CPAT Aaham Final Practice Exam
Questions and Answers
- 1.
_____________ is defined as the period in time when a person is qualified for healthcare services covered by the insurance plan or entity (third party payer).
- A.
Pre-certification.
- B.
Benefit level.
- C.
Eligibility period.
- D.
Authorization.
Correct Answer
C. Eligibility period.Explanation
The term "eligibility period" refers to the specific time period during which an individual is eligible to receive healthcare services covered by their insurance plan or third-party payer. This period is typically determined by factors such as enrollment in the insurance plan, payment of premiums, and meeting any other requirements set by the insurance provider. During this eligibility period, the individual can access healthcare services without any additional authorization or pre-certification.Rate this question:
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- 2.
It is through the verification process we confirm the accuracy and completeness of key:
- A.
Demographic, encounter, and family information.
- B.
Encounter, payer, and demographic information.
- C.
Payer, encounter, and geographic information.
- D.
Demographic, insurance, and physician information.
Correct Answer
C. Payer, encounter, and geographic information.Explanation
The verification process is used to confirm the accuracy and completeness of key information. In this case, the key information includes payer, encounter, and geographic information. This suggests that these three categories are crucial for ensuring the accuracy and completeness of the data. The other options may also be important, but they are not specifically mentioned as key information in this context.Rate this question:
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- 3.
____________ is to attest as meeting a standard of care prior to service.
- A.
Pre-certification.
- B.
Benefit level.
- C.
Eligibility period.
- D.
Referral
Correct Answer
A. Pre-certification.Explanation
Pre-certification is the process of obtaining approval from an insurance company before receiving a medical service or treatment. It involves meeting certain criteria or standards of care that the insurance company requires in order to ensure that the service is necessary and appropriate. Attesting, on the other hand, refers to providing evidence or proof of something, which is not directly related to meeting a standard of care prior to service. Therefore, the correct answer is pre-certification.Rate this question:
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- 4.
The key patient demographic information we gather at intake to identify if the Patient has previously been at the hospital includes:
- A.
Social security number, date of birth, gender, and address.
- B.
Name, date of birth, driver's license, and gender.
- C.
Date of birth, name, social security number, and gender.
- D.
Name, address, date of birth, and gender.
Correct Answer
C. Date of birth, name, social security number, and gender.Explanation
The key patient demographic information that is gathered at intake to identify if the patient has previously been at the hospital includes the date of birth, name, social security number, and gender. This combination of information is unique to each individual and can help in accurately identifying whether the patient has had previous interactions with the hospital.Rate this question:
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- 5.
_____________ is to give official approval or permission for the service.
- A.
Pre-certification.
- B.
Benefit level.
- C.
Eligibility period.
- D.
Authorization
Correct Answer
D. AuthorizationExplanation
Authorization is the act of giving official approval or permission for a service. It involves granting the necessary authorization or clearance for something to proceed. In the context of the question, authorization is the most appropriate term as it accurately describes the action of granting official approval or permission for the service.Rate this question:
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- 6.
_____________ is defined as the service the third party payer will pay, based on the Patient's coverage plan.
- A.
Pre-certification.
- B.
Benefit level.
- C.
Eligibility period.
- D.
Referral.
Correct Answer
B. Benefit level.Explanation
Benefit level is defined as the service that the third party payer will pay, based on the patient's coverage plan. This means that the amount or extent of coverage provided by the insurance company for a particular service or treatment is determined by the benefit level specified in the patient's plan. It determines the maximum amount that the payer will reimburse for a specific service or treatment, and any costs beyond this benefit level will typically have to be paid by the patient.Rate this question:
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- 7.
Necessary data needed to make an effective collection call include all of the following except:
- A.
Date of birth
- B.
Date of service
- C.
Insurance information
- D.
Patient’s address
Correct Answer
D. Patient’s addressExplanation
To make an effective collection call, the necessary data needed includes the date of service, insurance information, and the patient's address. However, the patient's date of birth is not essential for the collection call process. The date of birth may be useful for identification purposes or to verify the patient's age, but it is not directly related to collecting payment or resolving any outstanding bills.Rate this question:
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- 8.
