1.
Which of the following is not a goal of The Patient Bill of Rights?
Correct Answer
A. To ensure patients do not experience discrimination in billing and collections
Explanation
The Patient Bill of Rights aims to ensure that patients do not experience discrimination in various aspects of healthcare, including access to care, treatment decisions, and privacy. It emphasizes the importance of the patient-provider relationship and the role that patients have in their own healthcare. However, it does not specifically address the issue of discrimination in billing and collections, which may be covered by other laws or regulations.
2.
The statute commonly called "Obamacare" is formally known as which of the following?
Correct Answer
A. The Patient Protection and Affordable Care Act
Explanation
The correct answer is The Patient Protection and Affordable Care Act. This act, commonly referred to as "Obamacare," was signed into law in 2010. It aimed to expand access to healthcare, improve the quality of healthcare, and reduce healthcare costs. The act introduced various provisions such as the individual mandate, which required individuals to have health insurance, and the creation of health insurance exchanges. It also expanded Medicaid eligibility and implemented reforms to insurance practices, such as prohibiting insurance companies from denying coverage based on pre-existing conditions.
3.
PPACA is aimed primarily at decreasing the number of uninsured Americans and reducing the overall costs of healthcare.
Correct Answer
A. True
Explanation
The Patient Protection and Affordable Care Act (PPACA) is a healthcare reform law that aims to decrease the number of uninsured Americans and reduce the overall costs of healthcare. It does so by implementing various measures such as expanding Medicaid eligibility, creating health insurance marketplaces, and providing subsidies to help individuals afford insurance coverage. These provisions are designed to increase access to affordable healthcare and ultimately reduce the number of uninsured individuals in the United States. Additionally, the law includes provisions to promote cost containment and improve the quality of care, further supporting the statement that PPACA is aimed primarily at decreasing the number of uninsured Americans and reducing healthcare costs.
4.
Which of the following is not an area where tax-exempt hospitals are affected by the PPACA?
Correct Answer
A. Filing deadlines
Explanation
Tax-exempt hospitals are affected by the PPACA in various areas, including financial assistance, charging limitations, and collection actions. However, filing deadlines are not specifically mentioned as an area where tax-exempt hospitals are affected by the PPACA. This means that tax-exempt hospitals are not directly impacted by the PPACA in terms of filing deadlines.
5.
What is the title for individuals who help consumers fill out applications for health coverage in a state-based marketplace or state partnership marketplace?
Correct Answer
A. Non-Navigators
Explanation
Non-Navigators are individuals who assist consumers in filling out applications for health coverage in a state-based marketplace or state partnership marketplace. They are not certified application counselors or navigators, but they can still provide guidance and support in the application process. Agents or brokers are professionals who help consumers navigate the health insurance market and choose the right plan for their needs.
6.
ACL
Correct Answer
Administration for Community Living
Explanation
ACL stands for Administration for Community Living. This organization is responsible for promoting the independence, well-being, and rights of individuals with disabilities and older adults. They provide support and resources to help these individuals live in their communities and participate in various activities. The ACL aims to enhance the quality of life for these populations by ensuring access to services, advocating for their rights, and promoting inclusion and integration.
7.
AFCDC
Correct Answer
Aid to Families with Dependent Children
Explanation
The given acronym "AFCDC" stands for "Aid to Families with Dependent Children." This program was a federal assistance program in the United States that provided financial aid to low-income families with children. The program aimed to help these families meet their basic needs and reduce the risk of poverty. It was implemented from 1935 to 1996, when it was replaced by the Temporary Assistance for Needy Families (TANF) program.
8.
CDC
Correct Answer
Centers for Disease Control & Prevention
Explanation
The correct answer is "Centers for Disease Control & Prevention." The CDC is a national public health agency in the United States that is responsible for protecting public health and safety through the control and prevention of disease, injury, and disability. They provide information and resources to help individuals and communities prevent and respond to health emergencies, conduct research and surveillance to track and monitor diseases, and develop guidelines and recommendations for healthcare providers and the general public.
9.
The organization that ensures the quality, effectiveness, and efficiency of healthcare provided to Medicare beneficiaries and reviews all written quality-of-service complaints by Medicare beneficiaries is:
Correct Answer
A. QIO
Explanation
QIO stands for Quality Improvement Organization, which is an organization that ensures the quality, effectiveness, and efficiency of healthcare provided to Medicare beneficiaries. QIOs are responsible for reviewing all written quality-of-service complaints by Medicare beneficiaries. They work to improve the quality of care provided to Medicare beneficiaries and ensure that healthcare facilities are meeting the required standards. The other options, TJC, ACL, and CLIA, are not specifically responsible for reviewing quality-of-service complaints by Medicare beneficiaries.
