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Health care accounting

Point totals (   ) = 50 for grading the exam ……for the total course this equals 25 points of 150 points for the course


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  1. (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.




  1. (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?




  1. . Board of Directors in a medical practice:


  1. (1) What do we mean by fiduciary responsibility for board members?
  2. (1)What do we mean by the “ex-officio” role of the practice administrator in working with the board?
  3. (1) In a medical practice, who are the board members?




  1. (2). Name and describe four key elements in a physician employment contract?



  • (1) Define a buy/sell agreement
  1. (1) Provider two examples of method/criteria in how a medical practice is valued.




  1. (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.


  1. (2)Explain the term Days in Accounts Receivable as it relates to the billing process



  1. (1)Provide an explanation of the concept of a physician compensation plan.


  1. (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. (1) Balance Sheet, Practice OB/GYN, March 31, 2013

Assets                 $140,000

Liabilities                              $80,000

                   Owners Equity              X ______________

  1. (1) Income Statement, Practice Internal Medicine, March 31, 2013

Net Collections          $400,000

Variable Expenses    $100,000

                    Fixed Expenses X____________

Net Income               $40,000



(1 pts)       
Cash Flow  Statement, cash accounting  basis , Month end  Feb. 29, 2016    
 Beginning Cash Balance, Feb. 1   $100,000 
 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  



  1. (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. (1) Provide an example of a clinical standard for valued based reimbursement


15.(2) Explain the main  difference between an HMO and PPO.



  1. (1) Explain the difference between a deductible and co-insurance


  1. (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. (1) Define a line of credit, who issues it, and how it works


  1. (2) a. Define the elements of a well written management objective

(1) b. Provide an example of an objective in this format.


  1. (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.


  1. (2) Why would a company decide to self- insure instead of buying insurance directly from a health plan?


  1. (2) Is it ever proper to walk aware from a negotiation? Why or why not?

Last Updated on March 9, 2019

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