Ambulatory Care Test Healthcare Systems, Reimbursement and Regulatory Compliance

Question 1

Which feature best describes a Patient-Centered Medical Home (PCMH)?

Accepted Answer

Team-based, coordinated, accessible primary care with an ongoing relationship with a personal clinician

Answer

The PCMH model, recognized by NCQA, emphasizes comprehensive, team-based, coordinated, accessible primary care that is committed to quality and safety.

Question 2

How does value-based reimbursement differ from traditional fee-for-service payment?

Accepted Answer

It ties payment to quality, outcomes, and cost efficiency

Answer

Value-based models such as ACOs and MIPS reward quality outcomes and efficient care. Fee-for-service pays based on the volume of services delivered.

Question 3

Which Medicare service lets an RN, working under general supervision, deliver monthly non-face-to-face care for patients with two or more chronic conditions?

Accepted Answer

Chronic Care Management (CCM)

Answer

Chronic Care Management codes reimburse at least 20 minutes per month of care coordination for patients with two or more chronic conditions expected to last 12 months or longer. Clinical staff such as RNs can provide this time under general supervision.

Question 4

Under EMTALA, an ambulatory clinic located on a hospital campus must do what for a person who arrives with an emergency medical condition?

Accepted Answer

Provide a medical screening exam and stabilize or appropriately transfer them

Answer

EMTALA requires a medical screening examination and stabilization or appropriate transfer, regardless of ability to pay. Hospital-owned departments on campus may be subject to these obligations.

Question 5

Which organization accredits ambulatory health care facilities?

Accepted Answer

AAAHC (Accreditation Association for Ambulatory Health Care)

Answer

AAAHC is a major accrediting body for ambulatory settings. The Joint Commission also accredits ambulatory care. The FDA, DEA, and OSHA are regulatory agencies, not accreditors of ambulatory facilities.

Ambulatory Care Test Practice Test

Ambulatory Care Test Practice Test

Ambulatory Care Test Healthcare Systems, Reimbursement and Regulatory Compliance