Exam 3 ReviewMIS 4243

Question 1Which Medicare plan pays for hospital services?A. Part AB. Part BC. Part CD. Part D

Question 2What does comorbidity mean?A. The patient diedB. The patient developed an infection after

being admittedC. The patient developed a complicationD. The patient had more than one condition

when admitted

Question 3A participating provider charges $80, but the Medicare allowed amount is $70. What is the write-down amount?A. 10 percentB. 80 percentC. $10D. $80

Question 4Diagnosis codes assigned to represent disease or medical condition treated are:A. HCPCSB. CPT-4C. ICD-9-CMD. All of the above

Question 5A prospective payment system (PPS) is being used by a hospital. Which of the following is NOT true?A. There will be a maximum limit per

discharge.B. It will be based on reasonable costs given

the diagnosis.C. The hospital can be any type (general,

children’s, cancer, and so forth).D. Patients who stay one night versus two

nights will be charged the same amount if their diagnosis is the same.

Question 6Which paper form was designed for institutional claims?A. Part AB. UB-04C. CMS-1500D. W-4

Question 7A(n) _________ statement shows all unpaid items with payment, adjustments, and balance for each item.A. Balance forwardB. Open itemC. Either balance forward or open itemD. Neither balance forward or open item

Question 8Which of the following EDI transactions is currently NOT required by HIPAA?A. Claim attachmentB. Enrollment and de-enrollment in a health

planC. Health plan premium paymentsD. Referral certification and authorization

Question 9Provider payment delays can be caused by:A. A bill-hold periodB. Payment floorC. Secondary insurance plan billingD. All of the above

Question 10Special software that examines claim data before it is sent to eliminate preventable billing errors is called:A. Claim editB. Claim scrubberC. ClearinghouseD. EMC

Question 11What type of statistic can be used to compare patients who receive a therapy versus those who did not?A. MeanB. ModeC. RatioD. Standard deviation

Question 12Eighteen patients were counseled against smoking and twelve were not. What is the proportion of patients who were counseled?A. .40B. .60C. .66D. 1.5

Question 13A ___________ usually has a separate database created to track specific data types such as childhood immunizations.A. HEDISB. IndexC. ORYXD. Registry

Question 14The data mining technique called __________ could be used to predict length of stay of a patient in a hospital with a particular medical condition.A. AssociationB. ClusteringC. ClassificationD. Estimation

Question 15CMS developed the _______ program to encourage improvements in quality of care coordination for patients with chronic illnesses. It also gives bonus payments to doctors who meet or exceed performance standards.A. Data miningB. NHQMC. P4PD. Sampling

Question 16Software systems that share a common database are:A. InterfacedB. IntegratedC. IndexedD. Regulated

Question 17What department abstracts and reports National Hospital Quality Measures (NHQM)?A. BillingB. Utilization managementC. Quality managementD. Utility

Question 18Which of the following systems would be used track employee health?A. FinancialB. Human resourceC. SchedulingD. Quality management

Question 19An employee scheduling system is used for all of the following except:A. Processing doctors’ ordersB. Managing employee sick daysC. Scheduling pre-op cleaningD. Maintaining an on-call schedule

Question 20Which of the following is true regarding the Recovery Audit Contractor (RAC) program?A. It increases the risk of financial loss to the

hospital/physician.B. It was created by CMS in 2013.C. It utilizes a public company as its

contractor.D. All of the above are true.