CHSA CHSA Healthcare Finance & Revenue Cycle

Question 1

Which document outlines the itemized charges for services rendered to a patient during a hospital stay?

Accepted Answer

Uniform Bill (UB-04)

Answer

Explanation of Benefits (EOB)

Answer

Remittance Advice (RA)

Answer

Prior Authorization Form

Question 2

What term describes the process of verifying a patient's insurance coverage and benefits before providing non-emergency care?

Accepted Answer

Pre-certification/eligibility verification

Answer

Claims adjudication

Answer

Prior authorization

Answer

Concurrent review

Question 3

Under Medicare's Prospective Payment System (PPS), hospital reimbursement for inpatient stays is primarily based on:

Accepted Answer

Diagnosis-Related Groups (DRGs)

Answer

Actual days the patient stayed

Answer

Total charges submitted on the claim

Answer

Number of procedures performed

Question 4

A charge that a healthcare organization writes off because it exceeds the contracted payer rate is called a:

Accepted Answer

Contractual adjustment

Answer

Bad debt

Answer

Charity care write-off

Answer

Capitation payment

Question 5

Which revenue cycle metric measures the average number of days it takes to collect payment after a service is billed?

Accepted Answer

Days in accounts receivable (AR)

Answer

Case mix index

Answer

Denial rate

Answer

Cost-to-charge ratio

Question 6

What is the purpose of a Medicare Cost Report submitted annually by hospitals?

Accepted Answer

To reconcile actual costs with interim payments received from Medicare

Answer

To request new DRG assignments

Answer

To report physician quality metrics

Answer

To apply for Medicare certification renewal