It is used to record the details of patients' encounters for billing and insurance purposes.

\text{January 2017} & \text{180.000}\\ b. Assess Corrigans asset management position, and determine how it compares with peers and how its asset management efficiency has changed over time. Explanation of benefits; the remittance advice sent by the insurance company in response to the claim is transmitted through the mail. \begin{matrix} Which of the following are possible reasons why a patient may have coverage under more than one group plan? Also, because its pit is getting deeper each year, its costs are rising. Interim HIM management is an example of a role found in a consulting firm. The amount of the copayment and coinsurance should be checked at the time of service. Does the time to maturity affect the extent to which interest rate changes affect the bonds price? The minimum payment on the card is only$10 per month. c. What is their average tax rate? both parties agree to use a neutral party to settle any disputes regarding medical care. \text{Market price (average)} & \text{\$ 12.34} & \text{\$ 23.57}\\ If these are the only two investments in her portfolio, what is her portfolios beta? \text{ } & \text{2016} & \text{2015}\\ Lists the usual procedures the office performs and the corresponding charges. What is the primary goal of integrated delivery systems (IDS). \text{P/E ratio} & \text{15.42 }{\times} & \text{5.65 }{\times}\\ She has estimated the following sales forecasts for the firm for parts of 2016 and 2017. a.

No calculations are required, although if you prefer, you can use calculations to illustrate the effects. What is the advantage for the physician in obtaining the assignment of benefits? Subsequent visit made by the physician following an admission. The process of recording information in the medical chart, or the materials in a medical chart. \text{Industry Financial Ratios} & \text{ }\\ b. \text{Accrued liabilities} & \text{45.010} & \text{40.880}\\ Which related facts are entered into the PMP regarding insurance information? You are the vice president of Worldwide InfoXchange, headquartered in Minneapolis, Minnesota. \text{Notes payable} & \text{476.990} & \text{547.912}\\ d. Assess Corrigans profitability ratios, and determine how they compare with peers and how its profitability position has changed over time. \text{General administrative and selling expenses} & \text{303.320} & \text{297.550}\\ Patients should be told that it is difficult to discuss exact charges prior to a visit because the charges will depend on the extent of the examination, the tests, and the type of treatment provided. the term which most accurately describes a producers duty in regards to the transfer of premiums to the insurer would be: Which statement concerning individual A&H policy renewal provisions is most correct from the perspective of the insured. \end{matrix} Earlier this month you obtained a loan of 10 million Canadian dollars from a bank in Toronto to finance the construction of a new plant in Montreal. this amount is usually collected at the time of the visit, the amount that is not allowed by the insurance company and not the responsibility of the patient, the amount of money that the insured must incur before the policy begins to pay, a form that includes charges, diagnoses, date of service, and the patients name, the amount that a physician would bill the patient and/or insurance for an office visit, would be subtracted from the patients account. What does it mean to adopt a maturity matching approach to financing assets, including current assets? Who should sign and date the completed encounter form? Depreciation charges are $36,000 a month. insurance covering damages incurred on the insured by an uninsured driver, maximum exclusion period for medicare supplements or long-term care insurance (preexisting condition exclusions are not allowed in policies subject to the ACA). \text{October} & \text{234.000}\\ \text{Fixed assets turnover} & \text{13.0 }{\times}\\

\text{Corrigan Corporation: Balance Sheets as of December 31}\\ c. How much more in total payments will Simon make under the$10-a-month plan than under the $35-a-month plan? \text{Earnings before taxes (EBT)} & \text{\$30.680} & \text{\$ 159.950}\\ \text{Cash dividends} & \text{\$ 1.10} & \text{\$ 0.95}\\

What is the name of the financial agreement form given to notify patients of their obligation to pay the bill before the services are given? Calculate this yield using a geometric average. The cost of retained earnings is less than the cost of new outside equity capital. Maxwell Mining Companys ore reserves are being depleted, so its sales are falling. f the patient is part of an HMO health plan, the patient must be ______ to the PCP as of the date of service. A discount applied to a patient's account balance is an example of what type of transaction? -The patient may have coverage under an employer sponsored insurance and a policy from union membership. A method of payment for Medicare hospital insurance based on DRGs (a fixed dollar amount for a principal diagnosis) is known as. Which of the following should be considered when calculating what the patient will owe? \text{Number of shares outstanding} & \text{23.000} & \text{23.000}\\ If a 1-year Treasury bond yield is 5% and a 2-year Treasury bond yields 7%, what is the 1-year interest rate that is expected for Year 2? Differences in participation contracts may reduce the physician's fee. Who ensures databases related to diagnosis and procedure codes listed on encounter forms are updated? \text{June} & \text{90.000}\\

After the provider database information about the physicians and other health professionals who work in the practice is set up, the medical insurance specialist can enter _______. a. Helen Bowers, owner of Helens Fashion Designs, is planning to request a line of credit from her bank. \text{Common stock} & \text{575.00} & \text{575.000}\\ An increase in the personal income tax rate. \begin{matrix} The Hoosier HMO is structured as, prepaid hospital and medical expenses under which healthcare services are provided to individuals on the plan. c. Now suppose receipts from sales come in uniformly during the month (that is, cash receipts come in at the rate of 1/30 each day), but all outflows must be paid on the 5th.

