay on family policies until age 26.</div><br>
A prohibition against denying individuals health insurance coverage due to a pre-existing condition, from charging individuals with pre-existing conditions higher premiums, or excluding coverage for specific conditions.Key insurance and health plan reforms&nbsp;
A requirement to permit adult children to stay on family policies until age 26.Key insurance and health plan reforms
Insurers must provide first dollar coverage of preventive health care services including immunizations; women’s preventive care and screening; and infant, child, and adolescent preventive services.Key insurance and health plan reforms&nbsp;
No prior authorization for emergency services nor increased cost sharing for emergency services provided by out-of-network doctors.Key insurance and health plan reforms&nbsp;
A prohibition against canceling health coverage when a beneficiary gets sick.Key insurance and health plan reforms&nbsp;
Insurers may not place lifetime limits on the dollar amount of the coverage for which they will pay.Key insurance and health plan reforms&nbsp;
Insurance companies will abide by yearly caps on what they may charge beneficiaries for out-of-pocket expenses in new plans, such as co-payments or co-insurance chargesKey insurance and health plan reforms&nbsp;
Insurers must limit any waiting periods for coverage to 90 days. (Effective January 1, 2014)Key insurance and health plan reforms&nbsp;
<div>A patient is very upset because her insurance denied her claim. She was seen for a routine physical which is not covered by her insurance. The patient asks you to change the diagnosis code in order for the insurance company to pay the claim. Which of the following should be done?</div> <div>A. Explain to the patient the codes are correct and you cannot change the diagnosis unless you have her consent in writing.</div> <div>B. Have the provider or coder review the encounter to see if another diagnosis is appropriate before making any changes to the codes.</div> <div>C. Change the diagnosis so that the insurance company will pay the claim because a service was rendered and should be paid.</div> <div>D. Submit an appeal for the insurance company to reconsider the claim and include a copy of the medical record for the date of service in question.</div><div>B. Have the provider or coder review the encounter to see if another diagnosis is appropriate before making any changes to the codes.</div>
Prior to changing codes on claims, <span class=cloze>[...]</span> the medical record for the date of service in question to determine whether a coding change is appropriate.&nbsp;Prior to changing codes on claims, <span class=cloze>have the provider or coder review</span> the medical record for the date of service in question to determine whether a coding change is appropriate.&nbsp;<br> <div>You cannot change codes to seek payment because it is <span class=cloze>[...]</span>. It is good practice to verify benefits <span class=cloze>[...]</span> to services being rendered so patients will know whether the services provided are a covered benefit.</div><div>You cannot change codes to seek payment because it is <span class=cloze>fraud</span>. It is good practice to verify benefits <span class=cloze>prior</span> to services being rendered so patients will know whether the services provided are a covered benefit.</div><br> <div>Under <span class=cloze>[...]</span>, if any individual comes to the Emergency department and requests treatment, the hospital must perform an appropriate medical screening without delay to determine whether the patient has an emergency medical condition.</div><div>Under <span class=cloze>EMTALA</span>, if any individual comes to the Emergency department and requests treatment, the hospital must perform an appropriate medical screening without delay to determine whether the patient has an emergency medical condition.</div><br> <div>Which of the following sites of service must adhere to EMTALA?</div> <div>I. Physician office</div> <div>II. Ambulatory surgical center</div> <div>III. Emergency department</div> <div>IV. Intensive care unit</div> <div><b>&nbsp;</b></div> <div>A. III is correct</div> <div>B. I and III are correct</div> <div>C. III and IV are correct</div> D. All choices are correct<div>A. III is correct</div>
<div>Under OSHA, an emergency action plan should include:</div> <div>I. Evacuation procedures</div> <div>II. Fire extinguisher locations</div> <div>III. Emergency contacts and contact information</div> <div>IV. Designated meeting location</div> <div>V. Staff assignments and responsibilities</div> <div>&nbsp;</div> <div>A. I, II and V are correct</div> <div>B. I, II and IV are correct</div> <div>C. I, II, III, V are correct</div> D. All choices are correctD. All choices are correct
<div>The emergency action plan should include:<br> •&nbsp;&nbsp; &nbsp;Procedures for <span class=cloze>[...]</span> a fire or emergency<br> •&nbsp;&nbsp; &nbsp;<span class=cloze>[...]</span> procedures<br> •&nbsp;&nbsp; &nbsp;<span class=cloze>[...]</span> locations<br> •&nbsp;&nbsp; &nbsp;Emergency <span class=cloze>[...]</span> and <span class=cloze>[...]</span> information<br> •&nbsp;&nbsp; &nbsp;Designated <span class=cloze>[...]</span><br> •&nbsp;&nbsp; &nbsp;Staff <span class=cloze>[...]</span> and <span class=cloze>[...]</span></div><div>The emergency action plan should include:<br> •&nbsp;&nbsp; &nbsp;Procedures for <span class=cloze>reporting</span> a fire or emergency<br> •&nbsp;&nbsp; &nbsp;<span class=cloze>Evacuation</span> procedures<br> •&nbsp;&nbsp; &nbsp;<span class=cloze>Fire extinguisher</span> locations<br> •&nbsp;&nbsp; &nbsp;Emergency <span class=cloze>contacts</span> and <span class=cloze>contact</span> information<br> •&nbsp;&nbsp; &nbsp;Designated <span class=cloze>meeting location</span><br> •&nbsp;&nbsp; &nbsp;Staff <span class=cloze>assignments</span> and <span class=cloze>responsibilities</span></div><br> <div>Many practices provide only CLIA waived tests or provider-performed microscopy and will only need to apply for a <span class=cloze>[...]</span> or Certificate for <span class=cloze>[...]</span>.</div><div>Many practices provide only CLIA waived tests or provider-performed microscopy and will only need to apply for a <span class=cloze>Certificate of Waiver (COW)</span> or Certificate for <span class=cloze>Provider Performed Microscopy (PPM)</span>.</div><br> <div>To perform CLIA waived tests, a practice must have a</div> <div>A. Certificate of Registration</div> <div>B. Certificate of Compliance</div> <div>C. Certificate of Waiver</div> D. Certificate of AccreditationC. Certificate of Waiver
<div>A hospital provides free office space to providers who admit patients for inpatient procedures. Which law(s) does this violate?</div> <div>A. Stark Law</div> <div>B. Anti-Kickback Law</div> <div>C. Anti-Kickback Law and Stark Law</div> <div>D. This is standard practice and does not violate any laws</div><div>B. Anti-Kickback Law</div>
<div>The federal <span class=cloze>[...]</span> prohibits anyone (a person or corporate entity) from intentionally soliciting or receiving payment directly or indirectly, to get patient referrals and/or additional business reimbursed under federal health care programs like Medicare and Medicaid.</div><div>The federal <span class=cloze>anti-kickback law</span> prohibits anyone (a person or corporate entity) from intentionally soliciting or receiving payment directly or indirectly, to get patient referrals and/or additional business reimbursed under federal health care programs like Medicare and Medicaid.</div><br> <div>Which of the following is the best example of quality care improvement?</div> <div>A. Increase insurance claim submission accuracy to decrease denials.</div> <div>B. Flexibility in the training schedule to accommodate all employees.</div> <div>C. Effective communication between staff regarding sterilization of equipment.</div> <div>D. Monitor the no show rate to determine the cause and possible solution.</div><div>C. Effective communication between staff regarding sterilization of equipment.</div>
