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HCA 468 Quiz 2 With Complete Solutions 100% Verified
Which of the following best define Benchmarking as an overall concept? - ANSWER Process of collecting and analyzing data to identify trends in performance and, when compared with other collectors of the same data, identifying best performers and determining if interventions that were introduced to address identified problems yielded the desired results.
Benchmarking is risk management can be both a challenging and exciting activity, yielding valuable information that can provide direction to the organization. - ANSWER True
Incident can be defined as any written or verbal communication to the risk manager that an event has occurred that warrants further investigation - ANSWER True
The first responsibility in designing the data- collection instrument is to identify important demographic characteristics that enable benchmarking participants to select organizations that truly mirror their own - ANSWER True
Which of the following best define Removal of outliers? - ANSWER Claims in which money was paid in the absence of negligence or awards in excess of an agreed-on amount that might be considered a one-time event.
Which of the following abilities comprises Risk Assessment? Answer A,B,C - ANSWER A)
To assess particular environments and situations that poses a threat of risk to patients, healthcare providers, or the organization.
B)
To understand the root-cause-analysis process in order to identify the true systemic components contributing to risk.
C)
To use data to estimate the economic value to the risks assessed, and to minimize existing risks.
Answer A,B,C
Critical success factor is an activity or focus that, if achieved, would significantly improve the prospects for organizational success. Critical success factors are the foundation of the goals, objectives, and strategic initiatives - ANSWER True
Strategic planning is an organized process that is used to define long term goals and methods for achieving those goals - ANSWER True
Objectives are defined as statements that describe what the risk manager wants to achieve or create. - ANSWER False
Goals are statements that help to measure movement toward or away from a goal during a specific time frame. - ANSWER False
Which of the following is NOT a Quality Management responsibility - ANSWER Community activities
Fill in the blank: Profit Goals, Capital Structure, Tax Policy, Investment Strategy, and Major Considerations are the ____________Strategies. - ANSWER Financial
Which of the followings are Functions of Risk Management? - ANSWER All of the above
Which of the following defines Claims Handling? Answer A and B only - ANSWER )
The handling of actual and potential lawsuits is frequently assigned to the organization's risk management department
b)
If in-house legal counsel is employed by the organization, they may also perform or
Which of the followings statements are true about Private Insurance? Answer all of the above - ANSWER a)
Some private insurers are following CMS's quality push when contracting with providers not to pay for never events and not permitting patients to be billed for the charges
b)
Model their programs after the NQF 28 never-event list
c)
Aetna, the nation's third largest insurer, is including the NQF 28 when their contracts come up for renewal with their hospitals.
d)
WellPoint, parent for many Blue Cross Blue Shield plans & the largest insurer, is using four errors in Virginia with plans to include hospitals in New England, New York, and Georgia
Answer All of the above