Common stalls and delays include all of the following except:
- A.
Pre-existing conditions
- B.
Stop loss issues
- C.
Authorization not completed or on file
- D.
Incorrect patient phone number
Correct Answer
D. Incorrect patient phone numberExplanation
The given options list common stalls and delays in a healthcare setting. Pre-existing conditions, stop loss issues, and authorization not completed or on file are all potential causes for delays in providing care or processing claims. However, an incorrect patient phone number is not directly related to delays in healthcare services and is therefore the exception in this list.Rate this question:
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- 9.
Work lists to assist in third party follow up include all of the following except:
- A.
Physical bill form, ie UB04
- B.
Superbill
- C.
Paper aged trial balance
- D.
Automated collection work list
Correct Answer
B. SuperbillExplanation
A superbill is a document used in healthcare settings to record the services provided to a patient during a visit. It contains information such as the patient's demographics, the services rendered, and the corresponding billing codes. Unlike the other options listed, a superbill is not typically used for third-party follow-up. Instead, it is primarily used for internal record-keeping and for the patient to submit claims to their insurance company for reimbursement. Therefore, the correct answer is "Superbill."Rate this question:
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- 10.
All of the following are advantages of a Courtesy Discharge except:
- A.
Reduces accounts receivables
- B.
Allows for greater accuracy in billing
- C.
Improves traffic flow
- D.
Improves patient-hospital relations
Correct Answer
A. Reduces accounts receivablesExplanation
A courtesy discharge is a process where a patient is discharged from the hospital without being billed for their services. This is typically done as a gesture of goodwill or for patients who are unable to pay their medical bills. While a courtesy discharge can have several advantages, such as allowing for greater accuracy in billing, improving traffic flow, and enhancing patient-hospital relations, it does not directly reduce accounts receivables. Accounts receivables refer to the outstanding balances owed to the hospital by patients or insurance companies, and a courtesy discharge does not eliminate or reduce these balances.Rate this question:
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- 11.
What is an uncollectable account resulting from the extension of credit?
- A.
Tort liability
- B.
Lien
- C.
Bad debt
- D.
Judgment
Correct Answer
C. Bad debtExplanation
Bad debt refers to an uncollectable account resulting from the extension of credit. This means that when a company or individual extends credit to a customer, there is a risk that the customer may not be able to repay the debt. In such cases, the debt becomes uncollectable and is considered a bad debt. This can happen due to various reasons such as bankruptcy, financial difficulties, or non-payment by the customer. It is important for businesses to account for bad debts and make appropriate provisions to minimize their impact on financial statements.Rate this question:
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- 12.
What is a legally verified claim against a debtor?
- A.
Tort liability
- B.
Lien
- C.
Bad debt
- D.
Judgment
Correct Answer
D. JudgmentExplanation
A legally verified claim against a debtor refers to a judgment. This means that a court has made a decision regarding a claim against a debtor and has determined that the debtor is legally obligated to pay the claimed amount. A judgment is typically obtained through a legal process, such as a lawsuit, and it allows the creditor to take further action to collect the debt, such as garnishing wages or placing a lien on the debtor's property.Rate this question:
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- 13.
What is a liability for an injury or wrongdoing done by one person to another resulting from a breach of legal duty?
- A.
Tort liability
- B.
Lien
- C.
Bad debt
- D.
Judgment
Correct Answer
A. Tort liabilityExplanation
Tort liability refers to the legal responsibility or obligation that one person has towards another for any injury or wrongdoing caused due to a breach of legal duty. In other words, it is the liability that arises from a civil wrong, such as negligence or intentional harm, committed by one person against another. This can include situations where someone is injured due to a car accident, medical malpractice, or any other form of personal injury.Rate this question:
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- 14.
What is a recorded claim against real or personal property, generally arising out of a debt?
- A.
Tort Liability
- B.
Lien
- C.
Bad debt
- D.
Judgment
Correct Answer
B. LienExplanation
A lien is a recorded claim against real or personal property that typically arises from a debt. It gives the creditor the right to take possession of the property if the debtor fails to fulfill their financial obligations. This legal encumbrance ensures that the creditor has a security interest in the property until the debt is paid off.Rate this question:
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- 15.