<span class=cloze>[...]</span> improvement focuses on care that is safe, effective, patient-centered, timely, efficient and equitable. For examples, effective <span class=cloze>[...]</span> of equipment helps prevent infection which helps provide safe care.&nbsp;<span class=cloze>Quality care</span> improvement focuses on care that is safe, effective, patient-centered, timely, efficient and equitable. For examples, effective <span class=cloze>sterilization</span> of equipment helps prevent infection which helps provide safe care.&nbsp;<br> <div>A <span class=cloze>[...]</span> expense is one that can vary based on the volume in a clinic.&nbsp;<br>Physician salary, office rent, and utilities are usually considered <span class=cloze>[...]</span> expenses that do not <span class=cloze>[...]</span>.&nbsp; <br>Medical supply costs will <span class=cloze>[...]</span> depending on the number of patients that are seen.</div><div>A <span class=cloze>variable</span> expense is one that can vary based on the volume in a clinic.&nbsp;<br>Physician salary, office rent, and utilities are usually considered <span class=cloze>fixed</span> expenses that do not <span class=cloze>vary</span>.&nbsp; <br>Medical supply costs will <span class=cloze>vary</span> depending on the number of patients that are seen.</div><br> <div>On an income statement, which of the following expense categories would best represent a variable expense?</div> <div>A. Physicians salary</div> <div>B. Medical supplies</div> <div>C. Office rent</div> <div>D. Utilities</div><div>B. Medical supplies</div>
<div>As a manager, you are considering whether to purchase a new diagnostic device.&nbsp; The price of the device is $20,000 which will be paid in equal payments over 4 years.&nbsp; The average revenue you can expect per test is $40.&nbsp; The cost of supplies for each test is $5.&nbsp; Not accounting for staff costs, how many tests would need to be performed each year to break even?</div> <div>A. 572</div> <div>B. 143</div> <div>C. 500</div> D. 201<div>B. 143</div><br><div>This is found by dividing the yearly cost of the equipment (20,000/4= 5,000) by the profit from each test performed (40-5=35).&nbsp; The result is 5,000 / 35 = 142.9.&nbsp; Therefore, 143 tests would need to be performed to cover the cost of the equipment and break even.</div>
<div>Medical practices can operate their financials either under a cash-based accounting system or an accrual-based accounting system.&nbsp; Which of the following is the best advantage for using an accrual-based accounting system?</div> <div>A. It is a simpler way of accounting for income and expenses.</div> <div>B. It is a more accurate reflection of your current financial position.</div> <div>C. There are fewer accounting reconciliations required using this method.</div> D. It provides a truer reflection of money currently available in the practice<div>B. It is a more accurate reflection of your current financial position.</div>
<div>The <span class=cloze>[...]</span> method of accounting provides a more accurate reflection of your current financial position.&nbsp; <br><span class=cloze>[...]</span> accounting provides a truer reflection of actual cash on hand and requires less reconciliation such as contractual adjustments.</div><div>The <span class=cloze>accrual</span> method of accounting provides a more accurate reflection of your current financial position.&nbsp; <br><span class=cloze>Cash-based</span> accounting provides a truer reflection of actual cash on hand and requires less reconciliation such as contractual adjustments.</div><br> <div>During a specific month, your practice appears to have consistent productivity and charges submitted.&nbsp; Expenses also appear to be in line and consistent.&nbsp; However, you notice your accounts receivable has increased dramatically over the month.&nbsp; Based on this information, which of the following statements would be accurate?</div> <div>I. The income on a cash-based income statement should decrease</div> <div>II. The income on an accrual-based income statement would decrease</div> <div>III. There should not be a significant difference in beginning and ending cash amounts on your cash flow statement</div> <div>IV. The equity on your balance sheet should remain fairly constant</div> <div>V. The amount of assets on your balance sheet will grow higher than will your liabilities and equity.</div> <div>&nbsp;</div> <div>A. I, III, and IV are correct</div> <div>B. II and IV are correct</div> <div>C. I and IV are correct</div> <div>D. II and V are correct</div><div>C. I and IV are correct</div>
If accounts receivable spike during a month, that means <span class=cloze>[...]</span> payments have been received, which will <span class=cloze>[...]</span> collections and the income on the income statement.&nbsp;&nbsp;<br><br><span class=cloze>[...]</span> collections will also negatively impact your cash flow statement which monitors cash levels in your practice. Because accrual based accounting measures income based on <span class=cloze>[...]</span>, it would <span class=cloze>[...]</span> affectedIf accounts receivable spike during a month, that means <span class=cloze>fewer</span> payments have been received, which will <span class=cloze>decrease</span> collections and the income on the income statement.&nbsp;&nbsp;<br><br><span class=cloze>Decreased</span> collections will also negatively impact your cash flow statement which monitors cash levels in your practice. Because accrual based accounting measures income based on <span class=cloze>charges</span>, it would <span class=cloze>not be</span> affected<br> If accounts receivable <span class=cloze>[...]</span> during a month, that means fewer payments have been received, which will decrease collections and the income on the income statement.&nbsp;&nbsp;<br><br>Decreased collections will also negatively impact your cash flow statement which monitors cash levels in your practice. Because accrual based accounting measures income based on charges, it would not be affectedIf accounts receivable <span class=cloze>spike</span> during a month, that means fewer payments have been received, which will decrease collections and the income on the income statement.&nbsp;&nbsp;<br><br>Decreased collections will also negatively impact your cash flow statement which monitors cash levels in your practice. Because accrual based accounting measures income based on charges, it would not be affected<br> If <span class=cloze>[...]</span> spike during a month, that means fewer payments have been received, which will decrease collections and the income on the income statement.<br><br>Equity on your balance sheet is not directly affected by a change in cash flow as assets include both cash and accounts receivable.&nbsp; Finally, assets must always equal liabilities and equity on a balance sheet.If <span class=cloze>accounts receivable</span> spike during a month, that means fewer payments have been received, which will decrease collections and the income on the income statement.<br><br>Equity on your balance sheet is not directly affected by a change in cash flow as assets include both cash and accounts receivable.&nbsp; Finally, assets must always equal liabilities and equity on a balance sheet.<br> If accounts receivable spike during a month, that means fewer payments have been received, which will decrease collections and the income on the income statement.<br><br><span class=cloze>[...]</span> on your balance sheet is not directly affected by a change in cash flow as assets include both cash and accounts receivable.&nbsp; Finally, <span class=cloze>[...]</span> must always equal <span class=cloze>[...]</span> and <span class=cloze>[...]</span> on a balance sheet.If accounts receivable spike during a month, that means fewer payments have been received, which will decrease collections and the income on the income statement.