Question 1

The Commission for the Accreditation of Birth Centers publishes the Accreditation Handbook for Ambulatory Health Care

Accepted Answer

The Commission for the Accreditation of Birth Centers (CABC) does not publish the Accreditation Handbook for Ambulatory Health Care; that publication is associated with the Accreditation Association for Ambulatory Health Care (AAAHC).

Question 2

The Joint Commission accredits ambulatory health care facilities under the same standards as hospitals.

Accepted Answer

The Joint Commission has separate accreditation programs with tailored standards for different types of healthcare facilities, including specific ones for ambulatory health care facilities and hospitals, recognizing the unique operational and care delivery models of each.

Question 3

Two approaches to utilization management in ambulatory care are prospective and retrospective review.

Accepted Answer

Prospective review involves evaluating the necessity and appropriateness of care before it is provided, while retrospective review assesses the necessity and appropriateness of care after it has been delivered.

Question 4

It is not necessary for an ambulatory facility to document telephone communication with patients because insurance companies will not pay for telephone consultations

Accepted Answer

Insurance companies may pay for telephone consultations under certain circumstances, and documenting all communications, including telephone calls, is important for legal, medical, and billing purposes in any healthcare setting, including ambulatory facilities.

Question 5

Reimbursement for physicians under Medicare has changed from the resource-based relative value scale to the ambulatory payment classification system.

Accepted Answer

Reimbursement for physicians under Medicare continues to use the Resource-Based Relative Value Scale (RBRVS) system, while the Ambulatory Payment Classification (APC) system is used for hospital outpatient services, not for physician payments.

Question 6

Medicare certification of rural health clinics permits cost-based reimbursement as part of the effort to increase access to primary care in medically underserved rural areas.

Accepted Answer

Medicare certification allows rural health clinics to receive cost-based reimbursement, which is part of a broader strategy to enhance access to primary care services in rural areas that are medically underserved. This reimbursement model is designed to support these clinics financially, ensuring they can continue to provide essential healthcare services to rural populations.

Question 7

Because the federal government establishes requirements for licensure of health care facilities, the requirements are the same in each state.

Accepted Answer

The federal government sets certain standards, especially for facilities that receive federal funding (e.g., Medicare and Medicaid), but states have the authority to establish their own licensure requirements for health care facilities, leading to variations from state to state.

Question 8

A family numbering system is a simple way of organizing records because the numbers rarely change.

Accepted Answer

Family numbering systems can become complex and numbers may change due to events like births, deaths, or marriages, which can alter the family structure and require renumbering.

Question 9

NCDs list diagnosis codes that would indicate that a particular procedure is medically necessary.

Accepted Answer

NCDs, or National Coverage Determinations, are used in the United States by the Centers for Medicare & Medicaid Services (CMS) to specify the circumstances under which a procedure is considered to be medically necessary, often including diagnosis codes that justify the necessity of the procedure.

Question 10

Standard scheduling assigns all patients in a large block at the same appointment time.

Accepted Answer

Standard scheduling, also known as traditional or fixed scheduling, assigns specific appointment times to each patient to spread out appointments throughout the day and avoid large blocks of people arriving at the same time.

Question 11

​A(n) _____________________is a face-to-face contact between the patient and the provider.

Accepted Answer

The answer of ​A(n) _____________________is a face-to-face contact between the...

Question 12

The __________________ is a numbering system in which the family is given a number and each individual receives that number with a suffix indicating his or her position within the family.​

Accepted Answer

The answer of The __________________ is a numbering system in...

Question 13

The_______________________ is the office in the Department of Health and Human Services responsible for monitoring compliance with reimbursement laws and regulations.​

Accepted Answer

The answer of The_______________________ is the office in the Department...

Question 14

A(n) ___________________ is a nonprofit or public organization that provides or arranges for comprehensive health care services to a medically underserved area or population.​

Accepted Answer

The answer of A(n) ___________________ is a nonprofit or public...

Question 15

The _________________________ is a joint federal and state government initiative to identify fraud and abuse in the Medicaid system​

Accepted Answer

The answer of The _________________________ is a joint federal and...

