HFMA CRCR EXAM 2024/2025 QUESTIONS AND ANSWERS LATEST UPDATE
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Course
HFMA CRCR
Institution
HFMA CRCR
What are collection agency fees based on? Answer: A percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? Answer: Birthday
In what type of payment methodology is a lump sum or bundled payment negot...
HFMA CRCR EXAM 2024/2025
QUESTIONS AND ANSWERS LATEST
UPDATE
What are collection agency fees based on? Answer: A percentage of
dollars collected
Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? Answer: Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? Answer:
Case rates
What customer service improvements might improve the patient
accounts department? Answer: Holding staff accountable for
customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required
to do? Answer: Inform a Medicare beneficiary that Medicare may
not pay for the order or service
,What type of account adjustment results from the patient's unwillingness
to pay for a self-pay balance? Answer: Bad debt adjustment
What is the initial hospice benefit? Answer: Two 90-day periods and
an unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient
claim? Answer: If the patient requires ambulance transportation to a
skilled nursing facility
How should a provider resolve a late-charge credit posted after an
account is billed? Answer: Post a late-charge adjustment to the
account
an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts Answer: They are not being processed
in a timely manner
What is an advantage of a preregistration program? Answer: It
reduces processing times at the time of service
What are the two statutory exclusions from hospice coverage? Answer:
Medically unnecessary services and custodial care
,What core financial activities are resolved within patient access? Answer:
Scheduling, insurance verification, discharge processing, and payment of
point-of-service receipts
What statement applies to the scheduled outpatient? Answer: The
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? Answer:
Comparing the contract reimbursement rates with the contract on the
admittance advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for
inpatient care? Answer: Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? Answer: Medically
necessary inpatient hospital services for at least 3 consecutive days
before the skilled nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field
0$? Answer: When the patient is the insured
What are non-emergency patients who come for service without prior
notification to the provider called? Answer: Unscheduled patients
, If the insurance verification response reports that a subscriber has a
single policy, what is the status of the subscriber's spouse? Answer:
Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the
Truth in Lending Act, establishes what? Answer: Disclosure rules for
consumer credit sales and consumer loans
What is a principal diagnosis? Answer: Primary reason for the
patient's admission
Collecting patient liability dollars after service leads to what? Answer:
Lower accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day
used? Answer: 50% of the current deductible amount
What service provided to a Medicare beneficiary in a rural health clinic
(RHC) is not billable as an RHC services? Answer: Inpatient care
What code indicates the disposition of the patient at the conclusion of
service? Answer: Patient discharge status code
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