\text{Days sales outstanding} & \text{32.0 days}\\ How would each of the following changes tend to affect aggregate (i.e., the average for all corporations) payout ratios, other things held constant? A visit made by the physician to the patient's home. That is, will the cash budget you prepared be valid under these assumptions? Round to the nearest month. If interest rates rise after a bond issue, what will happen to the bonds price and YTM? Information on the person financially responsible for the patient's account. At the time the loan was received, the exchange rate was $0.81 to the Canadian dollar. A visit made by the physician to a patient who resides in a nursing home. Term used when a physician calls upon another physician to evaluate & make an assessment on a patient in the hospital setting. \text{EBIT} & \text{\$ 97.680} & \text{\$ 202.950}\\ Ideally, the patient should be told the approximate cost of the procedures before treatment begins. \text{Return on invested capital} & \text{14.5\\%}\\ The bond is downgraded by the rating agencies. \text{P/E ratio} & \text{6.0 }{\times}\\ If a patient has insurance coverage but the provider does not participate in their plan, the medical insurance specialist should verify the ______ benefit. When can an insured no longer take legal action against an insurer? Which of the following are true about the Advanced Beneficiary Notice? Assume that the real risk-free rate is 2% and that the maturity risk premium is zero. What must be returned when the practice sends the HIPAA standard transaction? \text{Net income} & \text{\$ 18.408} & \text{\$ 95.970}\\

According to the practice's encounter form policy, how are the encounter forms distributed? A sheet generated by the hospital listing all patient information, including demographics & insurance information. Under the birthday rule, the parents whose day of birth is earlier in the calendar year is ____. Comment on why the average interest rate during the 2-year period differs from the 1-year interest rate expected for Year 2. \text{EPS} & \text{\$ 0.80} & \text{\$ 4.17}\\ All shareholders of the firm live in the United States. the total amount owed by the practce to suppliers and other service providers, what the practices owes out. $$

Why should the provider wait until the claim is adjudicated before billing the patient? Physician and other health professionals who work in the practice. \text{Cost of goods sold} & \text{3.680.000} & \text{2.980.000}\\ \text{September} & \text{720.000}\\ Susan and Stan Britton are a married couple who file a joint income tax return, where the tax rates are based on the tax tables presented in the chapter. \text{Inventory turnover} & \text{7.0 }{\times}\\ Term used when the patient is checked in to the hospital. \text{Current ratio} & \text{2.7 }{\times}\\ If a nurse and a hospital administrator are both trying to use a new EHR and the nurse has problems using it, which testing step in the design process was probably ignored? The Health Insurance Portability & Accountability Act of 1996, a law that stipulates patients' privacy rights regarding their PHI. \text{Total assets turnover} & \text{2.6 }{\times}\\ Make sure you use three decimal places for N. An investor in Treasury securities expects inflation to be risk-free rate is 1.95% and that this rate will remain constant. e. Assess Corrigans market value ratios, and determine how its valuation compares with peers and how it has changed over time. An individual has $20,000 invested in a stock with a beta of 0.6 and another$75,000 invested in a stock with a beta of 2.5. When the claim form arrives at the office of the insurance carrier, either on paper or as a computer file, the insurance carrier processes the claim. Lease payments under long-term leases are$9,000 a month. \text{Machinery} & \text{132.000} & \text{133.000}\\ A confidential document that contains detailed & comprehensive information on the individual patient & the care given to the patient. (most common), scheduling patients the last half hour in 10 to 20 min. What is their marginal tax rate? In general, is one approach better than the others? \text{Retained earnings} & \text{254.710} & \text{261.602}\\ Consequently, it is totally irrational for a firm to sell a new issue of stock and to pay cash dividends during the same year. \text{September} & \text{306.000}\\ Why do U.S. corporations build manufacturing plants abroad when they can build them at home? The period of time over which a single sum or periodic deposits grow within an annuity is referred to as the. $$ \text{Accounts payable} & \text{\$80.000} & \text{\$ 72.708}\\ When a new patient is seen at a medical practice, it is required that a patient completes __________ history forms. Prepare monthly estimates of the required financing or excess fundsthat is, the amount of money Bowers will need to borrow or will have available to invest. $$ Designed to avoid once-a-month peak workloads and to stabilize the cash flow. \end{matrix} When does the collection of information begin when a patient is new to the practice? \text{Return on equity} & \text{18.2\\%}\\ \text{May 2016} & \text{\$ 180.000}\\ \text{July} & \text{360.000}\\ \text{Corrigan Corporation: Income Statements for Years Ending December 31}\\ When a payer approves the service, it issues a _________ number.

