Patient Access Services
CPAT Patient Access Services for PFS
- 1.
The two main governing bodies effecting healthcare change are:
- A.
CMS and AHCA
- B.
CMS and FDA
- C.
CMS and DHHS
- D.
DHHS and CDC
Correct Answer
C. CMS and DHHS -
- 2.
The DHHS include all of the programs listed below except:
- A.
Medicare
- B.
CMS
- C.
Child Support Enforcement
- D.
AFDC
Correct Answer
B. CMS -
- 3.
CMS is the acronym for:
- A.
Centers for Medicaid and Medicare Services
- B.
Center for Medicaid and State Operations
- C.
Center for Medicare Services
- D.
Centers for Medicare and Medicaid Services
Correct Answer
D. Centers for Medicare and Medicaid Services -
- 4.
Medicare is also know as:
- A.
Title XVIII
- B.
Itle XVII
- C.
Title XIII
- D.
Title XIX
Correct Answer
A. Title XVIII -
- 5.
Medicare has how many parts:
- A.
1
- B.
2
- C.
3
- D.
4
Correct Answer
D. 4 -
- 6.
Medicare provides insurance to:
- A.
People with end stage renal disease (ESRD requiring dialysis or a kidney transplant)
- B.
People who are 65 years or older
- C.
People who are disabled
- D.
All of the above
Correct Answer
D. All of the above -
- 7.
Medicare Part B pays for all of the following except:
- A.
Physician services
- B.
Hospice care
- C.
Outpatient hospital services
- D.
Medical equipment and supplies
Correct Answer
B. Hospice care -
- 8.
Medicare Part A provides coverage for which services except:
- A.
Home health services
- B.
Skilled nursing facilities
- C.
Preventative care
- D.
Inpatient hospital services
Correct Answer
C. Preventative care -
- 9.
Medicaid is also known as:
- A.
Title XVIII
- B.
Title XVII
- C.
Title XIII
- D.
Title XIX
Correct Answer
D. Title XIX -
- 10.
Medicaid is a health insurance program that covers which people:
- A.
People who are 65 years and older
- B.
Certain low-income people
- C.
People who are disabled
- D.
People with ESRD that requiring dialysis or a kidney transplant
Correct Answer
B. Certain low-income people -
- 11.
Medicaid is funded and administered through:
- A.
State and federal funding
- B.
Federal funding
- C.
State funding
- D.
Self funded
Correct Answer
A. State and federal funding -
- 12.
The State Children’s Health Insurance Program (SCHIP) is also known as:
- A.
Title XXI
- B.
Title XVII
- C.
Title XIII
- D.
Title XIX
Correct Answer
A. Title XXI -
- 13.
All states must cover the services listed below except:
- A.
Inpatient and outpatient hospital services
- B.
Laboratory and X-ray services
- C.
Dental care
- D.
Well baby/child care
Correct Answer
C. Dental care -
- 14.
Which legislation enacted the most significant changes to the Medicare an Medicaid Programs since their inception?
- A.
TEFRA
- B.
BBA
- C.
COBRA
- D.
DEFRA
Correct Answer
B. BBA -
- 15.
Which act removed the age limit previously imposed on a spouse for health plan coverage?
- A.
TEFRA
- B.
BBA
- C.
COBRA
- D.
DEFRA
Correct Answer
C. COBRA -
- 16.
The Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 required what:
- A.
Required EGHP with 50 or more employees to be primary to Medicare
- B.
Required EGHP with 15 or more employees to be primary to Medicare
- C.
Required EGHP with 40 or more employees to be primary to Medicare
- D.
Required EGHP with 20 or more employees to be primary to Medicare
Correct Answer
D. Required EGHP with 20 or more employees to be primary to Medicare -
- 17.
Which act provided for the Resource Based Relative Value Scale?
- A.
OBRA of 1986
- B.
COBRA of 1985
- C.
OBRA of 1989
- D.