<br><br><span class=cloze>Equity</span> on your balance sheet is not directly affected by a change in cash flow as assets include both cash and accounts receivable.&nbsp; Finally, <span class=cloze>assets</span> must always equal <span class=cloze>liabilities</span> and <span class=cloze>equity</span> on a balance sheet.<br> If accounts receivable spike during a month, that means fewer payments have been received, which will decrease <span class=cloze>[...]</span> and the <span class=cloze>[...]</span> on the income statement.<br><br>Equity on your balance sheet is not directly affected by a change in <span class=cloze>[...]</span> as assets include both cash and accounts receivable.&nbsp; Finally, assets must always <span class=cloze>[...]</span> liabilities and equity on a balance sheet.If accounts receivable spike during a month, that means fewer payments have been received, which will decrease <span class=cloze>collections</span> and the <span class=cloze>income</span> on the income statement.<br><br>Equity on your balance sheet is not directly affected by a change in <span class=cloze>cash flow</span> as assets include both cash and accounts receivable.&nbsp; Finally, assets must always <span class=cloze>equal</span> liabilities and equity on a balance sheet.<br> If <span class=cloze>[...]</span> shortfalls are not addressed throughout the year, it can be very difficult to make them up at the end of the year.&nbsp;&nbsp;Costs such as purchased services and supplies can both be <span class=cloze>[...]</span> and should be reviewed.&nbsp;&nbsp;<span class=cloze>[...]</span> wages&nbsp;may also have to be adjusted if revenue and productivity are <span class=cloze>[...]</span> than expected.If <span class=cloze>budget</span> shortfalls are not addressed throughout the year, it can be very difficult to make them up at the end of the year.&nbsp;&nbsp;Costs such as purchased services and supplies can both be <span class=cloze>controllable</span> and should be reviewed.&nbsp;&nbsp;<span class=cloze>Physician</span> wages&nbsp;may also have to be adjusted if revenue and productivity are <span class=cloze>lower</span> than expected.<br> If budget <span class=cloze>[...]</span> are not addressed throughout the year, it can be very difficult to make them up at the end of the year.&nbsp;&nbsp;Costs such as purchased <span class=cloze>[...]</span> and <span class=cloze>[...]</span> can both be controllable and should be reviewed.&nbsp;&nbsp;Physician wages&nbsp;may also have to be adjusted if <span class=cloze>[...]</span> and <span class=cloze>[...]</span> are lower than expected.If budget <span class=cloze>shortfalls</span> are not addressed throughout the year, it can be very difficult to make them up at the end of the year.&nbsp;&nbsp;Costs such as purchased <span class=cloze>services</span> and <span class=cloze>supplies</span> can both be controllable and should be reviewed.&nbsp;&nbsp;Physician wages&nbsp;may also have to be adjusted if <span class=cloze>revenue</span> and <span class=cloze>productivity</span> are lower than expected.<br> <div>As a manager you are preparing to apply for a large bank loan.&nbsp; In so doing, you will need to represent to the bank the overall financial strength of your business including money coming in, money owed to you, and money that you owe to other people.&nbsp; Which financial statement is best used to represent the current status of your practice in this regard?</div> <div>A. Profit/Loss Statement (P&amp;L)</div> <div>B. Balance Sheet</div> <div>C. Cash Flow Statement</div> <div>D. Yearly Budget</div><div>B. Balance Sheet</div>
<div>The <span class=cloze>[...]</span> is a snapshot of a business’ financial condition at a specific point in time.&nbsp; It includes values for assets, liabilities, and stockholders’ equity.</div><div>The <span class=cloze>balance sheet</span> is a snapshot of a business’ financial condition at a specific point in time.&nbsp; It includes values for assets, liabilities, and stockholders’ equity.</div><br> <div>Which code set is used to identify procedures?</div> <div>I. ICD-10-CM Index to Diseases and Injuries (Alphabetic Index)</div> <div>II. ICD-10-CM Tabular List</div> <div>III. ICD-10-PCS </div> <div>IV. HCPCS Level II</div> <div>V. CPT®</div> <div>&nbsp;</div> <div>A. III, IV and V are correct</div> <div>B. IV and V are correct</div> <div>C. III and V are correct</div> <div>D. All choices are correct</div><div>A. III, IV and V are correct</div>
<div>When a patient is covered by Medigap insurance, it is:</div> <div>A. Secondary to Medicare coverage</div> <div>B. Primary to Medicare coverage</div> <div>C. Secondary to Medicaid coverage</div> D. Private insurance in lieu of Medicare<div>A. Secondary to Medicare coverage</div>
<div><span class=cloze>[...]</span> is a type of health insurance policy or other health benefit plan offered by a private entity to those persons entitled to Medicare benefits. It is specifically designed to supplement Medicare benefits. It fills in some of the <span class=cloze>[...]</span> in Medicare coverage by providing payment for some of the charges for which Medicare does not have responsibility due to the applicability of deductibles, coinsurance amounts, or other limitations imposed by Medicare.</div><div><span class=cloze>Medigap</span> is a type of health insurance policy or other health benefit plan offered by a private entity to those persons entitled to Medicare benefits. It is specifically designed to supplement Medicare benefits. It fills in some of the <span class=cloze>gaps</span> in Medicare coverage by providing payment for some of the charges for which Medicare does not have responsibility due to the applicability of deductibles, coinsurance amounts, or other limitations imposed by Medicare.</div><br> <div>Medigap is a type of health insurance policy or other health benefit plan offered by a private entity to those persons entitled to Medicare benefits. It is specifically designed to <span class=cloze>[...]</span> Medicare benefits. It fills in some of the gaps in Medicare coverage by providing <span class=cloze>[...]</span> for some of the charges for which Medicare <span class=cloze>[...]</span> due to the applicability of deductibles, coinsurance amounts, or other limitations imposed by Medicare.</div><div>Medigap is a type of health insurance policy or other health benefit plan offered by a private entity to those persons entitled to Medicare benefits. It is specifically designed to <span class=cloze>supplement</span> Medicare benefits. It fills in some of the gaps in Medicare coverage by providing <span class=cloze>payment</span> for some of the charges for which Medicare <span class=cloze>does not have responsibility</span> due to the applicability of deductibles, coinsurance amounts, or other limitations imposed by Medicare.</div><br> <div>Medigap is a type of health insurance policy or other health benefit plan offered by a private entity to those persons entitled to <span class=cloze>[...]</span> benefits. It is specifically designed to supplement <span class=cloze>[...]</span> benefits. It fills in some of the gaps in <span class=cloze>[...]</span> coverage by providing payment for some of the charges for which <span class=cloze>[...]</span> does not have responsibility due to the applicability of deductibles, coinsurance amounts, or other limitations imposed by <span class=cloze>[...]</span>.</div><div>Medigap is a type of health insurance policy or other health benefit plan offered by a private entity to those persons entitled to <span class=cloze>Medicare</span> benefits. It is specifically designed to supplement <span class=cloze>Medicare</span> benefits. It fills in some of the gaps in <span class=cloze>Medicare</span> coverage by providing payment for some of the charges for which <span class=cloze>Medicare</span> does not have responsibility due to the applicability of deductibles, coinsurance amounts, or other limitations imposed by <span class=cloze>Medicare</span>.</div><br> <div>The purpose of an Advance Beneficiary Notice (ABN) is to:</div> <div>A. Inform Medicare beneficiaries of their copayment and deductible obligation before the service is rendered.</div> <div>B. Inform HMO/PPO beneficiaries of their copayment and deductible obligation before the service is rendered.</div> <div>C. Inform Medicare beneficiaries before the service is rendered that Medicare is not likely to cover this service.</div> <div>D. Inform HMO/PPO beneficiaries before the service is rendered that prior authorization has not been obtained.</div><div>C. Inform Medicare beneficiaries before the service is rendered that Medicare is not likely to cover this service.</div>
