CHAA Financial Processes 5

Question 1

A patient with a $40 copay and an unmet deductible comes for an office visit covered under the copay benefit. What is typically collected at check-in?

Accepted Answer

The $40 copay

Answer

The full deductible amount

Answer

Nothing until the claim is processed

Answer

20% of the estimated charge

Question 2

An uninsured patient's Good Faith Estimate was $1,000, but the final bill is $1,500. What option does the No Surprises Act provide?

Accepted Answer

The patient may initiate the patient-provider dispute resolution process

Answer

None; estimates are not binding

Answer

The hospital must automatically write off the full bill

Answer

The patient must appeal to Medicare

Question 3

A hospital uses third-party data (such as credit or demographic scoring) to qualify a patient for charity care without a full application. What is this called?

Accepted Answer

Presumptive eligibility

Answer

Retroactive eligibility

Answer

Coordination of benefits

Answer

Medical necessity screening

Question 4

Which account would most appropriately be classified as charity care rather than bad debt?

Accepted Answer

A patient who qualified under the financial assistance policy before collection efforts

Answer

A patient who could pay but ignored all statements

Answer

An insured patient whose claim was denied for late filing

Answer

A patient whose check bounced

Question 5

A patient presents an expensive elective procedure order with a prior authorization requirement that has not been obtained. What is the best financial clearance step?

Accepted Answer

Obtain the authorization or reschedule before the service

Answer

Proceed and bill the patient if denied

Answer

Ask the patient to sign a general consent form

Answer

Code the claim as an emergency

Question 6

At end of shift, a registrar's cash drawer is $20 short against the posted payments report. What should be done?

Accepted Answer

Report the variance to a supervisor and document it per cash-handling policy

Answer

Add personal money to balance the drawer

Answer

Adjust a patient account to match the cash

Answer

Ignore it if under $50

Question 7

Federal hospital price transparency rules require hospitals to post which of the following?

Accepted Answer

A machine-readable file of standard charges and a consumer-friendly list of shoppable services

Answer

Only their Medicare rates

Answer

Each physician's salary

Answer

Patient satisfaction scores

CHAA Financial Processes 5

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Sources & references