Question 16

_________________________ are guidance documents published by Medicare Administrative Contractors (MACs) that include information on codes that indicate medical necessity of services. These policies apply to services covered under Medicare in the region served by the contractor.​

Accepted Answer

The answer of _________________________ are guidance documents published by Medicare...

Question 17

​The ___________________________ is a system for physicians to report quality measures to CMS.

Accepted Answer

The answer of ​The ___________________________ is a system for physicians...

Question 18

​A(n) ____________________ is a health care professional whose license permits a degree of independent judgment in treating patients, generally under the supervision of a physician, for example, a nurse practitioner or physician assistant.

Accepted Answer

The answer of ​A(n) ____________________ is a health care professional...

Question 19

​A(n) _______________________ is a secure method of patient access to his or her own information through a facility's electronic information system.

Accepted Answer

The answer of ​A(n) _______________________ is a secure method of...

Question 20

______________________ are patients who arrive without an appointment or who receive an appointment at the last minute.​

Accepted Answer

The answer of ______________________ are patients who arrive without an...

Quiz 3: Freestanding Ambulatory Care

The Commission for the Accreditation of Birth Centers publishes the Accreditation Handbook for Ambulatory Health Care

The Joint Commission accredits ambulatory health care facilities under the same standards as hospitals.

Two approaches to utilization management in ambulatory care are prospective and retrospective review.

It is not necessary for an ambulatory facility to document telephone communication with patients because insurance companies will not pay for telephone consultations

Reimbursement for physicians under Medicare has changed from the resource-based relative value scale to the ambulatory payment classification system.

Medicare certification of rural health clinics permits cost-based reimbursement as part of the effort to increase access to primary care in medically underserved rural areas.

Because the federal government establishes requirements for licensure of health care facilities, the requirements are the same in each state.

A family numbering system is a simple way of organizing records because the numbers rarely change.

NCDs list diagnosis codes that would indicate that a particular procedure is medically necessary.

Standard scheduling assigns all patients in a large block at the same appointment time.

​A(n) _____________________is a face-to-face contact between the patient and the provider.

The __________________ is a numbering system in which the family is given a number and each individual receives that number with a suffix indicating his or her position within the family.​

The_______________________ is the office in the Department of Health and Human Services responsible for monitoring compliance with reimbursement laws and regulations.​

A(n) ___________________ is a nonprofit or public organization that provides or arranges for comprehensive health care services to a medically underserved area or population.​

The _________________________ is a joint federal and state government initiative to identify fraud and abuse in the Medicaid system​

_________________________ are guidance documents published by Medicare Administrative Contractors (MACs) that include information on codes that indicate medical necessity of services. These policies apply to services covered under Medicare in the region served by the contractor.​

​The ___________________________ is a system for physicians to report quality measures to CMS.

​A(n) ____________________ is a health care professional whose license permits a degree of independent judgment in treating patients, generally under the supervision of a physician, for example, a nurse practitioner or physician assistant.

​A(n) _______________________ is a secure method of patient access to his or her own information through a facility's electronic information system.

______________________ are patients who arrive without an appointment or who receive an appointment at the last minute.​

A(n) _____________________is a face-to-face contact between the patient and the provider.

The __________________ is a numbering system in which the family is given a number and each individual receives that number with a suffix indicating his or her position within the family.

The_______________________ is the office in the Department of Health and Human Services responsible for monitoring compliance with reimbursement laws and regulations.

A(n) ___________________ is a nonprofit or public organization that provides or arranges for comprehensive health care services to a medically underserved area or population.

The _________________________ is a joint federal and state government initiative to identify fraud and abuse in the Medicaid system

_________________________ are guidance documents published by Medicare Administrative Contractors (MACs) that include information on codes that indicate medical necessity of services. These policies apply to services covered under Medicare in the region served by the contractor.

The ___________________________ is a system for physicians to report quality measures to CMS.

A(n) ____________________ is a health care professional whose license permits a degree of independent judgment in treating patients, generally under the supervision of a physician, for example, a nurse practitioner or physician assistant.

A(n) _______________________ is a secure method of patient access to his or her own information through a facility's electronic information system.

______________________ are patients who arrive without an appointment or who receive an appointment at the last minute.