Chapter 31 — Quiz
26 questions. Answers and explanations are in the instructor guide.
1. Gross accounts receivable — AR stated at charges — is inflated because:
- A. Payers routinely overpay
- B. It contains contractual adjustments that will never be collectible by anyone
- C. Patient balances age faster than insurance balances
- D. Credit balances are included twice
2. The first cut every AR analysis should make is:
- A. By provider
- B. By date of service
- C. Insurance AR versus patient AR
- D. By dollar amount
3. On day 17, Account 10-4471's remaining AR of \$145.98 consists of:
- A. \$128.40 denied and on appeal, plus \$17.58 patient responsibility
- B. \$185.00 in charges less the copay
- C. \$98.40 plan and \$47.58 patient
- D. \$70.30 paid and \$75.68 pending
4. Re-aging means:
- A. Aging AR from the date of service
- B. An account's age resetting when it is rebilled or touched
- C. Writing off accounts over 120 days
- D. Aging patient AR from the first statement date
5. Credits should not be netted into an aging report because:
- A. Credits are always posting errors
- B. Old credits camouflage old debits — and are themselves the compliance problem
- C. Netting is prohibited by HIPAA
- D. Credits belong on the balance sheet only
6. Days in AR equals:
- A. Total AR ÷ average daily collections
- B. Total AR ÷ average daily charges
- C. Average daily charges ÷ total AR
- D. Total AR ÷ 365
7. A practice with \$412,300 in gross AR and \$2,920,000 in trailing-twelve-month charges has days in AR of approximately:
- A. 41.2
- B. 48.0
- C. 51.5
- D. 55.1
8. Writing off a large batch of aged denials does what to days in AR on that day?
- A. Nothing until the claims are collected
- B. Improves it — indistinguishably, on the metric alone, from collecting faster
- C. Worsens it
- D. Improves it only if the write-offs were preventable
9. The metric's definition changed when the new system netted credits. The correct response is:
- A. Restate history under the new definition and move on
- B. Use whichever definition looks better
- C. Write the definition on the dashboard and run both versions in parallel across the seam
- D. Stop reporting the metric
10. The real value of AR over 90 is:
- A. The percentage itself
- B. Its decomposition into components with different causes
- C. Comparison to the national benchmark
- D. Predicting write-offs
11. Of the constructed practice's \$70,850 over ninety days, the true finding was:
- A. \$16,400 of payment plans
- B. \$21,300 of one payer's pended-claims project
- C. \$9,850 of pending appeals
- D. \$12,700 of insurance balances with no activity on record
12. The AR follow-up queue sorts first by:
- A. Dollar amount
- B. Deadline
- C. Payer
- D. Age
13. The queue sorts on expected value at the allowed amount, not the charge, because:
- A. Charges are confidential
- B. The charge is arbitrary and the allowed amount is what the claim can actually retrieve
- C. Payers require it
- D. Allowed amounts age faster
14. "An aging report finds money at ninety days; a status event finds the same money at twenty." This is the argument for:
- A. Monthly aging review
- B. An event-fed queue
- C. Larger buckets
- D. Sorting by dollar
15. A strong follow-up call leaves with all of the following EXCEPT:
- A. The specific pend reason
- B. A date the claim will adjudicate by
- C. A reference number and a name
- D. A promise to check back in thirty days
16. Per Chapter 27 §27.7, a note about a phone call is:
- A. The strongest proof of timely filing
- B. The weakest proof — memory for your next touch, not evidence for a dispute
- C. Equivalent to a payer acknowledgment
- D. Inadmissible
17. The fully loaded cost of denial-management staff time published in §31.7 is:
- A. \$36.00 per hour — \$0.60 per minute
- B. \$60.00 per hour — \$1.00 per minute
- C. \$30.00 per hour — \$0.50 per minute
- D. Whatever the wage is
18. If a statement cycle costs \$2.95 and a small balance typically takes two cycles, a \$4.15 balance should be:
- A. Pursued for one cycle only
- B. Written off at posting under a uniform policy, because \$5.90 > \$4.15
- C. Placed with a collection agency
- D. Billed with interest
19. The arithmetic of giving up applies to:
- A. Instances and patterns alike
- B. Instances — never patterns, which must be classified and pursued at the contract level
- C. Patterns only
- D. Patient balances only
20. Routinely waiving Medicare cost sharing risks implicating:
- A. The Stark Law only
- B. The Anti-Kickback Statute and the Civil Monetary Penalties Law's inducement provisions
- C. HIPAA
- D. The No Surprises Act
21. A credit balance is:
- A. Always an overpayment
- B. A symptom with three possible diagnoses: posting error, patient refund, or payer refund
- C. Always the patient's money
- D. A reduction of the practice's charges
22. Under the sixty-day rule, an identified Medicare or Medicaid overpayment must be:
- A. Reported and returned within sixty days of identification
- B. Returned within sixty days of the payer requesting it
- C. Reported on the next cost report only
- D. Offset against future claims
23. A retained overpayment past the deadline becomes:
- A. A billing error
- B. An obligation actionable under the False Claims Act's reverse-false-claim provision
- C. A contractual adjustment
- D. Bad debt
24. Bad debt differs from charity care in that bad debt is:
- A. A balance the patient could not pay
- B. A balance the patient could have paid and, after genuine collection effort, did not
- C. Always placed with an agency
- D. Forgiven under the financial assistance policy
25. The financial assistance determination must occur:
- A. At write-off
- B. After agency placement fails
- C. Before collection activity — determine, then pursue, never the reverse
- D. Only if the patient requests it in writing
26. On §31.11's dashboard, the net collection rate is never read without:
- A. The gross collection rate
- B. The underpayment variance findings beside it, because a silent underpayment raises the rate
- C. Days in AR
- D. The payer mix