HSA546: Physician's Practice Management Final Exam Question 1 The __________ states the expected volume of services, makes key assumptions, and provides the general guidance needed to establish all other budgets used by the organization

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HSA546: Physician's Practice Management

Final Exam

Question 1

The __________ states the expected volume of services, makes key assumptions, and provides the general guidance needed to establish all other budgets used by the organization.

capital budget

operating budget

statistics budget

comprehensive budget

Question 2

The Statement of Financial Accounting Concepts No. 1 states that: Financial reporting should provide information that is useful to present to:

physicians, nurses, and other caregivers in determining the appropriate use of resources.

potential investors and creditors and other users in making rational investment, credit, and similar decisions.

government officials for proof of the firm’s solvency and full payment of tax and fee liabilities.

the firm’s internal employees and administrative staff in making sound day-to-day business decisions.

Question 3

Which of the following statements is true regarding budgeting?

Budgeting must comply with the established rules and regulations of the accounting industry.

The budget involves processes that are determined solely by the organization.

Budgets are the same across organizations and, by their nature, are designed to address multiple time periods.

The organizational budget only addresses financial performance in a retrospective manner, describing what has occurred.

Question 4

In a medical practice, who is responsible for preparing the financial statements, preparing the taxes, and conducting any audits or reviews?

The medical personnel

The physicians

The certified public accountants (CPAs)

The practice manager

Question 5

Which of the following statements is true regarding the hiring process?

The method for carrying out the job should be clearly established during the hiring process.

Advertising must be fair and not discriminate against any group of individuals.

The job application should ask for disability-related information to determine if the applicant can perform the job functions.

The interview should include disability-related questions to determine if the applicant can perform the job functions.

Question 6

Which of the following statements is true regarding medical records documentation in a practice?

The medical record that will best support a practitioner in a medical situation resulting in a bad outcome will be the one that reflects only facts, rather than the thought process of the provider.

A medical record needs to be consistent to support continuous attention to the process of care in the face of an adverse outcome.

Documentation should not only reflect the course of care; it should also reflect the provider’s personal bias and points of view not related to the patient’s health.

It is important to keep in mind that the target audience of medical record documentation is other care providers and the documentation should not be written to be understood by laypeople.

Question 7

Which of the following statements is true regarding the risk assessment phase of the risk management process?

It is imperative that a practice address each and every risk that has been identified, regardless of the time and money it will take to address them.

Each exposure to the practice should be treated with equal priority.

The strategic goals and objectives of the practice are not of importance when assessing risk.

Each exposure must be evaluated in terms of its frequency of occurrence and the severity of loss incurred.

Question 8

Communication scripting should be provided for appointment staff so that they:

provide patients with a Health Insurance Portability and Accountability Act (HIPAA) statement.

make sure the patient knows that he/she will be accepted for treatment.

do not hint of express warranty or satisfaction.

convince the patient that he/she will receive successful treatment from the practice.

Question 9

The __________ explains how the organization obtained and used cash during the accounting period.

statement of cash flows

statement of changes in equities

notes to financial statements

current assets statement

Question 10

The majority of medical practices use the __________ method of accounting.

accrual

cash

straight

curved

Question 11

__________ represent the balances due from patients, Medicare, Medicaid, insurance companies, health maintenance organizations (HMOs), and other third parties for services and sales to patients and other customers.

Marketable securities

Accounts receivable

Cash

Prepaid expenses

Question 12

The __________ shows the results of operations (income, expenses, and net profit or loss) for a period of time.

balance sheet

income statement

audit report

profits statement

Question 13

Gross collection rate, collection rate by payer, payer mix, reimbursement by service line, and reimbursement per procedure code are all benchmarks related to:

expenses.

revenue.

the productivity of providers.

liquidity.

Question 14

Calculating physicians’ income and performing a breakeven analysis are used for determining:

liquidity.

profitability.

productivity.

validity.

Question 15

Supply and demand indicators, space, and customer satisfaction can all be considered __________ benchmarks.

financial

profitability

productivity

operational

Question 16

Which of the following statements is true regarding customer satisfaction?

Benchmarking the patients’ level of satisfaction with the practice is an important measurement of the service, access, convenience, and operations that the practice is offering.

Patient satisfaction surveys should be used only for specific projects and are not worthwhile if they are distributed and measured on a periodic basis.

