1. Read All Questions Carefully: Make sure you understand each question.
2. Time Management: You have a specific amount of time to complete the exam.
Keep an eye on the clock and pace yourself.
3. Allowed Materials: Only use materials that are explicitly allowed. Unauthorized
materials can lead to disqualification.
4. ANS Format: Follow the required format for your ANS. For example, multiple-
choice questions might need you to select the best ANS, while essay questions
require detailed responses.
5. Academic Integrity: Adhere to the university's honor code. Any form of cheating or
plagiarism is strictly prohibited.
6. Technical Requirements: Ensure your computer and internet connection are
stable. For online exams, you might need a webcam and microphone for proctoring
purposes.
7. Submission: Submit your ANS before the time expires. Late submissions might
not be accepted.
,1. Which of the following best describes the primary goal of
healthcare reimbursement?
- A. Conducting market research
- B. Ensuring that healthcare providers are compensated for the
services they deliver
- C. Developing new software applications
- D. Managing daily business operations
- ANS: B
- Rationale: The primary goal of healthcare reimbursement is
to ensure that healthcare providers are compensated for the
services they deliver, facilitating the financial sustainability of
healthcare organizations.
2. What is the primary function of the Diagnosis-Related Group
(DRG) system in healthcare reimbursement?
- A. To manage daily business operations
- B. To classify hospital cases into groups for the purpose of
payment
- C. To conduct market research
- D. To develop new software applications
- ANS: B
, - Rationale: The Diagnosis-Related Group (DRG) system
classifies hospital cases into groups for the purpose of payment,
standardizing reimbursement rates based on the type and severity
of the patient's condition.
Fill-in-the-Blank Questions
3. The __________ model is used to determine reimbursement
rates based on the quality and efficiency of care provided.
- ANS: value-based reimbursement
- Rationale: The value-based reimbursement model
determines reimbursement rates based on the quality and
efficiency of care provided, incentivizing healthcare providers to
deliver high-quality, cost-effective care.
4. In healthcare reimbursement, __________ refers to the
process of submitting and following up on claims with health
insurance companies to receive payment for services rendered.
- ANS: medical billing
- Rationale: Medical billing refers to the process of
submitting and following up on claims with health insurance
companies to receive payment for services rendered, ensuring that
healthcare providers are compensated for their services.
, 5. Fee-for-service (FFS) is a reimbursement model where
providers are paid for each service they perform.
- ANS: True
- Rationale: Fee-for-service (FFS) is a reimbursement model
where providers are paid for each service they perform,
incentivizing volume of services rather than quality.
6. The primary focus of capitation is to reimburse providers
based on the number of services rendered.
- ANS: False
- Rationale: The primary focus of capitation is to reimburse
providers with a fixed amount per patient regardless of the
number of services rendered, promoting cost control and
preventive care.
Multiple Response Questions
7. Which of the following are common reimbursement models in
healthcare? (Select all that apply)
- A. Fee-for-service (FFS)
- B. Capitation
- C. Value-based reimbursement
- D. Inventory turnover
- ANS: A, B, C
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller MedGrad. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.49. You're not tied to anything after your purchase.
