1. Assume the following: Greenville Hospital’s full established rate for a certain procedure is $200, but the Eastern Health Plan’s managed care contract pays the hospital only $180 for the procedure. Required: What is the correct recorded revenue figure?
A. $180
B. $200
C. $190
D. None of the above
2. Charity service is:
A. Generally defined as services provided to financially indigent patients
B. Represents a major type of deduction from revenue classification
C. Both of the above
D. Neither of the above
3. The Town Center Clinic’s physician group has contracted with various managed care plans. For visit code 99213, Plan A has contracted to pay $55.00, Plan B has contracted to pay $39.00, and Plan C has contracted to pay $46.00. (These rates are examples only.) The variation in amounts paid by managed care plans for this visit code is:
A. Commonly accepted in healthcare today
B. Unusual and not a commonly accepted method
C. Considered to be a survival method
D. None of the above
4. Grouping expenses by diagnoses for planning and control is beneficial because it:
A. Matches commonly used expense classifications against costs
B. Matches commonly used revenue classifications against costs
C. Either of the above
D. Neither of the above
5. Grouping expenses by diagnoses and/or procedures for planning and control is especially useful because much of the revenue in many healthcare organizations is designated by either diagnoses or procedures.
A. Correct
B. Not correct
C. Not applicable