\text{Inventories} & \text{894.000} & \text{813.000}\\ If not, what could be done to make a valid estimate of the peak financing requirements? is 012345.10. is for sending letters, postcards,greeting cards appointments are made the first 30 minutes. When the policyholder authorizes insurance payments to be sent directly to the physician, this is known as ___________. $$ Up-front collection is money collected ______. Think about which ratios would be affected by changes in these two accounts. \text{Total liabilities and equity} & \text{\$ 1.836.000} & \text{\$ 1.667.000}\\ One of the five types of information that is important when a patient is new to the practice is ________. \begin{matrix} If the service is not be covered, the patient should be made aware of financial responsibility ________. Indicate whether each of the following actions will increase or decrease a bonds yield to maturity: a. The authorization number given to the referred physician is known as the _______. Craig has installed wall-to-wall carpeting on the ground floor as well as the top floor of his mansion. If Simon makes monthly payments of $35, how many months will it be before he pays off the debt? accept assignment (acceptance of assignment), a participating physician's agreement to accept the allowed charge as payment in full, Acknowledge of Receipt of Notice of Privacy Practices, form accompanying a covered entity's Notice of Privacy Practices; covered entities must make a good-faith effort to have patients sign the acknowledgement, authorization by a policyholder that allows a health plan to pay for benefits directly to a provider, the guideline that determines which of two parents with medical coverage has the primary insurance for a child; the parent whose day of birth is earlier in the calendar year is considered primary, the movement of monies into or out of a business, number returned electronically by a health plan approving a referral authorization request when preauthorization is required, office procedures that ensure that billable services are recorded and reported for payment, a unique number that identifies a patient, a clause in an insurance policy that explains how the policy will pay if more than one insurance policy applies to the claim, clinician who treats the patient face-to-face, in contrast to an indirect provider such as a laboratory, a list of the diagnoses, procedures, and charges for a patient's visit; also called the superbill, patient who has received professional services from a provider (or another provider with the same specialty in the same practice) within the past 3 years, a practice's rules governing payment for medical services from patients, coordination of benefits rule for a child insured under both parents' plans under which the father's insurance is primary, a person who is financially responsible for the bill from the practice, the HIPAA ASCX12N 837 transaction that is sent to a secondary or tertiary payer on a claim with the primary payer's remittance advice, HIPAA Referral Certification and Authorization, the HIPAA X12N 278 transaction in which a provider asks a health plan for approval of a service and the health plan responds, providing a certification number for an approved request, clinician who does not interact face-to-face with the patient, such as a laboratory, the policyholder or subscriber to a health plan or medical insurance policy; also known as the guarantor, a patient who has not received professional services from a provider (or another provider with the same specialty in the same practice) within the past 3 years, a provider who chooses not to join a particular government or other health plan, an amount a medical practice may ask the patient to pay at the time of service that represents a percentage of the total estimated amount due for the current services received, a provider who agrees to provide medical services to a payer's policyholders according to the terms of the plan's contract, form that includes a patient's personal, employment, and insurance company data needed to complete a healthcare claim; also known as a registration form, health plan that pays benefits first when a patient is covered by more than one plan, identifying code assigned by a government program or health insurance plan when preauthorization is required; also called the certification number, electronic health insurance claim processed at patient check-out; allows practice to know what the patient will owe for the visit, authorization number given by a referring physician to the referred physician, a document a patient is asked to sign guaranteeing payment when a required referral authorization is pending, the physician who refers the patient to another physician for treatment, the health plan that pays benefits after the primary plan pays when a patient is covered by more than one plan, a patient who does not have insurance coverage, health plan, such as Medigap, that provides benefits for services that are not normally covered by a primary plan, a number assigned to a HIPAA 270 electronic transaction sent to a health plan to inquire about patient eligibility for benefits, Briefly explain what is meant by the term efficiency continuum. Verify patient's eligibility for insurance benefits. The Corrigan Corporations 2015 and 2016 financial statements follow, along with some industry average ratios. \text{Cash } & \text{\$72.000} & \text{\$ 65.000}\\ What inflation rate is expected during Year 2? Which of the following is important information when a patient is new to the practice? $$ \text{October} & \text{360.000}\\

\text{Total current assets} & \text{\$ 1.405.000} & \text{\$ 1.206.000}\\ \text{May 2016} & \text{\$ 90.000}\\ which of the following are exclusions to the HIPAA Privacy Rule in releasing PHI? After the medical office receives the remittance advice, the administrative medical assistant reviews it and checks it against the original claim. All numbered forms must be accounted for and any missing forms found. From this analysis, how does Corrigans financial position compare with the industry average numbers? Also referred as the patient bill. The Hoosier HMO contracts with an independent medical group that specializes in a variety of medical services in order to provide those services to HMO subscribers. d. Bowers sales are seasonal; and her company produces on a seasonal basis, just ahead of sales.