Problems with electronic billing include all of the following except:
- A.
Creates challenges
- B.
Less paper
- C.
Vendor reporting is inflexible and/or not available
- D.
Upload / download issues
Correct Answer
B. Less paperExplanation
The given answer is "Less paper". This is the exception among the problems with electronic billing. While electronic billing does have its own set of challenges, such as creating challenges, vendor reporting issues, and upload/download problems, it actually reduces the need for paper in billing processes. Electronic billing eliminates the need for physical documents and allows for a more streamlined and efficient billing system.Rate this question:
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- 16.
Elements of a chargemaster include all of the following except:
- A.
Modifiers
- B.
Revenue codes
- C.
ICD-9 codes
- D.
CPT/HCPCS codes
Correct Answer
C. ICD-9 codesExplanation
A chargemaster is a comprehensive list of all the services and procedures provided by a healthcare facility along with their corresponding prices. It is used for billing and reimbursement purposes. The elements of a chargemaster typically include modifiers, revenue codes, and CPT/HCPCS codes. These codes help in identifying and categorizing the services provided. However, ICD-9 codes, which are used for diagnostic coding, are not typically included in a chargemaster as they are not directly related to the pricing and billing of services.Rate this question:
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- 17.
In a divorce or separation which plan is primary?
- A.
Father
- B.
The parent who has custody
- C.
Mother
- D.
The parent that presented the child for treatment
Correct Answer
B. The parent who has custodyExplanation
In a divorce or separation, the parent who has custody is considered the primary plan. This means that the parent who has been granted legal custody of the child is responsible for making decisions regarding the child's healthcare, education, and overall well-being. They are the primary caregiver and have the authority to make important decisions on behalf of the child.Rate this question:
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- 18.
What is a written authorization, signed by the policyholder to an insurance company, to pay benefits directly to the hospital?
- A.
Assignment of Benefits
- B.
Medicare Secondary Payer
- C.
Conditional Payments
- D.
Medicare Administrative Contractor
Correct Answer
A. Assignment of BenefitsExplanation
An assignment of benefits is a written authorization, signed by the policyholder, that allows an insurance company to pay benefits directly to a hospital. This means that the policyholder gives the hospital the right to receive the insurance benefits on their behalf. This can be beneficial for the policyholder as it ensures that the hospital is paid directly and eliminates the need for the policyholder to handle the payment process themselves.Rate this question:
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- 19.
A system generated free-form statement that is used to communicate the status of a patient’s account:
- A.
Data Mailer
- B.
Superbill
- C.
Itemized Statement
- D.
Both B and C
Correct Answer
A. Data MailerExplanation
A Data Mailer is a system generated free-form statement that is used to communicate the status of a patient's account. It provides information about the patient's account, such as billing details, payment history, and outstanding balances. This statement is typically sent to the patient or their insurance company to keep them informed about the financial aspects of their healthcare services. It is a convenient way to communicate the account status and ensure transparency between the healthcare provider and the patient.Rate this question:
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- 20.
SNF days 21 through 100:
- A.
$125 per day
- B.
$127.50 per day
- C.
$148.00 per day
- D.
$150.00 per day
Correct Answer
C. $148.00 per dayExplanation
The correct answer is $148.00 per day. This is the rate for SNF days 21 through 100.Rate this question:
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- 21.
The Medicare Part A Lifetime Reserve 91 through 150 days:
- A.
$275 per day
- B.
$350 per day
- C.
$592 per day
- D.
$1100 per spell of illness
Correct Answer
C. $592 per dayExplanation
The correct answer is $592 per day. This is the cost for Medicare Part A Lifetime Reserve days 91 through 150. During this time, Medicare will cover the cost of hospital stays up to $592 per day.Rate this question:
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- 22.
The Medicare Part A deductible for days 1 through 60 is:
- A.
$1000
- B.
$1184
- C.
$1200
- D.
