Comparative Health Information Management 4th Edition Peden - Test Bank - Updated 2025

Chapter 02 Hospital Based Care

MULTICHOICE

1. The physician sends the patient to the hospital for a radiological examination. The patient returns

to the physician's office for follow-up of test results. From the point of view of the hospital, what type

of hospital patient is this?

(A) inpatient

(B) emergency outpatient

(C) clinic outpatient

(D) referred outpatient

Answer : (D)

2. What is a program for the performance of elective surgical procedures on patients who are

classified as outpatients and typically are released from the surgery center on the day of surgery,

thus avoiding an overnight stay in the health care facility?

(A) ambulatory surgery

(B) partial hospitalization

(C) adult day care

(D) surgery clinic

Answer : (A)

3. Medicare Part A and Part B beneficiary information is maintained in __________________, allowing

real-time eligibility requests for coverage using a secure closed private network to communicate

with a CMS data center or via the CMS Extranet.

(A) the HIPAA Eligibility Transaction System

(B) ambulatory patient groups

(C) uniform ambulatory care data sets

(D) charge description masters

Answer : (A)

4. In the hospital setting, the term "resident" is primarily applied to .

(A) a licensed physician participating in an approved graduate medical education program(B) an outpatient evaluated and treated in the observation area of the hospital

(C) a computer program that resides in RAM, used to diagnose emergency patients quickly

(D) patients enrolled in the hospital's longterm ambulatory care program

Answer : (A)

5. Select the TRUE statement below with regard to Medicare hospital outpatient reimbursement.

(A) The hospital may be paid for only one RBRVS per day per patient

(B) The hospital may be paid for only one APC per day per patient

(C) The hospital may be paid for only one APC per patient per 72 hours

(D) The hospital may be paid for more than one APC per patient visit

Answer : (D)

6. Under EMTALA, hospitals that offer emergency services ___________________.

(A) are free to refuse emergency services to patients who do not show proof of insurance

(B) can refuse emergency services to patients as long as another hospital agrees to accept the

patient as a transfer

(C) must screen and stabilize, if necessary, any patient who arrives in the emergency department

(D) must provide emergency services free of charge to a certain number of individual to meet the

EMTALA charity obligations

Answer : (C)

7. Partial hospitalization services are paid for under Ambulatory Payment Classifications (APCs)

when _____________________.

(A) received by unstable dialysis patients in a part of the hospital where patients generally do not

stay overnight

(B) psychiatric or behavioral health patients receive certain services and spend part of the day or the

night in the hospital

(C) an observation patient has been in the hospital for over 48 hours and the patient's condition still

does not permit discharge to home

(D) an inpatient length of stay is too short for a regular diagnosis related group (DRG) payment

Answer : (B)8. Which of the following statements is FALSE?

(A) Documentation of telephone calls is an important element in good risk management for

ambulatory care.

(B) A hospital compliance officer may be concerned with avoiding fraudulent coding and billing as

well as with monitoring compliance with federal regulations such as HIPAA.

(C) Because of their knowledge of coding, health information managers can help review, revise, and

maintain the hospital's chargemaster.

(D) Hospitals receive Medicare reimbursement for ambulatory care through an outpatient

prospective payment system (OPPS) based on DRGs.

Answer : (D)

9. Medicare payments to long-term acute-care hospitals (LTACHs) are based on ___________.

(A) LTC-DRGs

(B) PIP-DCGs

(C) DRGs

(D) RUGs

Answer : (A)