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CRCR ~ 1. The vendor may have access to qualified staff not available to that particular healthcare facility 2.Vendor may have technology that is not cost-effective for an individual healthcare facility to purchase and maintain 3. Vendor limits the need$13.49
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CRCR ~ 1. The vendor may have access to qualified staff not available to that particular healthcare facility 2.Vendor may have technology that is not cost-effective for an individual healthcare facility to purchase and maintain 3. Vendor limits the need
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Course
CRCR
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CRCR
has always worked as a part-time barista. Janet and Tom, both age 66, want to
maximize their Social Security benefits by using the file and suspend strategy.
You should advise them that
~ The spouse who wants to file and suspend, typically the higher wage earner,
must be 66 before May 2016 ...
Which of the following statements are true of HFMA's Patient Financial
Communications Best Practices?
✓~ The best practices were developed specifically to help patients understand the
cost of services, their individual insurance benefits and their responsibility for balance
after insurance if any
The patient experience includes all of the following except:
✓~ The average number of positive mentions received by the health system or
practice and the public comments refuting unfriendly posts on social media sites
Corporate compliance programs play an important role in protecting the
integrity of operations and ensuring compliance with federal and state
requirements. The Code of Conduct is:
, ✓~ A critical tool to ensure the compliance with the organization's compliance
standards and procedures, an essential and integral component of the organization's
culture, fosters and environment where concerns and questions may be raised
without fear of retaliation or retribution
Specific to Medicare fee-for-service patients, which of the following payers
have always been liable for payment?
✓~ Public health service programs, federal grant programs, VA programs, black
lung program services and workers comp claims
Provider policies and procedures should be in plan to reduce the risk of ethics
violations. Examples of ethics violations are:
✓~ Financial misconduct, overcharging and miscoding claims, theft of property
and falsifying records to boost reimbursement, financial misconduct and applying
policies in an inconsistent manner
Providers are now being reimbursed with a focus on the value of the services
provided, rather than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery
system for a population of patients?
, ✓~ To eliminate duplicate services, prevent medical errors and ensure
appropriateness of care
What is the new terminology now employed in the calculation of net patient
service revenues?
✓~ Explicit price concessions and implicit price concessions
What are the two KPIs used to monitor performance related to the production
and submission of claims to third party payers and patients (self-pay)?
✓~ Elapsed days from discharge to final bill and elapsed days from final bill to
claim/bill submission
What are the three traditional steps of the Revenue Cycle?
✓~ Pre-service, time-of-service and post-service
What are the steps during pre-service?
✓~ 1. The patient is scheduled and pre-registered for service
2. The encounter record is generated and the patient/guarantor information is
obtained or updated
, 3. The requested service is screened for med necessity; insurance is verified
and pre-auths obtained
4. The cost is identified and insurance benefits are used to calculate the price
of the services to the patient
5. If the service is deemed not med necessary additional processing is done
6. The patient is notified of their financial responsibility including
copay/deductible and their eligibility for financial assistance is assessed
What happens for scheduled patients at the time of service?
✓~ 1. Pre-registration record is activated, consents are signed and
copays/balances are collected
2. Positive patient identification is completed and an armband is given
3. Alternatively, scheduled patients can report to an express arrival desk
What happens for unscheduled patients at the time of service?
✓~ Comprehensive registration and financial processing is completed at the time-
of-service. The process mirrors the work that was completed for scheduled patients
prior to service
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