CHSA CHSA Healthcare Finance & Reimbursement 2

Question 1

Which federal program provides health insurance coverage for individuals aged 65 and older as well as certain younger individuals with disabilities?

Accepted Answer

Medicare

Answer

Medicare is the federal health insurance program covering people 65 and older, certain individuals under 65 with qualifying disabilities, and people with end-stage renal disease.

Question 2

A healthcare administrator is reviewing a budget variance report showing an unfavorable volume variance. What does this indicate?

Accepted Answer

Actual patient volume was lower than the budgeted volume

Answer

An unfavorable volume variance means the facility served fewer patients than projected in the budget, resulting in lower-than-expected revenue.

Question 3

What is the purpose of the Medicare Cost Report that hospitals must submit annually?

Accepted Answer

Providing a detailed accounting of costs and charges to settle cost-based payments and update rate calculations

Answer

The Medicare Cost Report provides CMS with detailed financial data used to settle cost-based reimbursement, calculate future payment rates, and monitor financial performance.

Question 4

Which coding system is used to classify diagnoses and inpatient procedures for Medicare billing purposes in the US?

Accepted Answer

ICD-10-CM/PCS

Answer

ICD-10-CM (diagnoses) and ICD-10-PCS (inpatient procedures) are the required coding systems for hospital inpatient Medicare claims and DRG assignment.

Question 5

A hospital administrator notices that the facility's days in accounts receivable (A/R) has increased significantly. Which scenario most likely explains this?

Accepted Answer

There are billing errors, increased denials, or slow payer payment processing

Answer

Increasing days in A/R typically indicates problems in revenue cycle management such as billing errors, claim denials, payer delays, or inadequate follow-up on outstanding claims.

CHSA - Certified Health Service Administrator Practice Test

CHSA - Certified Health Service Administrator Practice Test

CHSA CHSA Healthcare Finance & Reimbursement 2