HFMA CRCR EXAM | PRACTICE
QUESTIONS AND ANSWERS | GRADED
AND RATED A+ | 2024/2025 GUIDE
The disadvantages of outsourcing include all of the following
EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable
services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced
staff
- Correct Answer - D
The Medicare fee-for service appeal process for both
beneficiaries and providers includes all of the following levels
EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for
Medicare
d) Review by the Medicare Appeals Council (Appeals Council)
,- Correct Answer - B
Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct
- Correct Answer - A
A portion of the accounts receivable inventory which has NOT
qualified for billing includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency
- Correct Answer - A
Local Coverage Determinations (LCD) and National Coverage
Determinations (NCD) are Medicare established guideline(s) used
to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
,d) What Medicare reimburses and what should be referred to
Medicaid - Correct Answer - C
Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date
- Correct Answer - C
Patients are contacting hospitals to proactively inquire about costs
and fees prior to agreeing to service. The problem for hospitals in
providing such information is:
a) That hospitals don't want to establish a price without knowing if
the patient has insurance and how much reimbursement can be
expected
b) The fact that charge master lists the total charge, not net
charges that reflect charges after a payer's contractual
adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information
, - Correct Answer - B
Across all care settings, if a patient consents to a financial
discussion during a medical encounter to expedite discharge, the
HFMA best practice is to:
a) Make sure that the attending staff can answer questions and
assist in obtaining required patient financial data
b) Have a patient financial responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt patient
care and patient flow
- Correct Answer - C
A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of
regulations imposed by a government agency are being met
d) The development of operational policies that correspond to
regulations
- Correct Answer - C
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