$1500
Correct Answer
B. $1184Explanation
The Medicare Part A deductible for days 1 through 60 is $1184. This means that Medicare beneficiaries are responsible for paying the first $1184 of their hospital stay costs during this time period. After the deductible is met, Medicare will cover a portion of the remaining costs. It is important for beneficiaries to understand their deductible amount and how it applies to their healthcare expenses.Rate this question:
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- 23.
A clean claim is one which:
- A.
If investigated does not require contact with the provider
- B.
Will pass all front end edits
- C.
Is processed electronically
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
A clean claim is one that meets all the criteria mentioned in the options. It does not require contact with the provider if investigated, passes all front end edits, and is processed electronically. Therefore, the correct answer is "All of the above."Rate this question:
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- 24.
The first digit in the type of bill indicates:
- A.
Frequency
- B.
Type of facility
- C.
Bill Classification
- D.
None of the above
Correct Answer
B. Type of facilityExplanation
The first digit in the type of bill indicates the type of facility. This means that the first digit in the bill number represents the category or type of healthcare facility where the bill originated from. It helps in identifying the specific type of facility, such as a hospital, nursing home, or outpatient clinic, which can be useful for administrative and billing purposes.Rate this question:
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- 25.
ICD-9 codes are used to identify:
- A.
Procedures
- B.
Diagnosis
- C.
Supplies
- D.
Office visits
Correct Answer
B. DiagnosisExplanation
ICD-9 codes are used to identify diagnoses. These codes are a standardized system of alphanumeric codes that represent specific medical conditions or diseases. They are used by healthcare providers to document and communicate diagnoses for billing, research, and statistical purposes. Each ICD-9 code corresponds to a specific diagnosis, allowing for accurate and consistent identification of medical conditions.Rate this question:
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- 26.
Medicare supports the electronic health record for which reason(s):
- A.
Lowers the chances of medical errors
- B.
Provider and organizations will have the same knowledge about a patients medical condition
- C.
Improve over all quality of patient care
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
Medicare supports the electronic health record because it lowers the chances of medical errors by providing accurate and up-to-date patient information. It also ensures that healthcare providers and organizations have the same knowledge about a patient's medical condition, leading to better coordination and continuity of care. Additionally, the use of electronic health records improves the overall quality of patient care by enabling more efficient and effective communication, decision-making, and care coordination among healthcare providers.Rate this question:
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- 27.
RBRVS is the acronym for:
- A.
Resource based relative value system
- B.
Resource based related value system
- C.
Resource based related value scale
- D.
Resource based relative value scale
Correct Answer
D. Resource based relative value scaleExplanation
RBRVS stands for Resource Based Relative Value Scale. This system is used to determine the reimbursement rates for medical services provided by healthcare professionals. It assigns a relative value to each service based on the resources required to provide it, such as time, skill, and overhead costs. The scale takes into account factors like the complexity of the service, the expertise needed to perform it, and the cost of the equipment and supplies involved. By using this scale, healthcare providers can be reimbursed fairly and accurately for the services they provide.Rate this question:
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- 28.
A _____________ is to send or direct for treatment, aid, information, or decision. Some third party payers utilize this process to monitor and manage patient care.
- A.
Pre-certification.
- B.
Benefit level.
- C.
Eligibility period.
- D.
Referral.
Correct Answer
D. Referral.Explanation
A referral is a process of sending or directing a patient for treatment, aid, information, or decision. Some third party payers use referrals to monitor and manage patient care.Rate this question:
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- 29.
The purpose of this act is to protect consumers from inaccurate or unfair practices by issuers of open-ended credit.
- A.
Fair and Accurate Credit Transaction Act
- B.
Fair Credit Billing Act
- C.
Fair Credit Reporting Act
- D.
Truth in Lending Act
Correct Answer
B. Fair Credit Billing ActExplanation
The Fair Credit Billing Act is the correct answer because its purpose aligns with the statement provided. The act aims to protect consumers from inaccurate or unfair practices by issuers of open-ended credit. This act specifically focuses on addressing billing errors and provides consumers with the right to dispute and correct these errors. It also establishes procedures for handling billing disputes and requires prompt investigation and resolution by creditors.Rate this question:
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- 30.