Where in the patient record should the medical insurance specialist document the communication with a payer representative? $$ Payments for labor and raw materials are made the month after these services were provided. c. A change in the bankruptcy code makes it more difficult for bondholders to receive payments in the event the firm declares bankruptcy. $$ 2. a consistent monetary flow occurs throughout the month versus an influx of payments during only a specific period during the month. the total amount of all charges for services rendered to patients which have not been paid to the physician; what is owed to the physician/practice, the patients has the right to be informed of hospital policies and practices that relate to patient care, treatment, and responsibilities. \text{Debt-to-capital ratio} & \text{50.0\\%}\\ The patient is told the approximate wait time until they will see the provider. \text{December} & \text{90.000}\\ \text{Sales} & \text{\$ 4.240.000} & \text{\$ 3.635.000}\\ Without making any calculations, discuss how the companys current and debt ratios would vary during the year if all financial requirements were met with short-term bank loans. How would a more aggressive or a more conservative approach differ from the maturity matching approach, and how would each affect expected profits and risk? $$ \text{Total assets} & \text{\$ 1.836.000} & \text{\$ 1.667.000}\\ \text{Interest} & \text{67.000} & \text{43.000}\\ (T or F). \end{matrix} General and administrative salaries are approximately $27,000 a month. the granting of permission for health care without a formal agreement between the patient and health care provider. Bills are sent out once a month and are timed to reach the patient no later than the last day of the month, but preferably by the 25th of each month. What is their federal tax liability? \text{Gross operating profit} & \text{\$ 560.000} & \text{\$ 655.000}\\ Could changes in these ratios affect the firms ability to obtain bank credit? Term used for the patient's release from the hospital. If $D_{0}=\$ 3$ and $r_{s}=10 \%$, what is the value of Maxwell Mining's stock, a policyowner who is also the insured wants to name her usband as the beneficiary of her life policy. \text{November} & \text{360.000}\\ \text{Per-Share Data}\\ Is attached to the patients medical record for completion. The person whose job it is to assign CPT, HCPCS, & ICD-9 codes on the superbill, based on the physician's documentation. Three-year Treasury securities yield 5.20%, while 5-year Treasury securities yield 6.00%. The process used to generate the amount owed by a patient is called ________. What is true about the verification of copayments and coinsurance? Explain your answers. The statement is generally sent to the patient who received treatment, although in some cases another person may be designated as the one responsible for receiving and paying the bill. \text{Other fixed assets} & \text{61.000} & \text{57.000}\\ Has your company made a gain or a loss as a result, and by how much? \text{Total current liabilities} & \text{\$ 602.000} & \text{\$ 571.500}\\ $$ With the card, he purchased an Apple iPhone 6 for $372.71. What is the next step after the medical insurance specialist verifies the patient's eligibility for insurance benefits? giving the patient adequate information concerning the method, risk, and consequences prior to a procedure. f. Permission for corporations to deduct dividends for tax purposes as they now deduct interest expense. b. The word VOID should be written in large red letters across encounter forms that are not to be used and should be included with other daily work. $$ Discuss the meaning of those statements. Here are the estimated costs of labor plus raw materials: Which policy provision protects the policy owner from the unintentional lapse of the contract? A physician who specializes in the diseases and disorders of the lungs and respiratory system, a doctor specializing in diseases of the rectum and anus, 1) epidermis, 2) dermis, 3) subcutaneous/hypodermis, the number following the decimal (.) What is the first step to determine patient's financial responsibility? A patient who has been seen in the past 36 months. A form listing CPT, HCPCS, & ICD-9 codes used to record services performed for the patient & the patient's diagnosis(es) for a given visit. \end{matrix} g. A change in the Tax Code so that realized and unrealized long-term capital gains in any year are taxed at the same rate as ordinary income. It must be given to the patient before the uncovered service. What items can be listed on a customized encounter form? Round to the nearest month. If Simon makes the minimum monthly payment and makes no other charges, how many months will it be before he pays off the card? The patient's copy of the information stored in the patient ledger. \text{Taxes (40\\%)} & \text{12.272} & \text{63.980}\\

Which type of life insurance policy allows the policyowner to pay more or less than the planned premium?

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