Define the “Captain of the Ship” concept as it relates to the training and mindset of physicians in medical practices. Why can physicians be challenging for an administrator to work with?
Define the “Captain of the Ship” concept
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Modules (weeks): 1-6
Point totals (56) = for grading the exam ……for the total course this equals 25 points for final grade
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1. (1 point) a. Define the “Captain of the Ship” concept as it relates to the training and mindset of physicians in medical practices.
(1 point) b. Why can physicians be challenging for an administrator to work with?
2. Board of Directors in a medical practice:
(1point) a. What do we mean by fiduciary responsibility for board members?
(1point) b. What do we mean by the “ex-officio” role of the practice administrator in working with the board?
(1point) c. Give an example of a board member violating fiduciary responsibility.
3.(3 points) a. Name and describe three issues which are appropriate for the physician board to directors’ address as part of their governing role?
b. (1 point) b. Name an issue which is not appropriate?
4. (2 points) Explain the term “contractual adjustment” for managed care contracts and reimbursement by insurance companies
5. (2 point) a. Define a buy/sell agreement for the physician entering the partnership and the physician leaving the practice.
(1 point) b. Identify and explain an example of how a medical practice is valued.
- (5 points) List five key financial reports reviewed in class which should be presented and explained to the physicians. Include a brief description and/ or formula for each report.
7. (1 points) For patient balances, what is the difference between a bad debt write off and charity care write off?
(2 point) what is the purpose of a physician compensation plan?
- (2 points) For the fiscal year ending 12/31/19.
Amount or Percentage
Insurance and patient collections/payments
Insurance contractual adjustment
Patient bad debts write off
Charity Care writes off
Collection ratio equals
Total discount per insurance contract
- (1 point) Balance Sheet, Practice OB/GYN, March 31, 2013
(1 point) a. Income Statement, Practice Internal Medicine, March 31, 2013
(1 point) b. What is the difference between a fixed expense, and a variable expense?
12. (1 point) Cash Flow Statement, Cash Account Basis, Month End Feb. 29, 2016
Cash Balance, Feb. 1
Deposit, Feb. 11
Payment for Supplies, Feb. 15
Payment for Payroll, Feb. 18
Deposit, Feb. 28
Ending Cash Balance, Feb. 29
- (2 points) Calculate days in accounts receivable:
Gross accounts receivable as of 12/31/17 = $800,000
Gross billing for the year was $10,000,000
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.
What is the answer?
14. (1 point) a. What is the difference between volume- based vs. value- based reimbursement?
(1 point) b. Provide an example of a clinical standard for valued based reimbursement which
relates to a health or wellness outcome.
(3 points) Explain a High Deductible Health Plans. (HDHP), and two components.
(3 points) A patient is making an initial visit for a surgical procedure, and then has the surgery. Explain the differences between a deductible, co-insurance, and a co-pay, as related to this process
17. (2 points) a. Define a Patient Centered Medical Home, and its main purpose.
(3 points) b. Name three medical specialties which frequently offer PCMH in conjunction with insurance companies?
18. (2 points) Define a line of credit, who issues it, and how it works as related to the practice checking account.
19. (2 points) a. Define the elements of a well written management objective (SMART)
(1 points) b. Provide an example of an objective in this format for a medical practice.
(1 points) a. Why would a company decide to self- insure instead of buying insurance directly from a health plan?
(1 point) b. Name of the contractor hired to process claims received from the provider under a self-insured plan.
22. (3) List and describe three government sponsored health plans.
23 (3). List three issues you would address in preparing for a managed care contract negotiation .
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