Transcript Exam 1 Review - University of Tulsa

MIS 4243
Question 1
Which Medicare plan pays for hospital services?
A. Part A
B. Part B
C. Part C
D. Part D
Question 2
What does comorbidity mean?
A. The patient died
B. The patient developed an infection after being
admitted
C. The patient developed a complication
D. The patient had more than one condition when
admitted
Question 3
A participating provider charges $80, but the Medicare
allowed amount is $70. What is the write-down
amount?
A. 10 percent
B. 80 percent
C. $10
D. $80
Question 4
Diagnosis codes assigned to represent disease or medical
condition treated are:
A. HCPCS
B. CPT-4
C. ICD-9-CM
D. All of the above
Question 5
A prospective payment system (PPS) is being used by a
hospital. Which of the following is NOT true?
A. There will be a maximum limit per discharge.
B. It will be based on reasonable costs given the
diagnosis.
C. The hospital can be any type (general, children’s,
cancer, and so forth).
D. Patients who stay one night versus two nights will be
charged the same amount if their diagnosis is the
same.
Question 6
Which paper form was designed for institutional claims?
A. Part A
B. UB-04
C. CMS-1500
D. W-4
Question 7
A(n) _________ statement shows all unpaid items with
payment, adjustments, and balance for each item.
A. Balance forward
B. Open item
C. Either balance forward or open item
D. Neither balance forward or open item
Question 8
Which of the following EDI transactions is currently
NOT required by HIPAA?
A. Claim attachment
B. Enrollment and de-enrollment in a health plan
C. Health plan premium payments
D. Referral certification and authorization
Question 9
Provider payment delays can be caused by:
A. A bill-hold period
B. Payment floor
C. Secondary insurance plan billing
D. All of the above
Question 10
Special software that examines claim data before it is
sent to eliminate preventable billing errors is called:
A. Claim edit
B. Claim scrubber
C. Clearinghouse
D. EMC
Question 11
What type of statistic can be used to compare patients
who receive a therapy versus those who did not?
A. Mean
B. Mode
C. Ratio
D. Standard deviation
Question 12
Eighteen patients were counseled against smoking and
twelve were not. What is the proportion of patients who
were counseled?
A. .40
B. .60
C. .66
D. 1.5
Question 13
A ___________ usually has a separate database created to
track specific data types such as childhood
immunizations.
A. HEDIS
B. Index
C. ORYX
D. Registry
Question 14
The data mining technique called __________ could be
used to predict length of stay of a patient in a hospital
with a particular medical condition.
A. Association
B. Clustering
C. Classification
D. Estimation
Question 15
CMS developed the _______ program to encourage
improvements in quality of care coordination for
patients with chronic illnesses. It also gives bonus
payments to doctors who meet or exceed performance
standards.
A. Data mining
B. NHQM
C. P4P
D. Sampling
Question 16
Software systems that share a common database are:
A. Interfaced
B. Integrated
C. Indexed
D. Regulated
Question 17
What department abstracts and reports National
Hospital Quality Measures (NHQM)?
A. Billing
B. Utilization management
C. Quality management
D. Utility
Question 18
Which of the following systems would be used track
employee health?
A. Financial
B. Human resource
C. Scheduling
D. Quality management
Question 19
An employee scheduling system is used for all of the
following except:
A. Processing doctors’ orders
B. Managing employee sick days
C. Scheduling pre-op cleaning
D. Maintaining an on-call schedule
Question 20
Which of the following is true regarding the Recovery
Audit Contractor (RAC) program?
A. It increases the risk of financial loss to the
hospital/physician.
B. It was created by CMS in 2013.
C. It utilizes a public company as its contractor.
D. All of the above are true.