<div>When conducting an audit of outstanding accounts, you notice the typical payment from a private payer is 46 days. This is not consistent with other private payers that usually pay claims within 30 days. In order to determine if the payer is violating prompt pay laws, you will review the:</div> <div>A. Payer contract</div> <div>B. State law</div> <div>C. Federal law</div> <div>D. Provider payment policy</div><div>B. State law</div><br>
<div>Contracts cannot contain items that reduce a practice’s rights as defined by <span class=cloze>[...]</span>. “Prompt payment” laws vary by <span class=cloze>[...]</span> and may offer a limit on the number of days in which to pay a “clean claim.”</div><div>Contracts cannot contain items that reduce a practice’s rights as defined by <span class=cloze>state laws</span>. “Prompt payment” laws vary by <span class=cloze>state</span> and may offer a limit on the number of days in which to pay a “clean claim.”</div><br> <div>Contracts cannot contain items that reduce a practice’s rights as defined by state laws. “<span class=cloze>[...]</span>” laws vary by state and may offer a limit on the number of days in which to pay a “clean claim.”</div><div>Contracts cannot contain items that reduce a practice’s rights as defined by state laws. “<span class=cloze>Prompt payment</span>” laws vary by state and may offer a limit on the number of days in which to pay a “clean claim.”</div><br> <div>Which of the following will NOT prevent claim denials?</div> <div>A. Verify insurance benefits at each encounter.</div> <div>B. Ensure medical documentation supports the medical necessity for the services rendered.</div> <div>C. Provide billing staff with the details included in the payer contracts to ensure proper billing.</div> <div>D. Provide medical documentation with an appeal letter to support the services rendered.</div>D. Provide medical documentation with an appeal letter to support the services rendered.
Proper appeals will not <span class=cloze>[...]</span> a denial but it can <span class=cloze>[...]</span> a denial.Proper appeals will not <span class=cloze>prevent</span> a denial but it can <span class=cloze>overturn</span> a denial.<br> Proper appeals will not prevent a <span class=cloze>[...]</span> but it can overturn a <span class=cloze>[...]</span>.Proper appeals will not prevent a <span class=cloze>denial</span> but it can overturn a <span class=cloze>denial</span>.<br> <div>Maintaining an appropriate accounts receivable is an important function of a practice manager.&nbsp; Which of the actions below are most effective in reducing an accounts receivable that is aging?</div> <div>I. Review all outstanding balances pending insurance over 30 days.</div> <div>II. Write off all balances over 120 days to minimize old accounts.</div> <div>III. Send out multiple patient statements per month for old balances.</div> <div>IV. Work A/R aging reports by type of payer for greater efficiency.</div> <div>V. Assign staff aging claims to work based on the adjustment to collection ratio.</div> <div>VI. Review the net collection ratio on a month by month basis.</div> <div>VII. Implement a clear bad debt and third-party collections policy.</div> <div>&nbsp;</div> <div>A. II, IV, VI are correct</div> <div>B. I, IV, and VII are correct</div> <div>C. I, III, V, and VII are correct</div> <div>D. IV, V, and VI are correct</div><div>B. I, IV, and VII are correct</div>
To effectively reduce an aging accounts receivable, review <span class=cloze>[...]</span> where insurance has not yet paid.&nbsp; To effectively reduce an aging accounts receivable, review <span class=cloze>outstanding balances</span> where insurance has not yet paid.&nbsp; <br> Working aging accounts can be done more efficiently by organizing outstanding balances by <span class=cloze>[...]</span> for follow-up conversations with the <span class=cloze>[...]</span>.&nbsp;Working aging accounts can be done more efficiently by organizing outstanding balances by <span class=cloze>payer</span> for follow-up conversations with the <span class=cloze>payers</span>.&nbsp;<br> Having a clear <span class=cloze>[...]</span> and <span class=cloze>[...]</span> policy will help to clear out old balances when there is little chance of collecting on them.&nbsp;Having a clear <span class=cloze>bad debt</span> and <span class=cloze>collections</span> policy will help to clear out old balances when there is little chance of collecting on them.&nbsp;<br> "Things that don't help decreasing the A/R<br><ul><li><span class=cloze>[...]</span> all old balances is not good business</li><li>Sending out more <span class=cloze>[...]</span> is too costly and not cost effective in most cases</li><li>The adjustment to collection ratio is used to verify inappropriate <span class=cloze>[...]</span>, not to assign collection <span class=cloze>[...]</span></li><li>Reviewing the net collection ratio provides information on how <span class=cloze>[...]</span> collection efforts are but does not help in actually <span class=cloze>[...]</span> the A/R.</li></ul>""Things that don't help decreasing the A/R<br><ul><li><span class=cloze>Writing off</span> all old balances is not good business</li><li>Sending out more <span class=cloze>statements</span> is too costly and not cost effective in most cases</li><li>The adjustment to collection ratio is used to verify inappropriate <span class=cloze>adjustment fluctuations</span>, not to assign collection <span class=cloze>efforts</span></li><li>Reviewing the net collection ratio provides information on how <span class=cloze>effective</span> collection efforts are but does not help in actually <span class=cloze>decreasing</span> the A/R.</li></ul><br> "
"<div>Based on the following denial report, what two actions should receive top priority by the practice manager to decrease denials in the practice?</div> <div><img src=""clip_image002.png""></div> <div>A. Review the insurance credentialing process and the process for collecting insurance information at the front desk.</div> <div>B. Review the process for getting claims submitted timely and the correct identification of patient insurance information.</div> <div>C. Educate all clinical staff on what procedures are covered by each insurance carrier and identify new insurance credentialing software.</div> D. Educate billers on appropriate billing for procedures performed and review the policy for obtaining prior authorizations for procedures."<div>A. Review the insurance credentialing process and the process for collecting insurance information at the front desk.</div>
"<div>Based on the following productivity dashboard, what valuable information can be derived to use in a conversation with a physician who is upset about decreasing compensation?</div> <div><br></div> <div><img src=""clip_image002-8926e6341f1bafcb497241f1bd424601979a7572.png""></div> <div>I. The reason compensation is decreasing is because production levels are below MGMA mean production levels</div><div>II. The provider’s productivity was on track with expectations during the first part of the year but has fallen behind in the latter part of the year.</div><div>III. Overall the average production of the provider should still support current compensation levels</div><div>IV. The manager can review trends of the providers practice to identify why there were unexpected drops in production in May&nbsp;<br><br><br></div> <div>A. All of the above are appropriate</div> <div>B. I and II are correct</div> <div>C. II is correct</div> D. II and IV are correct"C. II is correct<br><br><div>The productivity does show production lower than expected during the last part of the year and this would be crucial to revenue available to pay the provider.&nbsp;&nbsp;Just because the production is below MGMA numbers wouldn’t require a decrease in compensation.&nbsp;&nbsp;The productivity changes started in the August timeframe and rends should be examined during this time period and not May.</div>
