HSA 525 Week 5 Midterm Exam

            Question 1

            Assume that an ambulance brought Cindy Roe to the emergency department of Grace Medical Center. She decides to leave the hospital without receiving treatment. The attending physician and the hospital staff offer Cindy medical examination and treatment within the hospital before she leaves. Cindy refuses treatment and refuses to sign an informed consent, and they let her go. The physician/hospital most likely has violated EMTALA.                                           

            Question 2

            What is charge explosion?                                         

            Question 3

            EMTALA allows a hospital to transfer an emergency patient to another hospital because of the patient's inability to pay.                                              

            Question 4

            Governmental healthcare organizations are able to raise funds through equity investments.                                               

            Question 5

            The financial manager's main responsibility is to acquire and use funds so as to maximize the firm s value. Their main functions may include: forecasting and planning, making major investment financing decisions, coordinating and controlling, dealing with the financial markets, and managing public opinion.                                        

            Question 6

            Which of the following covers nearly 100% of hospital service charges but is subject to a 20% coinsurance payment for most physician services?                        

            Question 7

            Which of the following covers nearly 100% of hospital service charges but is subject to a 20% coinsurance payment for most physician services?                                    

            Question 8

            One of the advantages of a nonprofit organization compared with an investor-owned company is that the investor-owned company is subject to federal income taxes.                        

            Question 9

            What are the elements that should be present, at a minimum, in all charge masters?

            Question 10

            __________ is often referred to as the antidumping law because it prohibits hospitals from transferring an emergency patient to another hospital simply because of the patient's inability to pay.                                           

            Question 11

            Prosecution under the FCA requires that specific intent to defraud the government was present.                                      

            Question 12

            How does the False Claims Act (FCA) impact providers of health care services?               

            Question 13

            Hospital emergency room personnel are permitted to query the patient regarding his or her financial or insurance status at any time as long as the patient initiates such a discussion.

            Question 14

            What factors contribute to the complexity of the revenue cycle in health care?                   

            Question 15

            In order for integration with other physicians to be successful, what person is needed to arrange the financing of capital needs and to provide administrative leadership?                           

            Question 16

            What are the two types of forms used for health services billing?                                        

            Question 17

            What are primary uses of financial information?                                           

            Question 18

            What piece of legislation prohibits a person from receiving income from a pattern of activity, including committing an enumerated act (such as mail or wire fraud), at least twice in 10 years?                                           

            Question 19

            Most of the major coverage provisions of the Affordable Care Act went into effect in what year and gave millions of people coverage under the law?                           

            Question 20

            FCA charges against providers can be brought by individuals under a qui tam action.        

            Question 21

            What is the difference in ownership between a sole proprietorship, a partnership, and a corporation?                                            

            Question 22

            What type of physician alignment is most appealing to physicians because their control is maximized in this type of organizational setting?                                   

            Question 23

            Increased emphasis on which of the following by both Medicare and Medicaid have also provided a strong incentive for hospitals and nursing homes to either merge or establish affiliation arrangements?                                        

            Question 24

            Providing medically unnecessary care to a patient and then billing Medicare for it is an example of Medicare fraud.                                     

            Question 25

            What are the six stages of the revenue cycle?                                               

            Question 26

            What is the objective in a managed-care environment that often leads to conflict between hospitals and doctors?                                             

            Question 27

            For what reason is physician expenditures increasing?                                              

            Question 28

            The earnings of an investor-owned corporation can be subject to double taxation.              

            Question 29

            Describe how Medicaid payments to providers are limited by the federal government.      

            Question 30

            How does the Stark Law impact physicians?                                    

            Question 31

            Should hospitals and physicians undercode Medicare patient stays and patient visits in order to reduce the possibility of being charged under the False Claims Act?                             

            Question 1

What factors contribute to the complexity of the revenue cycle in health care?                                Question 2

The earnings of an investor-owned corporation can be subject to double taxation.                          

            Question 3

            FCA charges against providers can be brought by individuals under a qui tam action.        

            Question 4

            EMTALA allows a hospital to transfer an emergency patient to another hospital because of the patient's inability to pay.                                  

            Question 5

            What are primary uses of financial information?                                           

            Question 6

            __________ is often referred to as the antidumping law because it prohibits hospitals from transferring an emergency patient to another hospital simply because of the patient's inability to pay.                                           

            Question 7

            Should hospitals and physicians undercode Medicare patient stays and patient visits in order to reduce the possibility of being charged under the False Claims Act?                             

            Question 8

            What are the elements that should be present, at a minimum, in all charge masters?

            Question 9

            What piece of legislation prohibits a person from receiving income from a pattern of activity, including committing an enumerated act (such as mail or wire fraud), at least twice in 10 years?                   

            Question 10

            Governmental healthcare organizations are able to raise funds through equity investments.                                               

            Question 11

            How does the False Claims Act (FCA) impact providers of health care services?

            Question 12

            What is the difference in ownership between a sole proprietorship, a partnership, and a corporation?                                

Question 13

One of the advantages of a nonprofit organization compared with an investor-owned company is that the investor-owned company is subject to federal income taxes.                                      

            Question 14

            The financial manager's main responsibility is to acquire and use funds so as to maximize the firm s value. Their main functions may include: forecasting and planning, making major investment financing decisions, coordinating and controlling, dealing with the financial markets, and managing public opinion.                                        

            Question 15

            Providing medically unnecessary care to a patient and then billing Medicare for it is an example of Medicare fraud.                                     

            Question 16

            In order for integration with other physicians to be successful, what person is needed to arrange the financing of capital needs and to provide administrative leadership?                           

            Question 17

            Assume that an ambulance brought Cindy Roe to the emergency department of Grace Medical Center. She decides to leave the hospital without receiving treatment. The attending physician and the hospital staff offer Cindy medical examination and treatment within the hospital before she leaves. Cindy refuses treatment and refuses to sign an informed consent, and they let her go. The physician/hospital most likely has violated EMTALA.                                           

            Question 18

            Describe how Medicaid payments to providers are limited by the federal government.      

            Question 19

            For what reason is physician expenditures increasing?                                              

            Question 20

            Which of the following covers nearly 100% of hospital service charges but is subject to a 20% coinsurance payment for most physician services?                                    

            Question 21

            Increased emphasis on which of the following by both Medicare and Medicaid have also provided a strong incentive for hospitals and nursing homes to either merge or establish affiliation arrangements?                                        

            Question 22

            What are the two types of forms used for health services billing?                            

            Question 23

            What is the objective in a managed-care environment that often leads to conflict between hospitals and doctors?                                                         

            Question 24

            What are the six stages of the revenue cycle?                                               

            Question 25

            How does the Stark Law impact physicians?                                    

            Question 26

            What type of physician alignment is most appealing to physicians because their control is maximized in this type of organizational setting?                                               

            Question 27

            Prosecution under the FCA requires that specific intent to defraud the government was present.                                      

            Question 28

            What is charge explosion?                             

            Question 29

            Most of the major coverage provisions of the Affordable Care Act went into effect in what year and gave millions of people coverage under the law?                                       

            Question 30

            Which of the following covers nearly 100% of hospital service charges but is subject to a 20% coinsurance payment for most physician services?                                    

            Question 31

            Hospital emergency room personnel are permitted to query the patient regarding his or her financial or insurance status at any time as long as the patient initiates such a discussion.