The questions used in patient surveys should be changed and updated often in order to obtain a variety of responses.

Surveys are useful for determining the level of patient satisfaction but not for determining the level of satisfaction of referring physicians.

Question 17

__________ is the action of using the health information technology (HIT) in a production environment for the first time.

Trial run

Testing

Production

Go-live

Question 18

As all applications and their interfaces come together, __________ testing determines how well the applications generate the right data for display, for reports, and for clinical decision support.

performance

integrated system

stress

unit and functions

Question 19

A(n) __________ identifies the applications and technology a practice plans to acquire over time and the dependencies among them.

time table

migration path

wish list

dependency table

Question 20

A(n) __________ is an electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one healthcare organization.

electronic medical record

electronic health record

personal health record

individual medical record

Question 21

__________ organizations must engage exclusively in charitable and other exempt activities, and must comply with a number of other requirements.

Antitrust-exempt

Tax-exempt

Fraud-exempt

Kickback-exempt

Question 22

The __________ generally prohibits physician referrals for certain ancillary healthcare services to entities with which the physician (or a member of the physician’s immediate family) has a financial relationship, unless an exception to the law applies.

Patient Protection and Affordable Care Act

False Claims Act

Physician Referral Law

Stark Law

Question 23

The __________ to the Stark Law allows physicians in medical group practices to make referrals for certain designated health services (DHS) within the medical practice, furnish those DHS to practice patients, and bill Medicare and Medicaid for the services without violating the Stark law.

exception for bona fide employment relationships

in-office ancillary services exception

personal services arrangements exception

exception for space leases

Question 24

Under the __________, any person who knowingly presents a false claim to the U.S. government, or otherwise engages in certain activities with the intent to defraud the government, is liable for civil penalties, plus three times the amount of damages incurred, unless certain exceptions apply.

antitrust law

False Claim Act

Stark Law

Civil Monetary Penalty Statute

Question 25

Which of the following statements is true about the rules associated with the Medicare program?

Medicare has simple rules on the reimbursement of covered medical and other healthcare services.

Medicare rules are not concerned with how the services must be furnished and supervised.

Medicare rules define the basis for payment of services.

Medicare rules are not concerned with the site of services.

HSA546: Physician's Practice Management

Final Exam Part 2:

Question 1

Which of the following categories of physician work measures involves an objective measure of work and effort defined by Medicare or other programs?

Collections

Charges

Work Relative Value Units (RVUs)

Hybrid measures

Question 2

An important component of effective compensation plans is the clarification of:

capitation limits.

performance expectations.

expense categories.

operating costs.

Question 3

Which of the following types of compensation might offer a guaranteed base salary and incentives based on performance measures?

Individualistic model

Team-oriented model

Middle-ground model

Capitation model

Question 4

Which of the following is a feature of an effective physician compensation plan?

The compensation plan is independent of the practice goals.

The compensation plan does not focus on rewarding productive work.

The compensation plan clarifies performance expectations.

The compensation plan is complex and flexible.

Question 5

__________ space allows a number of individual providers or specialists who work at different times and may have very different patient volumes flexible use of medical practice spaces at different times in order to optimize efficiency.

Modular

Fixed

Expansive

Collapsible

Question 6

The reception area should:

include a window in a wall with a bell to call for service.

include large, prominent signs that stress procedural rules and payment terms.

include counters high enough to be comfortable for a person of average height while standing.

allow a personal welcome from a caring member of the practice.

Question 7

The appointment desk should:

be combined with the reception area.

have acoustical separation from other areas.

provide space for departing patients to wait while new arrivals converse with the receptionist.

include counters high enough to be comfortable for a person of average height while standing.

Question 8

Seating in the waiting area should:

be low and soft to provide as much comfort as possible.

have firm seats, at least 18 inches high, with fixed arms.

be fastened in place so that it cannot be moved.

consist of mostly large sofas.

Question 9

Once proper notice has been given to the insurance carrier, the insurer has a contractual:

opportunity to withdraw.

duty to defend.

obligation to pay damages.

assume liability.

Question 10

When terminating the physician-patient relationship, the physician must give proper notice to the patient, and afford the patient the opportunity to procure other medical attendance. Failure to do so may result in:

an inability to collect the patient’s co-payment.

abandoning the patient.

voiding the agreement with the patient’s insurance company.

difficulty maintaining compliance records

Question 11

In a medical malpractice action, the standard of care must almost always be established through:

hospital bylaws.

the state licensure board’s rules.

the American Medical Association’s guidelines.

the testimony of expert witnesses.

