HFMA CRCR EXAM WITH QUESTIONS AND ANSWERS (VERIFIED
ANSWERS GRAD A) LATEST EXAM RATIONALE 2024/2025
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
compliance programs in various provider setting
If a Medicare patient is admitted on Friday, what services fall within the three-day
DRG window 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, what must 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 is created for multiple days of service
What are nonemergency patients who come for service without prior notification to
the provider 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 requeste
The Time needed to prepare the patient before service is the difference between the
patients 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 the medical 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-set
level - CORRECT ANSWER stop loss
, what documentation must a primary care physician send to HMO patient to
authorize a visit 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 case management 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 approved APC payment rate
A patient has met the $200 individual deductible and $900 of the $1000 co-
insurance responsibility. 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's outstanding medical bills exceed a defined dollar amount or percentage of
assets.
What patient assets are considered in the financial assistance application? -
CORRECT ANSWER Sources of readily available funds , vehicles, campers, boats
and saving accounts
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller tutorWADE. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $21.49. You're not tied to anything after your purchase.