"<div>Based on the revenue by payer report for a three week period provided below, which statement is TRUE?&nbsp;&nbsp;&nbsp; </div> <div><img src=""clip_image002-4217128b976cae82898262ae8620b0e62122648b.png""></div> <div>A. Increasing the proportion of visits for patients covered by private insurance will increase practice revenue.</div> <div>B. To increase revenue, the practice must see a higher proportion of patients with Medicare coverage.</div> <div>C. For the three week period, revenue received from government payers (Medicare and Medicaid) exceeds revenue from private and commercial payers.</div> D. Over the three week period, the practice sees more patients covered by BC/BS than any other payer."<div>A. Increasing the proportion of visits for patients covered by private insurance will increase practice revenue.</div>
<div>Calculate the days in A/R based on the following numbers over a 2 month (60 day) period of time. Total charges = $932,000</div> <div>A/R balance = $616,000</div> <div>Average charge=$225</div> <div>A. 32</div> <div>B. 40</div> <div>C. 57</div> <div>D. 90</div><div>B. 40</div><br><div>To determine the total days in A/R the equation is Total A/R/(Total charges/# of days). For this example: $616,000/(932,000/60)<br></div>
<div>Which of the following would NOT be the most effective recruitment tool to select the ideal candidate for an open medical assistant position?</div> <div>A. A detailed job description including the qualifications required to perform the job.</div> <div>B. A proficiency test that includes demonstrating the technical skills required to perform the job.</div> <div>C. Job recruitment ad which generates a high volume of applicants in order to identify the best fit for the office.</div> <div>D. Ask the applicant how they handle stressful situations with anxious patients.</div><div>C. Job recruitment ad which generates a high volume of applicants in order to identify the best fit for the office.</div><br>
When developing recruitment ads the goal is <span class=cloze>[...]</span> not <span class=cloze>[...]</span>. If you are not <span class=cloze>[...]</span> in the skills that you seek you may spend a lot of unnecessary time reviewing resumes.&nbsp;<br>A <span class=cloze>[...]</span> is important to help you communicate the qualifications and skills needed for the position.When developing recruitment ads the goal is <span class=cloze>quality</span> not <span class=cloze>quantity</span>. If you are not <span class=cloze>specific</span> in the skills that you seek you may spend a lot of unnecessary time reviewing resumes.&nbsp;<br>A <span class=cloze>detailed job description</span> is important to help you communicate the qualifications and skills needed for the position.<br> <span class=cloze>[...]</span> which include demonstrating technical skills will help determine if the candidate can perform the skills needed for the job. <br>In the interview, ask the applicant <span class=cloze>[...]</span> questions to determine how he or she will handle certain situations. <br>In all medical practices, medical assistants will need to be able to properly handle <span class=cloze>[...]</span> patients.<span class=cloze>Proficiency tests</span> which include demonstrating technical skills will help determine if the candidate can perform the skills needed for the job. <br>In the interview, ask the applicant <span class=cloze>behavioral</span> questions to determine how he or she will handle certain situations. <br>In all medical practices, medical assistants will need to be able to properly handle <span class=cloze>anxious</span> patients.<br> <div>Which of the following statements is best regarding employee performance evaluations?</div> <div>A. The evaluation should only be initiated to address poor performance and determine an improvement plan.</div> <div>B. The evaluation should be performed in a group setting to foster team work in the practice.</div> <div>C. The evaluation gives you the opportunity to acknowledge strengths in the employee and provide opportunity for growth.</div> <div>D. The evaluation should be tied to compensation in order for the employees to find it valuable.</div><div>C. The evaluation gives you the opportunity to acknowledge strengths in the employee and provide opportunity for growth.</div><br>
"<div>Determine the physician’s compensation for the first quarter using the percentage of net professional revenue model with the information provided below at a 50 percent compensation percentage.</div> <div><img src=""clip_image001.png""></div> <div>A. $41,479</div> <div>B. $46,931</div> <div>C. $60,279</div> <div>D. $120,558</div>""<div>B. $46,931</div><br><img src=""paste-4d1f39cf0ace84bc1ca18d6293ce05bd6cc42921.jpg""><br>"
<div>What are the benefits of hiring mid-level providers?</div> <div>I. Increased patient satisfaction</div> <div>II. Increased fee schedule</div> <div>III. Increased practice productivity</div> <div>IV. Increased hours worked by the physician</div> <div><b>&nbsp;</b></div> <div>A. I and III are correct</div> <div>B. I, III and IV are correct</div> <div>C. I and II are correct</div> <div>D. All answer options are correct</div><div>A. I and III are correct</div><br>
<div>Benefits for employing mid-level providers include:<br> •&nbsp;&nbsp; &nbsp;Patient satisfaction can be <span class=cloze>[...]</span> by providing additional access to care so that patients are able to see a provider sooner, or spend more time with a provider than may otherwise be possible.<br> •&nbsp;&nbsp; &nbsp;Physician work life balance can <span class=cloze>[...]</span> as more patients are able to be seen without the physician having to see them all. The economic impact also helps a physician maintain an income level <span class=cloze>[...]</span> having to work as many hours.<br> •&nbsp;&nbsp; &nbsp;Because mid-level salaries are lower than physician salaries, if a mid-level is <span class=cloze>[...]</span>, he or she can positively affect the bottom line of a practice. The physician’s fee schedule <span class=cloze>[...]</span> increase but the number of services that can be provided by the practice will <span class=cloze>[...]</span>.</div><div>Benefits for employing mid-level providers include:<br> •&nbsp;&nbsp; &nbsp;Patient satisfaction can be <span class=cloze>increased</span> by providing additional access to care so that patients are able to see a provider sooner, or spend more time with a provider than may otherwise be possible.<br> •&nbsp;&nbsp; &nbsp;Physician work life balance can <span class=cloze>improve</span> as more patients are able to be seen without the physician having to see them all. The economic impact also helps a physician maintain an income level <span class=cloze>without</span> having to work as many hours.<br> •&nbsp;&nbsp; &nbsp;Because mid-level salaries are lower than physician salaries, if a mid-level is <span class=cloze>productive</span>, he or she can positively affect the bottom line of a practice. The physician’s fee schedule <span class=cloze>will not</span> increase but the number of services that can be provided by the practice will <span class=cloze>increase</span>.</div><br> <div>Which of the following would be the most effective referral source for a new orthopedic practice?</div> <div>A. A pharmaceutical company</div> <div>B. A medical supply company</div> <div>C. A diagnostic imaging center owned by the practice</div> D. A local hospital’s online physician directoryD. A local hospital’s online physician directory
