CHSA CHSA Healthcare Finance & Reimbursement 1

Question 1

Under Medicare's Inpatient Prospective Payment System (IPPS), what is the primary basis for determining hospital reimbursement?

Accepted Answer

Diagnosis-Related Groups (DRGs)

Answer

Medicare IPPS pays hospitals a predetermined, fixed amount based on the patient's Diagnosis-Related Group (DRG), regardless of the actual cost of services rendered.

Question 2

Which financial statement shows a healthcare organization's revenues, expenses, and net income over a specific time period?

Accepted Answer

Statement of Operations (Income Statement)

Answer

The Statement of Operations (equivalent to an income statement) reports revenues earned and expenses incurred during a specific accounting period, showing the organization's operational financial performance.

Question 3

A hospital's net patient revenue is calculated by taking gross charges and subtracting what?

Accepted Answer

Contractual adjustments, bad debt, and charity care

Answer

Net patient revenue equals gross patient service revenue minus contractual adjustments (payer discounts), provision for bad debt, and charity care write-offs.

Question 4

What does Case Mix Index (CMI) measure in hospital financial management?

Accepted Answer

The average relative weight of all DRGs for a hospital's Medicare patients

Answer

CMI is the average DRG relative weight across all Medicare inpatient cases, reflecting the complexity and resource intensity of the patient population served.

Question 5

Under the Stark Law (Physician Self-Referral Law), what is prohibited without meeting a specific exception?

Accepted Answer

Physicians referring Medicare/Medicaid patients to entities where they have a financial relationship

Answer

The Stark Law prohibits physicians from referring Medicare/Medicaid patients to entities with which the physician or immediate family member has a financial relationship, unless a specific exception applies.

CHSA - Certified Health Service Administrator Practice Test

CHSA - Certified Health Service Administrator Practice Test

CHSA CHSA Healthcare Finance & Reimbursement 1