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HFMA CRCR /172 Questions And Answers (A+)
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HFMA CRCR /172 Questions And Answers (A+)
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HFMA CRCR 2023-2024 /172 Questions AndAnswers (A+)
Quiz :Through what document does a hospital establish compliance standards? -
√Answer :code of conduct
Quiz :What is the purpose OIG work plant? - √Answer :Identify Acceptable
compliance programs in various provider setting
Quiz :If a Medicare patient is admitted on Friday, what services fall within the
three-day DRG window rule? - √Answer :Non-diagnostic service provided on
Tuesday through Friday
Quiz :What does a modifier allow a provider to do? - √Answer :Report a
specific circumstance that affected a procedure or service without changing the
code or its definition
Quiz :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 - √Answer :They must be
billed separately to the part B Carrier
Quiz :what is a recurring or series registration? - √Answer :One registration
record is created for multiple days of service
Quiz :What are nonemergency patients who come for service without prior
notification to the provider called? - √Answer :Unscheduled patients
Quiz :Which of the following statement apply to the observation patient type? -
√Answer :It is used to evaluate the need for an inpatient admission
Quiz :which services are hospice programs required to provide around the clock
patient - √Answer :Physician, Nursing, Pharmacy
Quiz :Scheduler instructions are used to prompt the scheduler to do what? -
√Answer :Complete the scheduling process correctly based on service requeste
Quiz :The Time needed to prepare the patient before service is the difference
between the patients arrival time and which of the following? -
√Answer :Procedure time
, Quiz :Medicare guidelines require that when a test is ordered for a LCD or NCD
exists, the information provided on the order must include: -
√Answer :Documentation of the medical necessity for the test
Quiz :What is the advantage of a pre-registration program - √Answer :It reduces
processing times at the time of service
Quiz :What date are required to establish a new MPI(Master patient Index)
entry - √Answer :The responsible party's full legal name, date of birth, and
social security number
Quiz :Which of the following statements is true about third-party payments? -
√Answer :The payments are received by the provider from the payer responsible
for reimbursing the provider for the patient's covered services.
Quiz :Which provision protects the patient from medical expenses that exceed
the pre-set level - √Answer :stop loss
Quiz :what documentation must a primary care physician send to HMO patient
to authorize a visit to a specialist for additional testing or care? -
√Answer :Referral
Quiz :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? - √Answer :Medical screening and stabilizing treatment
Quiz :Which of the following is a step in the discharge process? -
√Answer :Have a case management service complete the discharge plan
Quiz :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? -
√Answer :To the approved APC payment rate
Quiz :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? - √Answer :$100.00
Quiz :When is a patient considered to be medically indigent? - √Answer :The
patient's outstanding medical bills exceed a defined dollar amount or percentage
of assets.
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