There <span class=cloze>[...]</span> a violation of Stark or Anti-kickback laws with a hospital having a directory of the physicians who are affiliated with the hospital.There <span class=cloze>is not</span> a violation of Stark or Anti-kickback laws with a hospital having a directory of the physicians who are affiliated with the hospital.<br> <div>Which of the following is most important before initiating a marketing campaign to generate new patients for an OB/GYN practice?</div> <div>A. The practice must have quality controls in place to ensure quality care and patient satisfaction</div> <div>B. The practice must announce the services provided in the office to existing patients.</div> <div>C. The practice must survey the community to understand the local demographics.</div> <div>D. The practice must survey patients to determine the level of satisfaction with services rendered.</div><div>A. The practice must have quality controls in place to ensure quality care and patient satisfaction</div>
<div>The physician you work for recently attended a medical conference. In talking with other physicians, he learned he could increase his revenue by offering ancillary services in the office instead of referring these services out. You are tasked with determining if this will be profitable. Which of the following is NOT a factor to consider?</div> <div>A. Determine the number of services currently being referred out.</div> <div>B. Determine the number of tests that must be performed to be profitable.</div> <div>C. Determine revenue streams based on Medicare payment amounts provided by the vendor.</div> <div>D. Determine the cost of the equipment and supplies needed to render the ancillary services.</div>"<div>C. Determine revenue streams based on Medicare payment amounts provided by the vendor.<br><br><span style=""color: rgb(92, 92, 92);"">Medicare is not the only payer to consider in your analysis. Some payers may not cover the services at all or they could cover services that are not covered by Medicare.</span><br></div>"
<div>To evaluate performing ancillary services in the office, you must<br> •&nbsp;&nbsp; &nbsp;Identify accurate <span class=cloze>[...]</span> currently being ordered so that a good financial analysis can be performed to determine profitability.&nbsp;<br> •&nbsp;&nbsp; &nbsp;How much will the equipment or services cost to provide these services through the clinic?<br> •&nbsp;&nbsp; &nbsp;Identify how much you will be able to collect from payers for billing the service.&nbsp;<br> •&nbsp;&nbsp; &nbsp;Identify whether <span class=cloze>[...]</span> will pay for these services, or if it is a service that patients will pay for <span class=cloze>[...]</span>.<br> •&nbsp;&nbsp; &nbsp;Do these services fall under your liability insurance policies, or will a change in the coverage need to be made?<br> •&nbsp;&nbsp; &nbsp;Make sure you understand how the Stark and Anti-kickback laws may apply to the service, and if there appears to be any violation potential.<br> •&nbsp;&nbsp; &nbsp;Verify what level of <span class=cloze>[...]</span> or <span class=cloze>[...]</span> is necessary, and that you are committed to providing these requirements.<br> •&nbsp;&nbsp; &nbsp;Verify how the service is treated by Medicare. Medicare has rules about who can bill and collect for certain services.&nbsp;</div><div>To evaluate performing ancillary services in the office, you must<br> •&nbsp;&nbsp; &nbsp;Identify accurate <span class=cloze>volumes</span> currently being ordered so that a good financial analysis can be performed to determine profitability.&nbsp;<br> •&nbsp;&nbsp; &nbsp;How much will the equipment or services cost to provide these services through the clinic?<br> •&nbsp;&nbsp; &nbsp;Identify how much you will be able to collect from payers for billing the service.&nbsp;<br> •&nbsp;&nbsp; &nbsp;Identify whether <span class=cloze>third party payers</span> will pay for these services, or if it is a service that patients will pay for <span class=cloze>out of pocket</span>.<br> •&nbsp;&nbsp; &nbsp;Do these services fall under your liability insurance policies, or will a change in the coverage need to be made?<br> •&nbsp;&nbsp; &nbsp;Make sure you understand how the Stark and Anti-kickback laws may apply to the service, and if there appears to be any violation potential.<br> •&nbsp;&nbsp; &nbsp;Verify what level of <span class=cloze>supervision</span> or <span class=cloze>certification</span> is necessary, and that you are committed to providing these requirements.<br> •&nbsp;&nbsp; &nbsp;Verify how the service is treated by Medicare. Medicare has rules about who can bill and collect for certain services.&nbsp;</div><br> <div>To evaluate performing ancillary services in the office, you must<br> •&nbsp;&nbsp; &nbsp;Identify accurate volumes currently being ordered so that a good financial analysis can be performed to determine profitability.&nbsp;<br> •&nbsp;&nbsp; &nbsp;How much will the <span class=cloze>[...]</span> or <span class=cloze>[...]</span> cost to provide these services through the clinic?<br> •&nbsp;&nbsp; &nbsp;Identify how much you will be able to collect from payers for billing the service.&nbsp;<br> •&nbsp;&nbsp; &nbsp;Identify whether third party payers will pay for these services, or if it is a service that patients will pay for out of pocket.<br> •&nbsp;&nbsp; &nbsp;Do these services fall under your <span class=cloze>[...]</span> insurance policies, or will a change in the <span class=cloze>[...]</span> need to be made?<br> •&nbsp;&nbsp; &nbsp;Make sure you understand how the Stark and Anti-kickback laws may apply to the service, and if there appears to be any violation potential.<br> •&nbsp;&nbsp; &nbsp;Verify what level of supervision or certification is necessary, and that you are committed to providing these requirements.<br> •&nbsp;&nbsp; &nbsp;Verify how the service is treated by <span class=cloze>[...]</span>. <span class=cloze>[...]</span> has rules about who can bill and collect for certain services.&nbsp;</div><div>To evaluate performing ancillary services in the office, you must<br> •&nbsp;&nbsp; &nbsp;Identify accurate volumes currently being ordered so that a good financial analysis can be performed to determine profitability.&nbsp;<br> •&nbsp;&nbsp; &nbsp;How much will the <span class=cloze>equipment</span> or <span class=cloze>services</span> cost to provide these services through the clinic?<br> •&nbsp;&nbsp; &nbsp;Identify how much you will be able to collect from payers for billing the service.&nbsp;<br> •&nbsp;&nbsp; &nbsp;Identify whether third party payers will pay for these services, or if it is a service that patients will pay for out of pocket.<br> •&nbsp;&nbsp; &nbsp;Do these services fall under your <span class=cloze>liability</span> insurance policies, or will a change in the <span class=cloze>coverage</span> need to be made?<br> •&nbsp;&nbsp; &nbsp;Make sure you understand how the Stark and Anti-kickback laws may apply to the service, and if there appears to be any violation potential.<br> •&nbsp;&nbsp; &nbsp;Verify what level of supervision or certification is necessary, and that you are committed to providing these requirements.<br> •&nbsp;&nbsp; &nbsp;Verify how the service is treated by <span class=cloze>Medicare</span>. <span class=cloze>Medicare</span> has rules about who can bill and collect for certain services.&nbsp;</div><br> <div>To evaluate performing ancillary services in the office, you must<br> •&nbsp;&nbsp; &nbsp;Identify accurate volumes currently being ordered so that a good financial analysis can be performed to determine profitability.&nbsp;<br> •&nbsp;&nbsp; &nbsp;How much will the equipment or services cost to provide these services through the clinic?<br> •&nbsp;&nbsp; &nbsp;Identify how much you will be able to <span class=cloze>[...]</span> from payers for billing the service.