This act requires creditors to inform debtors of their rights and responsibilities under the act.
- A.
Fair and Accurate Credit Transaction Act
- B.
Fair Credit Billing Act
- C.
Fair Credit Reporting Act
- D.
Truth in Lending Act
Correct Answer
B. Fair Credit Billing ActExplanation
The Fair Credit Billing Act requires creditors to inform debtors of their rights and responsibilities under the act. This act focuses specifically on protecting consumers from unfair billing practices and provides guidelines for resolving billing errors. It ensures that consumers are aware of their rights to dispute charges and receive proper billing statements. The act also outlines the procedures that creditors must follow when handling billing disputes.Rate this question:
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- 31.
Patient accounts that occur after the petition and/or were not included in the notification will be subject to the discharge.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Patient accounts that occur after the petition and/or were not included in the notification will not be subject to the discharge.Rate this question:
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- 32.
A Bankruptcy notice that releases the guarantor/patient from financial responsibility of any and all account balances listed on the bankruptcy petition is called:
- A.
Dismissal
- B.
Bankruptcy Notice
- C.
Discharge of Debtor
- D.
Chapter 7
Correct Answer
C. Discharge of DebtorExplanation
A discharge of debtor is a bankruptcy notice that releases the guarantor or patient from the financial responsibility of any and all account balances listed on the bankruptcy petition. This means that the person who filed for bankruptcy is no longer obligated to repay the debts listed in the petition. It provides a fresh start for the debtor by eliminating their financial obligations and allowing them to move forward without the burden of past debts.Rate this question:
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- 33.
A debtor can be placed in involuntary bankruptcy under chapter 7 or 11 if the debtor has:
- A.
10 or more creditor, three of which have claims in excess of $2500 each
- B.
12 or more creditors, three of which have claims in excess of $5000 each
- C.
15 or more creditors, five of which have claims in excess of $10,000 each
- D.
20 or more creditor, ten of which have claims in excess of $15,000 each
Correct Answer
B. 12 or more creditors, three of which have claims in excess of $5000 eachExplanation
If a debtor has 12 or more creditors, with three of them having claims in excess of $5000 each, they can be placed in involuntary bankruptcy under chapter 7 or 11. This means that if enough creditors meet these criteria, they can force the debtor into bankruptcy proceedings.Rate this question:
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- 34.
Under chapter 13, how long is a debtor permitted to repay creditors?
- A.
1 year
- B.
2 years
- C.
3 years
- D.
5 years
Correct Answer
C. 3 yearsExplanation
Under chapter 13 bankruptcy, debtors are allowed to repay their creditors over a period of 3 years. This chapter of bankruptcy is specifically designed for individuals with a regular income who want to reorganize their debts and create a repayment plan. The 3-year timeframe provides debtors with a reasonable period to fulfill their financial obligations and work towards becoming debt-free.Rate this question:
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- 35.
Under chapter 13, in no case may a plan provide for payments over a period of longer than:
- A.
1 year
- B.
2 years
- C.
3 years
- D.
5 years
Correct Answer
D. 5 yearsExplanation
According to chapter 13, a plan cannot allow for payments over a period longer than 5 years.Rate this question:
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- 36.
How long does a business have to initially draft a repayment plan:
- A.
1 month
- B.
3 months
- C.
6 months
- D.
1 year
Correct Answer
B. 3 monthsExplanation
A business has 3 months to initially draft a repayment plan. This timeframe allows the business enough time to assess its financial situation, gather necessary information, and create a comprehensive repayment plan that addresses its debts and obligations. It provides a reasonable period for the business to analyze its cash flow, negotiate with creditors if needed, and develop a strategy to repay its debts in a sustainable manner. This timeframe strikes a balance between allowing the business enough time to prepare a well-thought-out plan while also ensuring that prompt action is taken to address any financial difficulties.Rate this question:
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- 37.
70% of all bankruptcies are filed under this chapter:
- A.
Chapter 7
- B.
Chapter 11
- C.
Chapter 12
- D.
