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Exam (elaborations)

C425 OA Exam Review Questions with 100% Correct Answers

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C425 OA Exam Review Questions with 100% Correct Answers Which of the following is true in regards to health care today in the United States? There are more primary care physicians than specialty physicians. Primary care receives a higher reimbursement in professional fees. There are more spec...

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  • October 25, 2024
  • 21
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • C425
  • C425
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JOSHCLAY
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
C425 OA Exam Review Questions with

100% Correct Answers


Which of the following is true in regards to health care today in the United

States?

There are more primary care physicians than specialty physicians.

Primary care receives a higher reimbursement in professional fees.

There are more specialty physicians than primary physicians.

Outpatient care is slowly decreasing. - ✔✔There are more specialty

physicians than primary physicians.

What triggered the downsizing phase in the U.S. hospital industry during

the 1980s?

Hill-Burton Act

Managed care

Prospective payment system

Medicare and Medicaid - ✔✔Prospective payment system

Designated Related Groups (DRG) -based reimbursement necessitated

hospitals to do what?

,©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
Admit new patients at a faster rate than before

Admit a greater number of Medicare patients than before

Reduce the length of stay for hospitalized patients

Admit a smaller number of Medicare patients than before - ✔✔Reduce the

length of stay for hospitalized patients

In which type of utilization management is a primary care physician's

opinion necessary in referring or not referring a patient to a specialist?

Concurrent

Retrospective

Gatekeeping

Precertification - ✔✔Gatekeeping

What is one aspect in which managed care differs from conventional

insurance?

Collection of premiums

Assumption of risk

Responsibility for delivery of services

Payments to providers - ✔✔Responsibility for delivery of services

What is the purpose of Skilled Nursing Facilities (SNF) certification?

It enables a facility to be operated as a skilled nursing facility.

, ©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
It is required to legally operate a nursing home.

It enables a facility to serve Medicare clients.

It enables a facility to serve both Medicare and Medicaid clients. - ✔✔It

enables a facility to serve Medicare clients.

What is the main goal of long-term care as it relates to a patient's function?

Restore function

Provide assistance

Promote independence

Adapt to change - ✔✔Promote independence

The U.S. government plays a limited role in the health delivery system. The

government's role in the arena of health care delivery consists of:

developing private hospital organizations.

regulating public and private programs at the local levels.

being the responsible party for health care delivery through Medicare and

Medicaid programs.

aiding in competition among managed care organizations. - ✔✔being the

responsible party for health care delivery through Medicare and Medicaid

programs.

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