DEFRA of 1984
Correct Answer
C. OBRA of 1989 -
- 18.
The RBRVS consist of which major elements?
- A.
RVU
- B.
MVPS
- C.
Limiting charge
- D.
All of the above
Correct Answer
D. All of the above -
- 19.
The Relative Value Unit (RVU) is comprised of all of the following except:
- A.
Work required
- B.
Limiting charge
- C.
Practice expense
- D.
Malpractice insurance
Correct Answer
B. Limiting charge -
- 20.
The limiting charge is what percentage of the fee schedule amount?
- A.
120%
- B.
150%
- C.
115%
- D.
125%
Correct Answer
C. 115% -
- 21.
HIPAA is the acronym for:
- A.
Health Information Portable and Accountable Act
- B.
Health Insurance Portable and Accountable Act
- C.
Health Insurance Portability and Accountability Act
- D.
Health Information Portability and Accountability Act
Correct Answer
C. Health Insurance Portability and Accountability Act -
- 22.
HIPAA’s key provisions include:
- A.
Guaranteed access to health insurance for small businesses
- B.
Guaranteed renewal of insurance regardless of health status
- C.
Limitations on pre-existing conditions
- D.
All of the above
Correct Answer
D. All of the above -
- 23.
All of the following are parts to HIPAA’s Administrative Simplification except:
- A.
NPI
- B.
Health savings accounts
- C.
Security requirements
- D.
Electronic transactions and code set standards
Correct Answer
B. Health savings accounts -
- 24.
The National Provider Identifier (NPI) consists of how many digits?
- A.
10
- B.
6
- C.
5
- D.
8
Correct Answer
A. 10 -
- 25.
ANSI X12 837I is the transaction standard for which of the following:
- A.
Healthcare claims status
- B.
Eligibility for a health plan
- C.
Institutional claim
- D.
None of the above
Correct Answer
C. Institutional claim -
- 26.
The transaction standard for Enrollment and Disenrollment in a health plan is:
- A.
837
- B.
834
- C.
820
- D.
148
Correct Answer
B. 834 -
- 27.
Standard Code Sets include:
- A.
CPT
- B.
ICD-9
- C.
HCPCS
- D.
All of the above
Correct Answer
D. All of the above -
- 28.
HCPCS codes are used for:
- A.
Institutional services
- B.
Physician services
- C.
Dental services
- D.
None of the above
Correct Answer
A. Institutional services -
- 29.
The False Claims Act is also known as:
- A.
Qui Tam Statute
- B.
Lincoln Act
- C.
Informer Act
- D.
All of the above
Correct Answer
D. All of the above -
- 30.
Examples of false and fraudulent schemes include all of the following except:
- A.
Kickbacks for inappropriate patient referrals
- B.
Providing services deemed medically necessary for financial gain
- C.
Billing for services not rendered
- D.
Misrepresenting services, supplies and procedures provided to patients
Correct Answer
B. Providing services deemed medically necessary for financial gain -
- 31.
The intentional or illegal deception or misrepresentation made for the purpose of personal gain, or to harm or manipulate another person or organization is:
- A.
Fraud
- B.
Kickbacks
- C.
Abuse
- D.
Misrepresentation
Correct Answer
A. Fraud -
- 32.
The misuse of a person, substance, service, or financial matter such that harm is cause is known as what?
- A.
Fraud
- B.
Kickbacks
- C.
Abuse
- D.
Misrepresentation
Correct Answer
C. Abuse -
- 33.
How many components are there in the OIG Compliance Plan?
- A.
5
- B.
6
- C.
7
- D.
8
Correct Answer
C. 7 -
- 34.
The components of the OIG Compliance Plan include all of the following except:
- A.
Auditing and monitoring
- B.
Ineffective lines of communication
- C.
Written policies and procedures
- D.
Effective training and education
Correct Answer
B. Ineffective lines of communication -
- 35.