&nbsp;<br> •&nbsp;&nbsp; &nbsp;Identify whether third party payers will pay for these services, or if it is a service that patients will pay for out of pocket.<br> •&nbsp;&nbsp; &nbsp;Do these services fall under your liability insurance policies, or will a change in the coverage need to be made?<br> •&nbsp;&nbsp; &nbsp;Make sure you understand how the <span class=cloze>[...]</span> and <span class=cloze>[...]</span> may apply to the service, and if there appears to be any violation potential.<br> •&nbsp;&nbsp; &nbsp;Verify what level of supervision or certification is necessary, and that you are committed to providing these requirements.<br> •&nbsp;&nbsp; &nbsp;Verify how the service is treated by Medicare. Medicare has rules about who can bill and collect for certain services.&nbsp;</div><div>To evaluate performing ancillary services in the office, you must<br> •&nbsp;&nbsp; &nbsp;Identify accurate volumes currently being ordered so that a good financial analysis can be performed to determine profitability.&nbsp;<br> •&nbsp;&nbsp; &nbsp;How much will the equipment or services cost to provide these services through the clinic?<br> •&nbsp;&nbsp; &nbsp;Identify how much you will be able to <span class=cloze>collect</span> from payers for billing the service.&nbsp;<br> •&nbsp;&nbsp; &nbsp;Identify whether third party payers will pay for these services, or if it is a service that patients will pay for out of pocket.<br> •&nbsp;&nbsp; &nbsp;Do these services fall under your liability insurance policies, or will a change in the coverage need to be made?<br> •&nbsp;&nbsp; &nbsp;Make sure you understand how the <span class=cloze>Stark</span> and <span class=cloze>Anti-kickback laws</span> may apply to the service, and if there appears to be any violation potential.<br> •&nbsp;&nbsp; &nbsp;Verify what level of supervision or certification is necessary, and that you are committed to providing these requirements.<br> •&nbsp;&nbsp; &nbsp;Verify how the service is treated by Medicare. Medicare has rules about who can bill and collect for certain services.&nbsp;</div><br> <div>Which model of patient scheduling best prevents patients from arriving late and affecting the schedule?</div> <div>A. Open access scheduling</div> <div>B. Confirmed time slot scheduling</div> <div>C. Dedicated time slot scheduling</div> D. Block schedulingD. Block scheduling
<div><span class=cloze>[...]</span> is a model where several patients may be scheduled for a block of time and patients are seen in the order they arrive. This model attempts to mitigate patients showing up late and disrupting the remainder of the appointment times. For example, if the provider can perform three established patient visits every 30 minutes, give three patients the same block of time with the instructions they will be seen in the order they arrive.</div><div><span class=cloze>Block scheduling</span> is a model where several patients may be scheduled for a block of time and patients are seen in the order they arrive. This model attempts to mitigate patients showing up late and disrupting the remainder of the appointment times. For example, if the provider can perform three established patient visits every 30 minutes, give three patients the same block of time with the instructions they will be seen in the order they arrive.</div><br> <div>Block scheduling is a model where several patients may be scheduled for a block of time and patients are seen in the order they arrive. This model attempts to mitigate patients showing up <span class=cloze>[...]</span> and <span class=cloze>[...]</span> the remainder of the appointment times. For example, if the provider can perform three established patient visits every 30 minutes, give three patients the same block of time with the instructions they will be seen in the order <span class=cloze>[...]</span>.</div><div>Block scheduling is a model where several patients may be scheduled for a block of time and patients are seen in the order they arrive. This model attempts to mitigate patients showing up <span class=cloze>late</span> and <span class=cloze>disrupting</span> the remainder of the appointment times. For example, if the provider can perform three established patient visits every 30 minutes, give three patients the same block of time with the instructions they will be seen in the order <span class=cloze>they arrive</span>.</div><br> <div>When planning patient exam rooms, remember</div> <div>A. The nursing station should be far from the exam rooms so patients cannot overhear private conversations.</div> <div>B. The physician’s office should be far from the exam rooms so patients cannot overhear private conversations.</div> <div>C. The exam table should be positioned to maximize patient privacy while the exam door is open.</div> <div>D. Limit the amount of supplies in the room so patients do not have access to them.</div> <div><br></div><div>C. The exam table should be positioned to maximize patient privacy while the exam door is open.<br><br>Having a “pod” or area focused on having nurses, exam rooms, and even physician offices all located in the same area of the clinic helps with efficiency. If there are adequate cabinets that are secure, you can effectively stock supplies without clutter or theft.</div>
<div>What is the most effective way to determine the overall work flow for a practice?</div> <div>A. Develop a flow chart for each policy and procedure in the practice.</div> <div>B. Monitor the amount of time it takes to prepare the patient for a visit.</div> <div>C. Develop a spreadsheet to monitor the number of appeals submitted.</div> <div>D. Develop a budget to help monitor the supplies needed each month.</div> <div>A. Develop a flow chart for each policy and procedure in the practice.<br><br>Work flow deals with all the services performed to run the practice, not just one area. The best way to understand your workflow is to evaluate the processes and policies in your clinic and to write them down. Documenting workflow can be done in different ways. A common way to understand workflow is to create flow diagrams. A flow diagram will identify each action performed in accomplishing work in a designated area.<br></div>
<div>Which of the following disclosures of PHI are acceptable without a written release from the patient?</div> <div>A. Release of the patient’s complete medical record to an auto insurance carrier to review an auto accident claim.</div> <div>B. Release of a patient’s surgical pathology report to an oncologist who will take over the patient’s care.</div> <div>C. Release of a patient’s records to a custodial care giver.</div> <div>D. Release of the patient’s entire medical record at the request of the specialist scheduled to see the patient.</div> <div>B. Release of a patient’s surgical pathology report to an oncologist who will take over the patient’s care.</div><br>Under the HIPAA Privacy Rule, covered entities and business associates are allowed to disclose PHI without a signed authorization for treatment, payment, or health care operations (TPO) reasons. Although PHI can be disclosed for TPO, the minimally necessary rule must be followed. The provider can only provide the PHI needed to treat or pay for the claim which does not always require release of the patient’s entire medical record.<br>
<div>Which of the following is not a covered entity under HIPAA?</div> <div>A. Clearinghouse</div> <div>B. Hospital</div> <div>C. Collection agencies</div> <div>D. Diagnostic centers</div> <div>C. Collection agencies</div><br>Collection agencies are business associates not a covered entity.&nbsp;<br>
<div>What must a business associate (BA) agreement include?</div> <div>A. The BA must include the fees associated with maintaining the confidentiality of PHI.</div> <div>B. The covered entity must have online access to all PHI provided to the BA.</div> <div>C. The BA must document all disclosures of PHI to provide to the covered entity upon request.</div> <div>D. The BA must sign a confidentiality agreement each time the covered entity submits PHI to the BA.</div><div>C. The BA must document all disclosures of PHI to provide to the covered entity upon request.</div><br>
