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
Under Medicare's Inpatient Prospective Payment System (IPPS), what is the primary basis for determining hospital reimbursement?
Answer: Diagnosis-Related Groups (DRGs)
Medicare IPPS pays hospitals a predetermined, fixed amount based on the patient's Diagnosis-Related Group (DRG), regardless of the actual cost of services rendered.
Which financial statement shows a healthcare organization's revenues, expenses, and net income over a specific time period?
Answer: Statement of Operations (Income Statement)
The Statement of Operations (equivalent to an income statement) reports revenues earned and expenses incurred during a specific accounting period, showing the organization's operational financial performance.
A hospital's net patient revenue is calculated by taking gross charges and subtracting what?
Answer: Contractual adjustments, bad debt, and charity care
Net patient revenue equals gross patient service revenue minus contractual adjustments (payer discounts), provision for bad debt, and charity care write-offs.
What does Case Mix Index (CMI) measure in hospital financial management?
Answer: The average relative weight of all DRGs for a hospital's Medicare patients
CMI is the average DRG relative weight across all Medicare inpatient cases, reflecting the complexity and resource intensity of the patient population served.
Under the Stark Law (Physician Self-Referral Law), what is prohibited without meeting a specific exception?
Answer: Physicians referring Medicare/Medicaid patients to entities where they have a financial relationship
The Stark Law prohibits physicians from referring Medicare/Medicaid patients to entities with which the physician or immediate family member has a financial relationship, unless a specific exception applies.
What is the primary purpose of a healthcare organization's days cash on hand metric?
Answer: Indicating how many days the organization can operate using only its available cash
Days cash on hand measures financial liquidity by calculating how many days of average operating expenses can be covered by current cash and investments without new revenue.