Under EMTALA, what is the purpose of the examination?
- A.
To determine if the patient needs to be admitted
- B.
To determine if the patient is stable
- C.
To determine if the patient is stable
- D.
To determine if the patient is in an emergency medical condition
Correct Answer
D. To determine if the patient is in an emergency medical condition -
- 36.
What is an appropriate transfer?
- A.
The receiving facility has available space
- B.
The receiving facility has qualified staff
- C.
The transferring hospital provides medical treatment to minimize risks
- D.
All of the above
Correct Answer
D. All of the above -
- 37.
The Patient Bill of Rights was developed by which association?
- A.
AMA
- B.
DHHS
- C.
CMS
- D.
IRS
Correct Answer
A. AMA -
- 38.
The Patient Bill of Rights guarantees the basic rights listed below except:
- A.
Privacy
- B.
Refusal to pay
- C.
Confidentiality
- D.
Continuity of care
Correct Answer
B. Refusal to pay -
- 39.
The basic components of the Bill of Rights include:
- A.
If the entity accepts Medicare assignment
- B.
Private room
- C.
Considerate and respectful care
- D.
Both A and C
- E.
All of the above
Correct Answer
D. Both A and C -
- 40.
What is the acronym QIO?
- A.
Quality Improvement Organization
- B.
Quality Insurance Organization
- C.
Quick Improvement Options
- D.
Quality Inspection Office
Correct Answer
A. Quality Improvement Organization -
- 41.
The mission of the QIO includes all of the following except:
- A.
Quality
- B.
Effectiveness
- C.
Efficiency
- D.
Privacy
Correct Answer
D. Privacy -
- 42.
Traditionally, the admission process includes all of the following except
- A.
Storage of valuables
- B.
Collecting patient demographics
- C.
Guest services
- D.
Collecting financial data
Correct Answer
A. Storage of valuables -
- 43.
Emphasis on patient accounting falls on which department:
- A.
Admission and Registration
- B.
Financial Services Department
- C.
Both A and B
- D.
None of the above
Correct Answer
A. Admission and Registration -
- 44.
The Division of Access services include all of the following except:
- A.
Pre-certification
- B.
Discharge of the patient
- C.
Inpatient admitting
- D.
Outpatient registration
Correct Answer
B. Discharge of the patient -
- 45.
Affiliated health coverage includes:
- A.
24 hour access to a registered nurse
- B.
Referral services for physicians
- C.
Customer service and/or feedback
- D.
All of the above
Correct Answer
D. All of the above -
- 46.
General admitting responsibilities include all of the following except:
- A.
Public Relations
- B.
Recognition of Financial Risks
- C.
Insurance Verification
- D.
Insurance Claims Filing
Correct Answer
D. Insurance Claims Filing -
- 47.
The registration process includes:
- A.
Creating the permanent patient medical record for the stay
- B.
Assuring the accuracy of the patient account record
- C.
Insurance verification
- D.
Collection of information necessary to produce a clean claim
Correct Answer
C. Insurance verification -
- 48.
Information to be gathered during the scheduling process include:
- A.
Admission data
- B.
Employer information
- C.
Reason for seeking treatment
- D.
Both A and B
- E.
All of the above
Correct Answer
E. All of the above -
- 49.
A patient is more likely to pay their estimated portion of the bill:
- A.
After the insurance has paid
- B.
Before or at the time of admission
- C.
After the patient has been discharged
- D.
None of the above
Correct Answer
B. Before or at the time of admission -
- 50.
The advantages of pre-admitting patients include all of the following except:
- A.
Pre-certification is not obtained
- B.
Admission time is reduced
- C.
Second opinion surgeries can be identified
- D.
Special needs can be accommodated
Correct Answer
A. Pre-certification is not obtained -
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Current Version
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Jan 22, 2013Quiz Edited by
ProProfs Editorial Team -
Feb 06, 2011Quiz Created by
Jalmeida
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