CHSA CHSA Healthcare Finance & Revenue Cycle

Question 1

Which document outlines the itemized charges for services rendered to a patient during a hospital stay?

Accepted Answer

Uniform Bill (UB-04)

Answer

The UB-04 is the standardized claim form used by hospitals to bill institutional services to Medicare, Medicaid, and private insurers.

Question 2

What term describes the process of verifying a patient's insurance coverage and benefits before providing non-emergency care?

Accepted Answer

Pre-certification/eligibility verification

Answer

Pre-certification and eligibility verification confirm that the patient's plan is active and covers the planned services before care is delivered.

Question 3

Under Medicare's Prospective Payment System (PPS), hospital reimbursement for inpatient stays is primarily based on:

Accepted Answer

Diagnosis-Related Groups (DRGs)

Answer

DRGs group patients with similar diagnoses and expected resource use, and Medicare pays a fixed rate per DRG rather than per service.

Question 4

A charge that a healthcare organization writes off because it exceeds the contracted payer rate is called a:

Accepted Answer

Contractual adjustment

Answer

A contractual adjustment is the difference between a provider's billed charge and the negotiated rate the payer is obligated to pay.

Question 5

Which revenue cycle metric measures the average number of days it takes to collect payment after a service is billed?

Accepted Answer

Days in accounts receivable (AR)

Answer

Days in AR measures how efficiently a healthcare organization converts billed services into cash, with lower values indicating faster collections.

CHSA - Certified Health Service Administrator Practice Test