CHSA Healthcare Finance & Revenue Cycle 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 & Revenue Cycle flashcards as text
Under the False Claims Act, a healthcare organization can face penalties for:
Answer: Submitting inaccurate claims to federal healthcare programs such as Medicare or Medicaid
The False Claims Act imposes significant civil penalties on entities that knowingly submit or cause submission of false or fraudulent claims to federal programs.
The Stark Law (Physician Self-Referral Law) primarily prohibits physicians from:
Answer: Referring Medicare/Medicaid patients to entities in which they have a financial relationship
The Stark Law bars physicians from referring patients to designated health services entities where they or an immediate family member has a financial interest, unless an exception applies.
A healthcare organization's 'net patient revenue' is calculated as:
Answer: Gross charges minus contractual adjustments, bad debt, and charity care
Net patient revenue reflects what the organization actually expects to collect after deducting contractual adjustments, charity care, and estimated bad debt from gross charges.
Which financial ratio helps administrators assess a hospital's short-term ability to meet its current obligations?
Answer: Current ratio (current assets ÷ current liabilities)
The current ratio measures liquidity by comparing current assets to current liabilities; a ratio above 1.0 indicates the organization can cover near-term debts.
When a payer denies a claim due to a coding error, the appropriate first administrative step is to:
Answer: File a corrected claim or formal appeal with supporting documentation
Filing a corrected claim or a formal appeal with documentation—such as medical records and a corrected code—is the standard process to recover denied revenue.
The CMS Hospital Price Transparency rule enacted in 2021 requires hospitals to publicly post:
Answer: A machine-readable file of standard charges for all items and services
CMS requires hospitals to publish a comprehensive machine-readable file and a consumer-friendly shoppable services display of their standard charges.