Point totals ( ) = 50 for grading the exam ……for the total course this equals 25 points of 150 points for the course
Respond below in BOLD or colored font on this document, and post on assignment board
- (1) a.(1) What payer is used to benchmark (compare) all other rates for all managed care payers in a medical practice? Why?
(1) b.(1) In addition to reimbursement rates, name three other items which should be negotiated.
- (2) A. Define the “Captain of the Ship” concept as it relates to working with physicians in medical practices. Why can physicians be challenging for an administrator to work with?
- . Board of Directors in a medical practice:
- (1) What do we mean by fiduciary responsibility for board members?
- (1)What do we mean by the “ex-officio” role of the practice administrator in working with the board?
- (1) In a medical practice, who are the board members?
- (2). Name and describe four key elements in a physician employment contract?
- (1) Define a buy/sell agreement
- (1) Provider two examples of method/criteria in how a medical practice is valued.
- (12) . List and understand the six key financial reports in class which should be presented and explained to the physicians. Include a brief description and/ or formula for each.
- (2)Explain the term Days in Accounts Receivable as it relates to the billing process
- (1)Provide an explanation of the concept of a physician compensation plan.
- (1 pts) For the fiscal year ending 12/31/11;
Billed charges $100,000
Insurance and patient collections/payments $60,000
Insurance Discounts $30,000
Patient bad debts write off $5,000
Charity Care writes off $5,000
Collection ratio =X_________________%.
- (1) Balance Sheet, Practice OB/GYN, March 31, 2013
Assets $140,000
Liabilities $80,000
Owners Equity X ______________
- (1) Income Statement, Practice Internal Medicine, March 31, 2013
Net Collections $400,000
Variable Expenses $100,000
Fixed Expenses X____________
Net Income $40,000
| . 12. | (1 pts) | |||||||
| Cash Flow Statement, cash accounting basis , Month end Feb. 29, 2016 | ||||||||
| Beginning Cash Balance, Feb. 1 | $100,000 | |||||||
| DR | CR | |||||||
| Deposit, Feb. 11 | $30,000 | |||||||
| Payment for supplies, Feb. 15 | $20,000 | |||||||
| Payment for Payroll, Feb 18 | $70,000 | |||||||
| Deposit, Feb. 28 | $80,000 | |||||||
| Ending Cash Balance, Feb. 29, 2016 | X | |||||||
- (2) Calculate days in accounts receivable:
-Gross accounts receivable as of 12/31/17 = $600,000
-Gross billing for the year was $7,200,000
-Applying the formula, what is days in AR as of 12/31/17. (Use the full year of 360 days in calculation average daily revenue needed to complete the calculation)
14.a. (1) What is the difference between volume- based vs. value- based reimbursement
- (1) Provide an example of a clinical standard for valued based reimbursement
15.(2) Explain the main difference between an HMO and PPO.
- (1) Explain the difference between a deductible and co-insurance
- (1) a. Define what an Accountable Care Organization (ACO) and what this their purpose?
b. (1) What is the role of a medical practice as a participant in an ACO with a hospital?
- (1) Define a line of credit, who issues it, and how it works
- (2) a. Define the elements of a well written management objective
(1) b. Provide an example of an objective in this format.
- (2) What are the four primary care specialties, and what is the role of a primary care physician in providing care in our healthcare system? Provide an example.
- (2) Why would a company decide to self- insure instead of buying insurance directly from a health plan?
- (2) Is it ever proper to walk aware from a negotiation? Why or why not?