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Health Management MCQs




Question;Question 1.1. (TCO B) The original impetus of HMO development came from which of the following? (Points: 5)Providers seeking patient revenuesConsumers seeking access to healthcareEmployersAll of the aboveNone of the above;Question 2.2. (TCO A) Key common characteristics of PPOs include _____.(Points: 5)selected provider panelsnegotiated payment ratesconsumer choiceutilization managementAll of the aboveA, B, and D only;Question 3.3. (TCO B) Basic elements of credentialing include _____.(Points: 5)hospital privilegesmalpractice historymedical licensecontinuing medical education (CME)All of the aboveA, B, and C only;Question 4.4. (TCO D) A common financial risk arrangement used as a performance-based incentive is _____.(Points: 5)carve-outswithholdsper diemFFS;Question 5.5. (TCO B) Which of the following forms of hospital reimbursement contain no elements of risk sharing by the hospital? (Points: 5)CapitationDRGsPer diemSliding scale FFSBoth C and D;Question 6.6. (TCO C) Common sources of information to trigger DM include _____.(Points: 5)claimslaboratory testsreferrals from inpatient care coordinatorspharmacy dataelectronic medical recordsAll of the aboveA through D only;Question 7.7. (TCO C) One potential negative consequence of drug formularies with high copayments is _____.(Points: 5)increased use of generic drugsincreased use of brand drugscopayments may be a barrier to adherence.decreased use of the most cost-effective medications;Question 8.8. (TCO C) Which of the following are components of a strong MCO prevention program? (Points: 5)Member benefitsServices for members, such as health risk assessmentsContracts with providersPublic policiesA and C onlyA, B, C, and D;Question 9.9. (TCO D) This federal law has established specific, enforceable regulations regarding the standardization of electronic transactions and code sets for procedures and diagnoses. (Points: 5)OCRHEDISHIPAAEMTALA;Question 10.10. (TCO D) Employees who are engaged in their healthcare will do the following except what? (Points: 5)Have better compliance with health intervention programsHave lower healthcare costsHave higher productivityHave more direct reports;Question 11.11. (TCO D) Which of the following does HIPAA regulate? (Points: 5)Electronic communications between payors and providersPortability and access standardsGuaranteed renewability of group coverageAll of the above;Question 12.12. (TCO D) Which of the following clauses states that the provider agrees not to sue or assert any claims against the enrollee for services covered under the contract? (Points: 5)Flow down clauseNo-balance-billing clauseForce majeure clauseHold-harmless clause


Paper#58695 | Written in 18-Jul-2015

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