Chapter 13
Correct Answer
A. Chapter 7Explanation
Chapter 7 is the correct answer because it is the most common type of bankruptcy filing. It is also known as "liquidation bankruptcy" and is typically used by individuals and businesses to discharge their debts and start fresh. This chapter allows the debtor to sell off non-exempt assets to repay creditors and have most remaining debts discharged.Rate this question:
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- 38.
Elements of a chargemaster include all of the following except:
- A.
Modifiers
- B.
Revenue codes
- C.
ICD-9-codes
- D.
CPT/HCPCS codes
Correct Answer
C. ICD-9-codesExplanation
A chargemaster is a comprehensive list of all the services and procedures provided by a healthcare facility along with their corresponding prices. It is used for billing and reimbursement purposes. The elements of a chargemaster typically include modifiers, revenue codes, and CPT/HCPCS codes, which are all used to accurately describe and code the services provided. However, ICD-9-codes are not part of the chargemaster. Instead, they are used for diagnostic coding and are typically included in medical records and claims forms.Rate this question:
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- 39.
The assignment of benefits is usually acquired at what time:
- A.
Discharge
- B.
Admission
- C.
After surgery
- D.
None of the above
Correct Answer
B. AdmissionExplanation
The assignment of benefits is usually acquired at the time of admission. This means that when a patient is admitted to a healthcare facility, they are typically asked to sign a form that assigns their insurance benefits to the provider. This allows the provider to bill the insurance company directly for the services rendered to the patient. By obtaining the assignment of benefits at admission, the provider can ensure that they will be reimbursed for the care provided.Rate this question:
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- 40.
The medicare Part B annual deductible is:
- A.
$147.00
- B.
$155.00
- C.
$120.00
- D.
Free for STUDS Like Eric
Correct Answer
A. $147.00Explanation
The correct answer is $147.00. This is the annual deductible for Medicare Part B. The deductible is the amount that a beneficiary must pay out of pocket before their Medicare Part B coverage begins. Once the deductible is met, Medicare will pay its share of the approved services and the beneficiary will be responsible for any remaining costs.Rate this question:
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- 41.
Under this act a patient has 60 days after a statement to notify the hospital of any errors. and the hospital has 30 days to respond to the complaint.
- A.
Fair Credit Reporting Act
- B.
Fair Credit Billing Act
- C.
Truth in Lending Act
- D.
Chocolate Honey Buns are the Best
Correct Answer
B. Fair Credit Billing ActExplanation
The Fair Credit Billing Act is the correct answer because it provides consumers with the right to dispute billing errors on their credit card statements. According to the act, a patient has 60 days after receiving a statement to notify the hospital of any errors. The hospital then has 30 days to respond to the complaint. This act ensures that consumers have a fair process for resolving billing disputes and protects them from being held responsible for unauthorized charges or billing mistakes.Rate this question:
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- 42.
The Fair Debt Collections Act is also known as (which title):
- A.
Title I
- B.
Fair Credit Reporting Act
- C.
Title VI
- D.
Title VIII
Correct Answer
D. Title VIIIExplanation
The correct answer is Title VIII. The Fair Debt Collections Act is also known as Title VIII.Rate this question:
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- 43.
This act imposed strict limitations on communications with consumers for call times, harassment and false or misleading info.
- A.
Fair Debt Collections Act
- B.
Truth in Lending Act
- C.
Fair Credit Reporting Act
- D.
Fair Credit Billing Act
Correct Answer
A. Fair Debt Collections ActExplanation
The Fair Debt Collections Act is the correct answer because it is a federal law that regulates the actions of debt collectors. It imposes strict limitations on how debt collectors can communicate with consumers, including restrictions on call times, harassment, and providing false or misleading information. The purpose of this act is to protect consumers from abusive and unfair debt collection practices.Rate this question:
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- 44.
This legislation creates federal standards for insurers, HMOs, and employer plans including those who are also self insured.
- A.
The Hill-Burton Act
- B.
False Claims Act
- C.
HIPAA
- D.
