CRCR Exam Prep 2024 with 100% correct answers
Terms in this set (146)
What are collection agency fees based on? A percentage of dollars collected
Self-funded benefit plans may choose to Birthday
coordinate benefits using the gender rule
or what other rule?
In what type of payment methodology is a Case rates
lump sum or bundled payment negotiated
between the payer and some or all
providers?
What customer service improvements Holding staff accountable for customer service during performance reviews
might improve the patient accounts
department?
What is an ABN (Advance Beneficiary Inform a Medicare beneficiary that Medicare may not pay for the order or service
Notice of Non-coverage) required to do?
What type of account adjustment results Bad debt adjustment
from the patient's unwillingness to pay for a
self-pay balance?
What is the initial hospice benefit? Two 90-day periods and an unlimited number of subsequent periods
When does a hospital add ambulance If the patient requires ambulance transportation to a skilled nursing facility
charges to the Medicare inpatient claim?
CRCR Exam Prep
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How should a provider resolve a late- Post a late-charge adjustment to the account
charge credit posted after an account is
billed?
an increase in the dollars aged greater than They are not being processed in a timely manner
90 days from date of service indicate what
about accounts
What is an advantage of a preregistration It reduces processing times at the time of service
program?
What are the two statutory exclusions from Medically unnecessary services and custodial care
hospice coverage?
What core financial activities are resolved Scheduling, insurance verification, discharge processing, and payment of point-of-
within patient access? service receipts
What statement applies to the scheduled The services do not involve an overnight stay
outpatient?
How is a mis-posted contractual allowance Comparing the contract reimbursement rates with the contract on the admittance
resolved? advice to identify the correct amount
What type of patient status is used to Observation
evaluate the patient's need for inpatient
care?
Coverage rules for Medicare beneficiaries Medically necessary inpatient hospital services for at least 3 consecutive days
receiving skilled nursing care require that before the skilled nursing care admission
the beneficiary has received what?
When is the word "SAME" entered on the When the patient is the insured
CMS 1500 billing form in Field 0$?
What are non-emergency patients who Unscheduled patients
come for service without prior notification
to the provider called?
If the insurance verification response Neither enrolled not entitled to benefits
reports that a subscriber has a single
policy, what is the status of the subscriber's
spouse?
Regulation Z of the Consumer Credit Disclosure rules for consumer credit sales and consumer loans
Protection Act, also known as the Truth in
Lending Act, establishes what?
What is a principal diagnosis? Primary reason for the patient's admission
Collecting patient liability dollars after Lower accounts receivable levels
service leads to what?
What is the daily out-of-pocket amount for 50% of the current deductible amount
each lifetime reserve day used?
What service provided to a Medicare Inpatient care
beneficiary in a rural health clinic (RHC) is
not billable as an RHC services?
What code indicates the disposition of the Patient discharge status code
patient at the conclusion of service?
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