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HFMA CRCR EXAM WITH 100% CORRECT ANSWERS 2024
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HFMA CRCR EXAM WITH 100% CORRECT ANSWERS 2024 Through what document does a hospital establish compliance standards? - Correct answer-code of conduct
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HOSMERITHFMA CRCR EXAM WITH 100% CORRECT
ANSWERS 2024
Through what document does a hospital establish compliance standards? - Correct
answer-code of conduct
What is the purpose OIG work plant? - Correct answer-Identify Acceptable
complianceprograms in various provider setting
If a Medicare patient is admitted on Friday, what services fall within the three-day
DRGwindow rule? - Correct answer-Non-diagnostic service provided on Tuesday
through Friday
What does a modifier allow a provider to do? - Correct answer-Report a specific
circumstance that affected a procedure or service without changing the code or its
definition
IF outpatient diagnostic services are provided within three days of the admission
of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System)
hospital, whatmust happen to these charges - Correct answer-They must be billed
separately to the part B Carrier
what is a recurring or series registration? - Correct answer-One registration record
iscreated for multiple days of service
What are nonemergency patients who come for service without prior notification
to theprovider called? - Correct answer-Unscheduled patients
Which of the following statement apply to the observation patient type? - Correct
answer-It is used to evaluate the need for an inpatient admission
,which services are hospice programs required to provide around the clock patient -
Correct answer-Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what? - Correct
answer-Complete the scheduling process correctly based on service requested
The Time needed to prepare the patient before service is the difference between
thepatients arrival time and which of the following? - Correct answer-Procedure
time
Medicare guidelines require that when a test is ordered for a LCD or NCD exists,
the information provided on the order must include: - Correct answer-
Documentation of themedical necessity for the test
What is the advantage of a pre-registration program - Correct answer-It reduces
processing times at the time of service
What date are required to establish a new MPI(Master patient Index) entry -
Correct answer-The responsible party's full legal name, date of birth, and social
security number
Which of the following statements is true about third-party payments? - Correct
answer-The payments are received by the provider from the payer responsible for
reimbursing the provider for the patient's covered services.
Which provision protects the patient from medical expenses that exceed the pre-
setlevel - Correct answer-stop loss
what documentation must a primary care physician send to HMO patient to
authorize avisit to a specialist for additional testing or care? - Correct answer-
Referral
, Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the
provider may not ask about a patient's insurance information if it would delay
what? -Correct answer-Medical screening and stabilizing treatment
Which of the following is a step in the discharge process? - Correct answer-Have a
casemanagement service complete the discharge plan
The hospital has a APC based contract for the payment of outpatient services.
Total anticipated charges for the visit are $2,380. The approved APC payment rate
is $780. Where will the patients benefit package be applied? - Correct answer-To
the approvedAPC payment rate
A patient has met the $200 individual deductible and $900 of the $1000 co-
insuranceresponsibility. The co-insurance rate is 20%. The estimated insurance
plan responsibility is $1975.00. What amount of coinsurance is due from the
patient? - Correct answer-$100.00
When is a patient considered to be medically indigent? - Correct answer-The
patient'soutstanding medical bills exceed a defined dollar amount or percentage
of assets.
What patient assets are considered in the financial assistance application? -
Correctanswer-Sources of readily available funds , vehicles, campers, boats and
saving accounts
If the patient cannot agree to payment arrangements, What is the next option? -
Correctanswer-Warn the patient that unpaid accounts are placed with collection
agencies for further processing
What core financial activities are resolved within patient access? - Correct answer-
scheduling , pre-registration, insurance verification and managed care processing
What is an unscheduled direct admission? - Correct answer-A patient who arrives
at thehospital via ambulance for treatment in the emergency department
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