Chapter 1
Budgeting, Reporting, Payables & Financial Operations
What are controller/comptroller duties?
A legal entity that is separate & distinct from its owners & managers.
What is a corporation?
Cash & other assets that can be converted into cash within 1 year.
What are current assets?
Those with greater risk are more likely to purchase insurance.
What is Adverse Selection?
Fixed versus Variable & Direct versus Indirect (overhead)
What are Cost Classifications?
Defined as the volume needed to produce zero profit.
What is accounting breakeven?
Capital acquisition, Debt management, Financial Risk management
What are Treasurer duties?
Blue Cross/Blue Shield, Commercial Insurers, Self-Insurers
What are Private Insurers?
Revenues for services provided that have not been collected.
What are Net Patient Accounts Receivables?
Fee-for-Service & Capitation
What are Reimbursement Approaches?
Financial Accounting & Managerial Accounting
What are the 2 main areas of accounting?
Defined as the volume needed to produce some target profit level.
What is Economic breakeven?
The measurement of events that reflect the resources, operations.
What is accounting?
Medicare and Medicaid
What are public insurers?
Investments in securities (land, buildings and equipment), that have maturities greater than 1 year.
What are Long-Term Investments?
ICD Codes & CPT Codes
What are 2 different types of medical codes?
Cost Pool & Cost Driver
What are 2 terms used in cost allocation?
The cost of providing one additional unit of output.
What is marginal cost?
Provides the theory, concepts and tools necessary for better financial decisions.
What is financial management?
Payer pays all allowable costs incurred in providing services.
What is Fee for Service (FFS)?
Payment obligations that come due within 1 year.
What are Current Liabilities?
Overuse of health services because the individual does not bear full cost of consequences.
What is Moral Hazard?
Cost unique and exclusive to a subunit/department.
What are Direct Costs?
A management strategy that helps providers offset the limitations imposed when they are price takers.
What is Target Costing?
To acquire and utilize resources to maximize the efficiency of an organization.
What is the role of finance?
Payment to providers made on a per member per month (PMPM) basis.
What is Capitation?
The non-liability claims against a business's assets.
What is Equity?
Deductibles, Copayments, Coinsurance & Policy Restrictions.
What are the ways insurers protect themselves?
Costs associated with shared resources used by an entire organization.
What are Indirect or Overhead Costs?
The difference between per unit revenue and per unit variable costs.
What is Contribution Margin