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) 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
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
|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|
- (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?
Last Updated on March 9, 2019 by Essay Pro