CHSA Healthcare Finance & Reimbursement Flashcards
6 cards from real CHSA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CHSA Healthcare Finance & Reimbursement flashcards as text
Which type of healthcare budget projects expected revenues and expenses over a specific future period and is the most commonly used budgeting method?
Answer: Operating budget
The operating budget projects day-to-day revenues and expenses (salaries, supplies, utilities) over a fiscal year, forming the primary financial plan for ongoing operations.
What is the Anti-Kickback Statute's primary prohibition in US healthcare?
Answer: Prohibiting offering or receiving anything of value to induce or reward referrals of federal healthcare program business
The Anti-Kickback Statute prohibits knowingly offering, paying, soliciting, or receiving remuneration to induce or reward referrals of items or services covered by federal healthcare programs.
A healthcare organization uses a rolling 12-month budget. What is the main advantage of this approach compared to a traditional annual budget?
Answer: It continuously extends the planning horizon, allowing more timely adjustments to changing conditions
A rolling budget always maintains a full 12-month forward-looking plan, enabling more responsive and continuous financial planning compared to a static annual budget that becomes increasingly dated.
What does the term 'payer mix' refer to in healthcare financial management?
Answer: The distribution of patients by insurance type (Medicare, Medicaid, commercial, self-pay)
Payer mix describes the proportion of patients (and therefore revenue) from each payer category — Medicare, Medicaid, commercial insurance, and self-pay — which directly impacts financial performance.
Under Medicare's Outpatient Prospective Payment System (OPPS), how are outpatient services grouped for reimbursement?
Answer: Ambulatory Payment Classifications (APCs)
Medicare OPPS uses Ambulatory Payment Classifications (APCs) to group outpatient services with similar clinical characteristics and costs into single payment units.
A healthcare CFO is analyzing the organization's debt service coverage ratio (DSCR). What does a DSCR below 1.0 indicate?
Answer: The organization's income is insufficient to cover its debt payments
A DSCR below 1.0 means the organization does not generate sufficient operating income to cover its annual debt service (principal and interest payments), indicating financial distress.