CRCR/HFMA CRCR Exam Bundle (Full pack solution) Graded A

Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by - Answer- The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid - Answer- Meet Income and Assets Require...

What are collection agency fees based on? - Answer- A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - Answer- Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between...

Important revenue cycle activities in the pre-service stage include; - Answer- Obtaining or updating patient and guarantor information In the pre-service stage, the cost of the scheduled service is identified and the patient's health plan and benefits are used to calculate; - Answer- The amount ...

Net Days in AR - Answer- Measures how fast receivables are collected. It is a trending indicator of overall A/R performance & revenue cycle efficiency. A/R Aging - Answer- Reports divide the AR into 30, 60, 90, and 120 day categories, based on discharge. Credit Balances - Days Outstanding - An...

Which of the following statements are true of HFMA's Patient Financial Communications Best Practices? - Answer- The best practices were developed specifically to help patients understand the cost of services, their individual insurance benefits, and their responsibility for balances after insurance...

Which option is NOT a main HFMA Healthcare Dollars and Sense revenue cycle initiative? A) Patient Financial Communications B) Medical Account Resolution C) Price Transparency D) Process Compliance - Answer- D) Process Compliance Approximately what ______% of billing information is obtained du...

Which of the following statements are true of HFMA's Financial Communications Best Practices - Answer- The best practices were developed specifically to help patients understand the cost of services, their individual insurance benefits, and their responsibility for balances after insurance, if any....

What do Case Managers do? - Answer- Monitor high resource cases to ensure effective utilization What is HIM responsible for? - Answer- all pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? - Answer- mana...

Through what document does a hospital establish compliance standards? - Answer- code of conduct What is the purpose OIG work plant? - Answer- Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day...

What happens during the post service stage? - Answer- Final coding of all services, preparation and submission of claims, payment processing and balance billing resolution. Acc - Answer- Ambulatory care center AAR - Answer- After hours activity report 837 record - Answer- A standard electro...

Patient-Centric Revenue Cycle - Answer- The major processing steps required for a request for service through closing the account at zero balance. Pre-Service - Answer- Scheduled & pre-registered pt.,cost est., data colleted Time-Of-Service - Answer- Scheduled & Unscheduled-caser mgmt. & disch...

General Ledger Cash - Answer- Petty cash used as payments for miscellaneous purchases Electronic Funds Transfer (EFT) - Answer- The transfer of funds from payer to payee through the banking system. It is considered the quickest way to move money because it is possible to transfer funds between ba...

Emergency Medical Treatment and Labor Act (EMTALA) - Answer- Requires hospitals to provide a medical screening examination and any needed stabilizing treatment to every person presenting at an ED and requesting treatment. The screening examination must not be delayed to inquire about the patient's ...

The liens types - Answer- agreement, judicial process, statue The third party payer follow up and account resolution activities include - Answer- electronic work list after untimely non payments, comparison of actual and expected reimbursement, adjustment posts, submitting secondary claims if nec...