HFMA Certified Healthcare Financial Professional CHFP Questions & Answers

• Question 301:

  A system to pay providers whereby the fees for all providers are included in a single negotiated amount is called:

  A. Single member per month payment

  B. Global payment

  C. Revolutionary payment

  D. Ambulatory payment

  Correct Answer: B

• Question 302:

  Gatekeepers requiring a patient to obtain a referral from his or her primary care physician, the gatekeeper, before assign a specialist.

  A. True

  B. False

  Correct Answer: A

• Question 303:

  Requiring providers to have their capital expenditures preapproved by an independent state agency to avoid unnecessary duplication of services is referred to as:

  A. Preapproval certifications and opinions

  B. Preapproved payments

  C. Certificate of need

  D. State service reviews

  Correct Answer: C

• Question 304:

  Stark law sates that:

  A. Legislation enacted by HIPAA to guard against providers' ordering self-referrals for Medicare or Medicaid patients directly to any settings in which they have a vested financial interest.

  B. Legislation enacted by CMS to guard against providers' ordering self-referrals for Medicare or Medicaid patients directly to any settings in which they have a vested financial interest.

  C. Legislation enacted by CMS to guard against providers' ordering self-referrals for Medicare or Medicaid patients indirectly to any settings in which they have a vested financial interest.

  D. Legislation enacted by HIPAA to guard against providers' ordering self-referrals for Medicare or Medicaid patients indirectly to any settings in which they have a vested financial interest.

  Correct Answer: B

• Question 305:

  Which one of the following is NOT the factor of Uninsured?

  A. Health insurance premiums becoming too costly

  B. Requiring patients to pay for the part of their own care-up

  C. Individuals being screened out of insurance policies

  D. Employers feeling they cannot afford to continue to provide health insurance as a benefit

  Correct Answer: B

• Question 306:

  Concurrent review states that:

  A. Planning appropriateness and medical necessity of a hospital stay while the patient is in the hospital and implementing discharge planning.

  B. Monitoring appropriateness and medical necessity of a hospital stay while the patient is not in the hospital and try to implement discharge planning.

  C. Planning appropriateness and medical necessity of a hospital stay while the patient is not in the hospital and try to implement preadmission planning.

  D. Monitoring appropriateness and medical necessity of a hospital stay while the patient is in the hospital and implementing discharge planning.

  Correct Answer: D

• Question 307:

  A set of federal compliance regulations to ensure standardization of billing, privacy and reporting as institutions convert to electronic systems is called:

  A. Health Insurance standard Act

  B. Reimbursement Insurance Act

  C. Medicare Reporting Act

  D. Health Insurance portability and Accountability Act

  Correct Answer: D

• Question 308:

  In which act, federal legislation designed to tighten accounting standards in financial reporting and that holds top executives personally liable as to the accuracy and fairness of their financial statements?

  A. Sarbanes-Oxley Act

  B. Insurance accountability Act

  C. Financial statement Act

  D. Portability and Accountability Standardized Act

  Correct Answer: A

• Question 309:

  The need to abide by governmental regulations, whether they are for the provision of care, billing, privacy accounting standards, security or the like refers to:

  A. Compliance

  B. Chronic Medicare

  C. Health proactive standards

  D. None of the above

  Correct Answer: A

• Question 310:

  that providers have to pay insurers to cover the cost of defending against the lawsuits and paying large jury awards.

  A. Ambulatory payment classifications

  B. Reimbursement Insurance cost plan

  C. Health proactive Insurance standard act

  D. Increased insurance premiums

  Correct Answer: D