Healthcare Management Flashcards

A medical manager is developing a staffing model. Which metric is MOST useful for determining optimal front-desk staffing levels?

Answer: Patient volume per hour by day of week

Hourly patient volume patterns identify peak demand periods and allow precise staffing alignment.

The Primary purpose of a practice's charge master (chargemaster) is to:

Answer: List the standard prices for all services and supplies

The chargemaster is the comprehensive price list that drives the revenue cycle by establishing charges for all billable items.

Which federal law requires employers with 15 or more employees to provide reasonable accommodations for qualified individuals with disabilities?

Answer: ADA (Americans with Disabilities Act)

The ADA mandates reasonable accommodations for qualified employees with disabilities in workplaces with 15 or more employees.

A practice wants to benchmark its overhead ratio. Which formula is correct?

Answer: Total expenses ÷ total collections × 100

The overhead ratio equals total operating expenses divided by total collections, expressed as a percentage.

In a capitation payment model, the provider assumes financial risk when:

Answer: Patients use services more than anticipated

In capitation, the provider receives a fixed per-member payment, so higher utilization than predicted results in a financial loss.

A CMM candidate reviewing a quality improvement initiative should recognize that the PDCA cycle stands for:

Answer: Plan, Do, Check, Act

The PDCA (Plan-Do-Check-Act) cycle is a foundational continuous improvement framework used in healthcare quality management.

Which of the following is a key indicator of revenue cycle efficiency in a medical practice?

Answer: First-pass claim acceptance rate

First-pass claim acceptance rate measures the percentage of claims paid without correction, directly reflecting billing accuracy and efficiency.