<div>The business associate must agree to document <span class=cloze>[...]</span> required for covered entities to respond to a request by an individual for an accounting of disclosures of PHI. Once a BA is signed, a <span class=cloze>[...]</span> is no longer required because all disclosures are covered by the BA. The covered entity must be given access if requested but there is no requirement it must be <span class=cloze>[...]</span>. There are fees for providing services as a BA but not for <span class=cloze>[...]</span>. The fees charged for services appear in a <span class=cloze>[...]</span> not the BAA.</div><div>The business associate must agree to document <span class=cloze>disclosures of PHI</span> required for covered entities to respond to a request by an individual for an accounting of disclosures of PHI. Once a BA is signed, a <span class=cloze>confidentially agreement</span> is no longer required because all disclosures are covered by the BA. The covered entity must be given access if requested but there is no requirement it must be <span class=cloze>online</span>. There are fees for providing services as a BA but not for <span class=cloze>confidentially</span>. The fees charged for services appear in a <span class=cloze>contract</span> not the BAA.</div><br> <div>What is the most secure method to allow remote employees access to the EMR?</div> <div>A. VPN</div> <div>B. Encrypted flash drive</div> <div>C. LAN</div> <div>D. Firewall</div><div>A. VPN</div>
<div>The primary objectives for the Quality Payment Program (QPP) include which of the following?</div> <div>I. Repeal the SGR (Sustainable Growth Rate)</div> <div>II. Reauthorize the Children’s Health Insurance Program</div> <div>III. Expand healthcare coverage</div> <div>IV. Simplify the number and complexity of federal regulations regarding the payment methodologies and Health IT</div> <div>&nbsp;</div> <div>A. I, II, and IV</div> <div>B. I, III, and IV</div> <div>C. I, II, and III</div> <div>D. None of the above.</div><div>A. I, II, and IV</div>
SGRSustainable Growth Rate
<div>Small practices can save money implementing an EMR by:</div> <div>A. Purchasing a client server system which has less upfront costs.</div> <div>B. Purchasing an application service provider system which has less upfront costs.</div> <div>C. Purchasing an extended warranty on the hardware to prevent high replacement costs.</div> <div>D. Purchasing a limited number of site licenses to access the system so employees can share.</div><div>B. Purchasing an application service provider system which has less upfront costs.<br><br>For many smaller practices, there is a better option. Rather than purchase their own computer servers, Web-based “cloud” installations, also known as Software as a Service (SaaS), delivered by an Application Service Provider (ASP), often gives the best benefit. They usually require less up-front cost and internal expertise.</div>
<div>Which question is NOT as important to ask when researching EMR systems to implement in your practice?</div> <div>A. How will the EMR system integrate with the practice’s existing systems?</div> <div>B. Will we be required to have internal IT staff on site to implement the system?</div> <div>C. How many documentation templates are available for each specialty?</div> <div>D. What information should be scanned versus abstracted from the old paper chart?</div> <div><br></div><div>D. What information should be scanned versus abstracted from the old paper chart?<br><br>All of these questions are important to ask during an EMR implementation process; however, deciding on what information will be abstracted versus scanned is a question that will typically not be used in making a decision of what EMR to implement.&nbsp; Rather, it is a vital question that should be asked when deciding how to implement your new EMR.</div>
<div>Which statement is TRUE regarding Alternative Payment Models (APMs)?</div> <div>A. Participation in an APM excludes a provider from the Quality Payment Program (QPP).</div> <div>B. An APM is a risk-bearing contract for insurance carriers contracted with CMS.</div> <div>C. A provider can only participate in an APM as a solo practitioner.</div> <div>D. An APM is a fee-for-service contract paid based on quality outcome.</div> <div><br></div><div>D. An APM is a fee-for-service contract paid based on quality outcome.<br><br>Qualified APMs are risk-bearing contracts that require providers to put up more than “nominal financial risk — for example, through shared losses.”&nbsp;</div>
<div>Advances in technology in the medical practice have increased efficiencies in many areas.&nbsp; Which of the following is LEAST impacted in increasing efficiencies?</div> <div>A. Patient response to care</div> <div>B. Real-time claim adjudication</div> <div>C. Electronic payment posting</div> <div>D. Claim editing prior to submission</div> <div><br></div><div>A. Patient response to care</div><br>With the use of technology offices can improve how they deliver health care but how the patient responds is influenced by many variables that are out of the control of the medical provider (eg non-compliance with medication regimen).<br>
<div>Which statement is NOT true regarding the development of a post disaster check list?</div> <div>A. Make sure the staff knows where all the exits are located.</div> <div>B. Take an inventory of all damaged equipment and supplies.</div> <div>C. Identify an alternate office location if the office cannot be used.</div> <div>D. Contact patients to inform them.</div> <div><br></div><div>A. Make sure the staff knows where all the exits are located.</div><br>The post disaster plan includes all the activities that must be done following the disaster. Staff knowing where exists are located and proper evacuation routes is important prior to and during a disaster but not after the disaster.<br>
<div>As the practice manager, it is your responsibility to minimize risk. To accomplish this, you perform a risk analysis. During the analysis you find that the refrigerator where medications are stored is not cooling to the appropriate temperature. Which of the following is NOT a step in performing a risk analysis?</div> <div>A. Determine the likelihood the risk will cause an adverse effect.</div> <div>B. Quickly resolve all risks identified.</div> <div>C. Determine the financial impact if the risk is not resolved.</div> <div>D. Determine the level of risk to the practice.</div><div>B. Quickly resolve all risks identified.</div>
<div><span class=cloze>[...]</span> is the process of identifying dangers to stakeholders as posed by potential adverse events. In <span class=cloze>[...]</span>, an attempt is made to measure the probabilities of various adverse events and the likely extent of the losses if a particular event takes place. Once the potential for loss is identified, it is evaluated to determine if action can wait or if it has to be addressed immediately.<br> It includes a report of the following:<br> •&nbsp;&nbsp; &nbsp;Risk identification<br> •&nbsp;&nbsp; &nbsp;Risk likelihood<br> •&nbsp;&nbsp; &nbsp;Risk impact<br> •&nbsp;&nbsp; &nbsp;Recommendations/Actions</div><div><span class=cloze>Risk analysis</span> is the process of identifying dangers to stakeholders as posed by potential adverse events. In <span class=cloze>quantitative risk analysis</span>, an attempt is made to measure the probabilities of various adverse events and the likely extent of the losses if a particular event takes place. Once the potential for loss is identified, it is evaluated to determine if action can wait or if it has to be addressed immediately.<br> It includes a report of the following:<br> •&nbsp;&nbsp; &nbsp;Risk identification<br> •&nbsp;&nbsp; &nbsp;Risk likelihood<br> •&nbsp;&nbsp; &nbsp;Risk impact<br> •&nbsp;&nbsp; &nbsp;Recommendations/Actions</div><br>