Module 1 - RCM Overview

1.

1 point

Who is mainly responsible for scheduling & registration of International patients?

Senior Financial Counselor, GPS

Patient Access Representative I, GPS

Patient Access Representative II, GPS

2.

1 point

Select all that apply: How does patient access impacts hospital operations?

c. Ensures Patient Safety

b. Revenue and A/R Days

a. Patient wait times and Patient experience

d. All of the above

3.

1 point

Diagnostic and Treatment (D&T) Block houses Patient Access General Admission (Inpatient) Area & the Emergency Department (ED)

True

False

4.

1 point

Who is the first line of escalation for daily operational challenges in Patient Access & will act as a front line for people management in the clinic setting?

Work Team Leader

Patient Access Representative II

Supervisor

Patient Access Representative I

5.

1 point

If a claim that is submitted to a patient’s insurer contains incomplete or inaccurate information, what may be the result?

CCAD may never get paid for its services

The patient may be asked to pay the bill

CCAD may have difficulty being paid for its services

6.

1 point

16. What is the purpose of pre-registration?

All of the above

To resolve any potential problems with insurance or other data before the patient’s appointment

To remind the patient of the appointment date, time and any other pre-appointment instructions

To speed up registration when the patient arrives at the hospital

7.

1 point

Root Word?
Cardi/o Means Heart

True

False

8.

1 point

Who is mainly responsible for identifying, coordinating & communicating financial assistance plan to the patient?

Patient Access Representative I

Work Team Leader

Senior Financial Counselor

Patient Access Representative II

9.

1 point

Why is it important that all required registration fields be completed with accurate and up to date information?

Invalid data will cause insurance companies to reject your hospital’s claims for payment

Correcting invalid data costs the hospital time and money

Invalid data will make it difficult for the hospital to contact the patient

All of the above

10.

1 point

Cashier's Office functions under Patient Access Services (PAS)

True

False

11.

1 point

When a Patient Access Representative (PAR) I is obtaining a patient’s demographic information, what is he or she asking for?

The patient’s diagnosis

Basic information about the patient such as name, address and date of birth

Basic information about the patient’s insurance company

12.

1 point

Which of the following areas are under Revenue Cycle Management

Patient Financial Services

Billing & Collection

Clinical Coding

Health Information Management Services

Patient Registration

Patient Access Services

13.

1 point

Which of the following department is responsible for activities related to billing the claim (based on the payers’ claims and adjudication rule), denials and appeals, maintains the Charge Master and makes attempts to collect on patient’s outstanding balances?

Patient Access Services

Health Information Management

Patient Financial Service

14.

1 point

Which of the following represents the correct activities done in Patient Access Services

Scheduling, Admission, Collection of bad debt, Claim Submission, Financial Clearance

Scheduling, Pre-Registration, Registration, Coding, Charge Capture, Financial Counseling b. Scheduling, Admission, Collection of bad debt, Claim Submission, Financial Clearance c. Scheduling, Pre-Registration, Registration, Insurance Verification, Financial Clearance Scheduling, Pre-Registration, Registration, Coding, Charge Capture, Financial Counseling

Scheduling, Pre-Registration, Registration, Insurance Verification, Financial Clearance

15.

1 point

Which of the following is/are identified as common mistakes done by Patient Access Services?

Insurance verification

Pre-registration

Incorrect spelling of patient’s name

Authorization for add on services not obtained

Entering of wrong insurance member number

Mistyped authorization number

Entering wrong insurance plan

16.

1 point

Which of the following department is responsible for disseminating information and educating appropriate hospital staff about the hospital’s policies and procedures regarding medical records, storing and safeguarding medical records, providing access to medical records, dictation and transcription and coding all client diagnoses and medical procedures for billing?

Patient Financial Service

Patient Access Services

Health Information Management

17.

1 point

Which of the following is responsible for unit costing at go live and will work closely with Revenue Cycle Management (RCM) because patient related data will be used for financial reports?

Finance Department, General Accounting Unit

Finance Department, EBI and Decision Support Unit

Finance Department, Accounts Payable Unit

Finance Department, Budgeting Unit

18.

1 point

Who assists the Manager in ensuring all department policies & procedures are implemented?

Supervisor

Patient Access Representative II, GPS

Work Team Leader

Senior Financial Counselor

19.

1 point

Who is mainly responsible for Follow Up scheduling & scheduling of Walk-In patients?

Patient Access Representative I

Patient Access Representative II

Work Team Leader

Senior Financial Counselor

20.

1 point

Patient Access Model for CCAD will reflect Cleveland Clinic's principle of Patient's First

True

False

21.

1 point

Who is mainly responsible for doing Patient Registration?

Patient Access Representative I

Work Team Leader

Patient Access Representative II

Senior Financial Counselor

22.

1 point

What does a Senior Financial Counselor do for uninsured patients? Choose the best answer

Help them get health insurance through their employer

Help them find the payment option that best suits their financial situation

Help them understand why they have to pay

Help them apply for Write Off

23.

1 point

Select languages that are the major source of medical terms?

Italian

Latin

Greek

English

French

24.

1 point

Patient Access Outpatient Area has 5 Clinic Floors

True

False

25.

1 point

Select all that apply: Why do uninsured patients need to be identified during registration?

So payment arrangements can be made before services are provided

So the hospital can receive payment in a timely manner

So the hospital can refuse service if they cannot pay

So that the patient can be admitted immediately