Question 12

__________ is based on the premise that the entity that hires or otherwise allows a physician to practice medicine on its behalf or within its four walls has a duty to act reasonably in the determination to allow that individual to practice. The failure to do so may expose the organization to liability.

Negligent hiring or credentialing

The “captain of the ship” doctrine

The “borrowed servant” doctrine

The joint and several liability doctrine

Question 13

Under the National Labor Relations Act of 1935 (NLRA), __________ employees have the right to form, join, or assist labor organizations to bargain collectively and to engage in other protected, concerted activities.

supervisory public sector

nonsupervisory public sector

supervisory private sector

nonsupervisory private sector

Question 14

According to the__________, employers are required to keep for 3 years all payroll records, collective bargaining agreements, trusts, and employment contracts, and to keep for 2 years all basic time and earnings cards showing daily starting and stopping times and wage rate tables.

Americans with Disabilities Act (ADA)

Fair Labor Standards Act (FLSA)

Occupational Safety and Health Act (OSHA)

Employee Retirement Income and Security Act (ERISA)

Question 15

__________ can manifest itself in two ways, as “quid pro quo” harassment or as a “hostile work environment” claim.

Age discrimination

Race discrimination

National origin harassment

Sexual harassment

Question 16

Under Title VII of the Civil Rights Act of 1964, an individual may show that he or she suffered __________ discrimination, which consists of intentional discrimination directed at the individual specifically.

disparate treatment

disparate impact (or adverse impact)

disparate inequality

separate protection

Question 17

The __________ is a federal law that generally requires private sector employers of 50 or more employees to provide up to 12 workweeks of unpaid, job-protected leave, within any 12-month period, to eligible employees for certain family and medical reasons.

Fair Labor Standards Act (FLSA)

Family and Medical Leave Act (FMLA)

Family Leave Discrimination Act (FLDA)

Civil Rights Act

Question 18

Which of the following statements is true regarding the integration of the compliance program?

Off-the-shelf plans should not be customized for different group practices.

The compliance program should address all operational areas of the group practice.

The compliance program should be administered by the chief executive officer who reports to the medical director on compliance matters.

The people responsible for billing and coding should oversee the development and implementation of the program.

Question 19

Because the literal wording of the antikickback statute prohibits a number of transactions generally believed to be necessary or beneficial to the healthcare industry, Congress authorized the creation of a number of __________ that permit conduct prohibited under this act.

“safe harbors”

“neutral zones”

“allowable arrangements”

“permissible actions”

Question 20

The two types of reviews that the Office of Inspector General (OIG) suggests can be performed as part of internal monitoring and auditing are:

(1) a standards and procedures review, and (2) a claims submission audit.

(1) a documentation and filing assessment, and (2) an implementation plan.

(1) a compliance contact designation, and (2) a full training program.

(1) a lines of communication review, and (2) a standards enforcement plan.

Question 21

Beginning in 1989, the Office of Inspector General (OIG) began to issue __________ designed to inform the healthcare industry about conduct that potentially violates fraud and abuse laws.

“special fraud alerts”

“noticeable action alerts”

“routine abuse alerts”

“civil fraud alerts”

Question 22

The compliance plan should begin with __________ from the governing board or shareholders that underscores their intent that the practice and its employees exhibit a code of conduct that is consistent with preventing, identifying, and reducing or eliminating wrongdoing.

an assessment of risk

a statement of commitment

an investigation of wrongdoing

operating policies and procedures

Question 23

__________ planning encompasses assignment of tasks to designated personnel, required budgets, and production timetables.

Strategic

Long-term

Operational

Compliance

Question 24

__________ are independent, objective, and systematic examinations of evidence for the purpose of providing an assessment of the performance of an organization, a unit within an organization, a function, or a program in order to improve accountability, efficiency and effectiveness, internal controls, profit, and decision making.

Operating policies and procedures

Risk assessments

Standards of conduct

Operational audits

Question 25

__________ should include updates on internal changes that have been made to the practice’s compliance programs.

Brochures and other materials written for patients

Media advertisements

Education and training

Compensation plans