10.
The primary purpose of the Criminal Health Care Fraud Statute is to prohibit sharing confidential patient health information for monetary gain.
Correct Answer
B. False
Explanation
The primary purpose of the Criminal Health Care Fraud Statute is not to prohibit sharing confidential patient health information for monetary gain. The statute is actually focused on addressing fraudulent activities related to healthcare, such as billing for services not rendered or misrepresenting services provided, in order to obtain financial gain. While the protection of patient health information is important, it falls under other laws such as the Health Insurance Portability and Accountability Act (HIPAA). Therefore, the statement is false.
11.
The two types of OIG exclusions for healthcare providers and suppliers who have been convicted of crimes are:
Correct Answer
A. Mandatory and permissive
Explanation
The correct answer is mandatory and permissive. Mandatory exclusions are imposed by law and apply to healthcare providers and suppliers who have been convicted of certain crimes, such as Medicare or Medicaid fraud. Permissive exclusions, on the other hand, are discretionary and may be imposed by the Office of Inspector General (OIG) based on factors such as the severity of the offense and the provider's history. This means that the OIG has the option to exclude a healthcare provider or supplier from participating in federal healthcare programs, even if they have not been convicted of a crime.
12.
HEAT stands for:
Correct Answer
A. Health Care Extension Action Time
Explanation
HEAT stands for Health Care Extension Action Time. This acronym is used to refer to a program or initiative that focuses on extending health care services and support. It implies that there is a specific action time or deadline associated with the extension of health care services. The other options provided in the question may sound plausible, but they do not accurately represent the commonly known meaning of HEAT in the context of health care.
13.
When someone applies for credit, creditors may not ask about the person's race, sex, or national origin.
Correct Answer
B. False
Explanation
It is true that creditors are prohibited from discriminating against applicants based on their race, sex, or national origin. However, the statement in the question is incorrect. When someone applies for credit, creditors are actually allowed to ask about the person's race, sex, or national origin for the purpose of monitoring and enforcing laws against discrimination. This information is collected to ensure that lenders are not engaging in discriminatory practices. Therefore, the correct answer is false.
14.
Which of the following is not true of TJC?
Correct Answer
A. TJC will conduct an audit of the hospital every five years.
Explanation
The statement "TJC will conduct an audit of the hospital every five years" is not true because TJC can audit without advance notice. TJC has the authority to conduct unannounced audits to ensure that hospitals are meeting their accreditation standards. Therefore, the frequency of audits is not limited to every five years.
15.
Which of the following is not a typical goal for reengineering Patient Access?
Correct Answer
A. Free up staff time for training on new technology and regulations.
Explanation
The goal of reengineering Patient Access is to improve the overall patient experience and streamline the registration and scheduling processes. This includes focusing on customer service, decreasing wait times, and making the process positive and painless for the patient and their family. However, freeing up staff time for training on new technology and regulations is not a typical goal for reengineering Patient Access. This goal would fall under the responsibility of the organization's training and development department, rather than being directly related to improving the patient's access experience.
16.
What is the recommendation for the percentage of scheduled admissions to be pre-registered within 24 hours of the service date?
Correct Answer
A. 70-90%
Explanation
The recommendation for the percentage of scheduled admissions to be pre-registered within 24 hours of the service date is 70-90%. This means that it is recommended to pre-register between 70% and 90% of the scheduled admissions within 24 hours of the service date. Pre-registering a high percentage of scheduled admissions ensures that necessary information and paperwork are completed in advance, streamlining the admission process and reducing waiting times for patients.
17.
Which of the following is not gathered during pre-registration or pre-admission?
Correct Answer
A. History of chief complaint
Explanation
During pre-registration or pre-admission, various information is collected to ensure a smooth admission process. This includes gathering patient demographics such as name, age, address, contact information, and insurance details. Financial information is also collected to determine the patient's ability to pay for medical services. Socioeconomic information helps in understanding the patient's social and economic background. However, the history of the chief complaint is not typically gathered during pre-registration or pre-admission. This information is usually obtained during the initial medical assessment or consultation with the healthcare provider.
18.
What is the term for patient screening before surgical or invasive procedures to determine hospitalization and/or surgical suitability?
Correct Answer
A. Pre-admission testing
Explanation
Pre-admission testing refers to the process of screening patients before surgical or invasive procedures to assess their suitability for hospitalization and surgery. This involves conducting various tests and evaluations to ensure that the patient is in optimal health and can safely undergo the procedure. This screening helps identify any potential risks or complications that may arise during or after the surgery, allowing healthcare providers to make informed decisions about the patient's admission and treatment plan.