CNML Test Practice Exam with Answers (175 Solved Questions)

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CNML Test1.DRGsDiagnostic-Related Groups: payment rate based on spe-cific diagnoses2.Prospective Pay-ment SystemUsed by Medicare-participating hospitals: pretreatmentdiagnosis billings based on DRGs; rate decided ahead oftime between insurance companies and hospitals3.ExclusiveProviderUsed by HMO's: insurance coverage for contractedproviders or institutions4.HMOsHealth maintenance organizations: comprehensivehealthcare to people who pay a fee for a fixed period oftime5.CapitationFixed rate paid to provider per member per month forhealthcare services; set fee paid by insurance companyper month for all the patient needs6.PPOsPreferred provider organizations: special reduced rate forservices when customers use certain providers approvedby the insurance company; usually fee-for-service7.IPAsIndividual provider arrangements: provide care in theiroffices for prepaid plans; coalition of physicians who serveHMO patients and third-party patients8.Fulltime FTEHours2080 hours (1.0 @ 40 hours per week)9.Capital Expens-esLong-term equipment or physical purchases: usually over$500-$1000 that will last years and depreciate over timeand be used multiple times10.Zero-Based Bud-getWith each new budget (i.e. fiscal year), it is determinedwhich programs/areas get money; no historical context isused; may rank packages and then only fund top-rankedones; can be time-consuming way to create a budget11.1 / 18

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