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CRCR Certification Exam 372 Questions with Answers 2023,100% CORRECT

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CRCR Certification Exam 372 Questions with Answers 2023 The disadvantages of outsourcing include all of the following EXCEPT: a) The impact of customer service or patient relations b) The impact of loss of direct control of accounts receivable services c) Increased costs due to vendor ineffec...

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  • April 8, 2023
  • 57
  • 2022/2023
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CRCR Certification Exam 372 Questions with Answers 2023
The disadvantages of outsourcing include all of the following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff - CORRECT
ANSWERSd) Reduced internal staffing costs and a reliance on outsourced staff

The Medicare fee-for service appeal process for both beneficiaries and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for Medicare
d) Review by the Medicare Appeals Council (Appeals Council) - CORRECT
ANSWERSb) Judicial review by a federal district court

Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct - CORRECT ANSWERSa) The principles and
standards by which organizations operate

A portion of the accounts receivable inventory which has NOT qualified for billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency - CORRECT ANSWERSa) Charitable
pledges

Local Coverage Determinations (LCD) and National Coverage Determinations
(NCD) are
Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility

,b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred to Medicaid -
CORRECT ANSWERSc) Which diagnoses, signs, or symptoms are reimbursable

Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date - CORRECT ANSWERSc) The time it takes to collect
anticipated revenue

Patients are contacting hospitals to proactively inquire about costs and fees prior
to
agreeing to service. The problem for hospitals in providing such information is:
a) That hospitals don't want to establish a price without knowing if
the patient has insurance and how much reimbursement can be
expected
b) The fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information - CORRECT ANSWERSb) The
fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment

Across all care settings, if a patient consents to a financial discussion during a
medical
encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer questions and
assist in obtaining required patient financial data
b) Have a patient responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow

,d) Decline such request as finance discussions can disrupt patient care and patient
flow - CORRECT ANSWERSc) Support that choice, providing that the discussion
does not interfere with patient care or disrupt patient flow

A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of regulations imposed by
a government
agency are being met
d) The development of operational policies that correspond to regulations -
CORRECT ANSWERSc) Systematic procedures to ensure that the provisions of
regulations imposed by a government

10. Case Management requires that a case manager be assigned
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual agreement - CORRECT
ANSWERSb) To a select patient group

Pricing transparency is defined as readily available information on the price of
healthcare
services, that together with other information, help define the value of those
services and
enable consumers to
a) Identify, compare, and choose providers that offer the desired level of value
b) Customize health care with a personally chosen mix of providers
c) Negotiate the cost of health plan premiums
d) Verify the cost of individual clinicians - CORRECT ANSWERSa) Identify, compare,
and choose providers that offer the desired level of value

Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and
treatment services for an enrolled group of persons based on a monthly fee is
known as a
a) MSO

, b) HMO
c) PPO
d) GPO - CORRECT ANSWERSb) HMO

In a Chapter 7 Straight Bankruptcy filing
a) The court liquidates the debtor's nonexempt property, pays creditors, and
discharges the debtor from the debt
b) The court liquidates the debtor's nonexempt property, pays creditors, and
begins to pay off
the largest claims first. All claims are paid some portion of the amount owed
c) The court vacates all claims against a debtor with the understanding that the
debtor may not
apply for credit without court supervision
d) The court establishes a creditor payment schedule with the longest
outstanding claims paid
first - CORRECT ANSWERSa) The court liquidates the debtor's nonexempt
property, pays creditors, and discharges the debtor from the debt

14. The core financial activities resolved within patient access include:
a) Scheduling, pre-registration, insurance verification and managed
care processing
b) Scheduling, insurance verification, clinical discharge processing
and payment posting of point of service receipts
c) Scheduling, registration, charge entry and managed care
processing
d) Scheduling, pre-registration, registration, medical necessity screening and
patient refunds - CORRECT ANSWERSa) Scheduling, pre-registration, insurance
verification and managed care processing

15. Which of the following is NOT contained in a collection agency agreement?
a) A clear understanding that the provider retains ownership of any
outsourced activities
b) Specific language as to who will pay legal fees, if needed
c) An annual renewal clause
d) A mutual hold-harmless clause - CORRECT ANSWERSd) A mutual hold-harmless
clause

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