Certified Revenue Cycle Representative - CRCR 2023 STUDY PACK EXAMS QUESTIONS AND ANSWERS WITH CERTIFIED SOLUTIONS 100% PASS

What do Case Managers do? Monitor high resource cases to ensure effective utilization What is HIM responsible for? all pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? manage cases: services correct, ...

What do Case Managers do? Monitor high resource cases to ensure effective utilization What is HIM responsible for? all pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? manage cases: services correct, ...

What are collection agency fees based on? A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some ...

Types of Unscheduled Patients (Ans- Urgent (ED) patients, Walk-in OP, Observation patients, and newborns. Resource Coordination (Ans- The process of reserving rooms and/or equipment, ordering devices or supplies, and ensuring that professional staff (physicians, nurses, and/or technicians) are...

Credit balances may be created by any of the following activities except: (Ans- Credits to pharmacy charges posted before the claim final bills. Which of the following statements represent common reasons for inpatient claim denials? (Ans- Failure to obtain a required pre-authorization; failure t...

Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid Meet Income and Assets Requirements In choosing ...

What are collection agency fees based on? A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or...

835 Record A standard electronic message between a health plan and provider sending remittance data on a claim to the provider. 837 Record A standard electronic message between a provider and health plan sending data on a claim to the health plan. AAR After-hours activity report ABN Advanced Be...

Patient Centric Revenue Cycle This includes all the major processing steps required to process a pt account from the request for service through closing the account with a zero balance and purging it from the system pre-service this is the period in which scheduling and pre-access takes place, in...

Important revenue cycle activities in the pre-service stage include; Obtaining or updating patient and guarantor information In the pre-service stage, the cost of the scheduled service is identified and the patient's health plan and benefits are used to calculate; The amount the patient may be e...

Through what document does a hospital establish compliance standards? code of conduct What is the purpose OIG work plant? 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? Non-...

Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by>>> The Medicare Administrative Contractor (MAC) at the end of the hospice cap period 2. Which of the following is required for participation in Medicaid>>> Meet In- come and Asse...