Food and Drug Administration
Correct Answer
C. HIPAAExplanation
HIPAA, or the Health Insurance Portability and Accountability Act, is the correct answer because it is a legislation that establishes federal standards for insurers, HMOs, and employer plans, including those who are self-insured. HIPAA aims to protect the privacy and security of individuals' health information, as well as ensure the portability of health insurance coverage for individuals who change jobs or lose their job. It also includes provisions for preventing healthcare fraud and abuse.Rate this question:
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- 45.
Fraud and abuse Initiatives are enforced by who:
- A.
Department of Justice
- B.
Office of Inspector General
- C.
Kenny Koerner
- D.
Answers A and B
Correct Answer
D. Answers A and BExplanation
The correct answer is "Answers A and B". Fraud and abuse initiatives are enforced by both the Department of Justice and the Office of Inspector General. The Department of Justice is responsible for investigating and prosecuting fraud cases, while the Office of Inspector General works to prevent and detect fraud, waste, and abuse within various government agencies. Both entities play crucial roles in combating fraud and abuse, making them the correct answers.Rate this question:
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- 46.
CMS was formerly known as what?
- A.
HCFA (Health Care Financing Administration)
- B.
Centers for Disease Control and Prevention (CDC)
- C.
Food and Drug Administration (FDA)
- D.
Indian Health Services (IHS)
Correct Answer
A. HCFA (Health Care Financing Administration)Explanation
CMS, which stands for Centers for Medicare & Medicaid Services, was formerly known as HCFA (Health Care Financing Administration). This change in name occurred in 2001 to better reflect the agency's expanded responsibilities in administering healthcare programs for both Medicare and Medicaid beneficiaries. The name change aimed to emphasize the agency's focus on providing access to quality healthcare services and ensuring the financial stability of these programs.Rate this question:
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- 47.
Medicare is which title:
- A.
Title XVIII (title 18)
- B.
Title I (title 1)
- C.
Title VI (title 6)
- D.
Title XIX (title 19)
Correct Answer
A. Title XVIII (title 18)Explanation
Medicare is known as Title XVIII (title 18) because it is the 18th title of the Social Security Act. Medicare is a federal health insurance program in the United States that primarily provides coverage for people who are 65 years old or older, as well as certain younger individuals with disabilities. The program is divided into different parts, including Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage plans), and Part D (prescription drug coverage).Rate this question:
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- 48.
The intentional or illegal deception or misrepresentation made for the purpose of personal gain is called:
- A.
Abuse
- B.
Fraud
- C.
Living Will
- D.
None of the Above
Correct Answer
B. FraudExplanation
Fraud refers to the intentional or illegal deception or misrepresentation made with the intention of personal gain. It involves dishonesty, deceit, or trickery, usually for financial or material benefits. Fraud can occur in various forms, such as financial fraud, identity theft, insurance fraud, or internet fraud. The perpetrator of fraud manipulates facts or conceals information to deceive others and obtain advantages or profits at their expense.Rate this question:
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- 49.
Total # of patient days/ total number of discharges is the equation for which:
- A.
Average Daily Census
- B.
Percentage of Occupancy
- C.
Average Length of Stay
- D.
Midnight Census
Correct Answer
C. Average Length of StayExplanation
The equation Total # of patient days/ total number of discharges calculates the Average Length of Stay. This is because the total number of patient days represents the total number of days that all patients stayed in the hospital, while the total number of discharges represents the total number of patients discharged from the hospital. Dividing these two values gives the average number of days each patient stayed in the hospital, which is the definition of Average Length of Stay.Rate this question:
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- 50.
For Medicare Part B patients, a mammogram screening is covered:
- A.
Twice Every 12 Months
- B.
Once every 24 Months
- C.
Never
- D.
Once Every 12 Months
Correct Answer
D. Once Every 12 MonthsExplanation
Medicare Part B patients are covered for a mammogram screening once every 12 months. This means that they can receive this preventive service once a year at no cost to them. Regular mammograms are essential for early detection of breast cancer, which increases the chances of successful treatment. By covering it annually, Medicare aims to ensure that beneficiaries have access to this important screening on a regular basis.Rate this question:
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Apr 17, 2024Quiz Edited by
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May 17, 2013Quiz Created by
Ewestb
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