CRCR EXAM MULTIPLE CHOICE, CRCR Exam Prep, Certified Revenue Cycle Representative - CRCR 2023
What are collection agency fees based on? - CORRECT ANSWERSA percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - ...
What are collection agency fees based on? - CORRECT ANSWERSA percentage of
dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule
or what other rule? - CORRECT ANSWERSBirthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? - CORRECT
ANSWERSCase rates
What customer service improvements might improve the patient accounts
department? - CORRECT ANSWERSHolding staff accountable for customer service
during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -
CORRECT ANSWERSInform a Medicare beneficiary that Medicare may not pay for
the order or service
What type of account adjustment results from the patient's unwillingness to pay
for a self-pay balance? - CORRECT ANSWERSBad debt adjustment
What is the initial hospice benefit? - CORRECT ANSWERSTwo 90-day periods and
an unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? -
CORRECT ANSWERSIf the patient requires ambulance transportation to a skilled
nursing facility
How should a provider resolve a late-charge credit posted after an account is
billed? - CORRECT ANSWERSPost a late-charge adjustment to the account
,an increase in the dollars aged greater than 90 days from date of service indicate
what about accounts - CORRECT ANSWERSThey are not being processed in a
timely manner
What is an advantage of a preregistration program? - CORRECT ANSWERSIt
reduces processing times at the time of service
What are the two statutory exclusions from hospice coverage? - CORRECT
ANSWERSMedically unnecessary services and custodial care
What core financial activities are resolved within patient access? - CORRECT
ANSWERSScheduling, insurance verification, discharge processing, and payment
of point-of-service receipts
What statement applies to the scheduled outpatient? - CORRECT ANSWERSThe
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? - CORRECT
ANSWERSComparing the contract reimbursement rates with the contract on the
admittance advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for inpatient
care? - CORRECT ANSWERSObservation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require
that the beneficiary has received what? - CORRECT ANSWERSMedically necessary
inpatient hospital services for at least 3 consecutive days before the skilled
nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? -
CORRECT ANSWERSWhen the patient is the insured
What are non-emergency patients who come for service without prior notification
to the provider called? - CORRECT ANSWERSUnscheduled patients
,If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse? - CORRECT ANSWERSNeither
enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what? - CORRECT ANSWERSDisclosure rules for consumer
credit sales and consumer loans
What is a principal diagnosis? - CORRECT ANSWERSPrimary reason for the
patient's admission
Collecting patient liability dollars after service leads to what? - CORRECT
ANSWERSLower accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? -
CORRECT ANSWERS50% of the current deductible amount
What service provided to a Medicare beneficiary in a rural health clinic (RHC) is
not billable as an RHC services? - CORRECT ANSWERSInpatient care
What code indicates the disposition of the patient at the conclusion of service? -
CORRECT ANSWERSPatient discharge status code
What are hospitals required to do for Medicare credit balance accounts? -
CORRECT ANSWERSThey result in lost reimbursement and additional cost to
collect
When an undue delay of payment results from a dispute between the patient and
the third party payer, who is responsible for payment? - CORRECT
ANSWERSPatient
Medicare guidelines require that when a test is ordered for a LCD or NCD exists,
the information provided on the order must include: - CORRECT ANSWERSA valid
CPT or HCPCS code
, With advances in internet security and encryption, revenue-cycle processes are
expanding to allow patients to do what? - CORRECT ANSWERSAccess their
information and perform functions on-line
What date is required on all CMS 1500 claim forms? - CORRECT ANSWERSonset
date of current illness
What does scheduling allow provider staff to do - CORRECT ANSWERSReview
appropriateness of the service request
What code is used to report the provider's most common semiprivate room rate?
- CORRECT ANSWERSCondition code
Regulations and requirements for coding accountable care organizations, which
allows providers to begin creating these organizations, were finalized in: -
CORRECT ANSWERS2012
What is a primary responsibility of the Recover Audit Contractor? - CORRECT
ANSWERSTo correctly identify proper payments for Medicare Part A & B claims
How must providers handle credit balances? - CORRECT ANSWERSComply with
state statutes concerning reporting credit balance
Insurance verification results in what? - CORRECT ANSWERSThe accurate
identification of the patient's eligibility and benefits
What form is used to bill Medicare for rural health clinics? - CORRECT
ANSWERSCMS 1500
What activities are completed when a scheduled pre-registered patient arrives for
service? - CORRECT ANSWERSRegistering the patient and directing the patient to
the service area
In addition to being supported by information found in the patient's chart, a CMS
1500 claim must be coded using what? - CORRECT ANSWERSHCPCS (Healthcare
Common Procedure Coding system)
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