CRCR Exam Questions and Correct Answers & Latest Updated
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Course
CRCR
Institution
CRCR
Which of the following statements are true of HFMA's Patient Financial Communications
Best Practices?
o :## The best practices were developed specifically to help patients understand the cost of
services, their individual insurance benefits and their responsibility for balance after insurance ...
CRCR Exam Questions and Correct Answers &
Latest Updated
Which of the following statements are true of HFMA's Patient Financial Communications
Best Practices?
o :## The best practices were developed specifically to help patients understand the cost of
services, their individual insurance benefits and their responsibility for balance after insurance
if any
The patient experience includes all of the following except:
o :## The average number of positive mentions received by the health system or practice and
the public comments refuting unfriendly posts on social media sites
Corporate compliance programs play an important role in protecting the integrity of
operations and ensuring compliance with federal and state requirements. The Code of
Conduct is:
o :## A critical tool to ensure the compliance with the organization's compliance standards and
procedures, an essential and integral component of the organization's culture, fosters and
environment where concerns and questions may be raised without fear of retaliation or
retribution
Specific to Medicare fee-for-service patients, which of the following payers have always
been liable for payment?
o :## Public health service programs, federal grant programs, VA programs, black lung program
services and workers comp claims
Provider policies and procedures should be in plan to reduce the risk of ethics violations.
Examples of ethics violations are:
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o :## Financial misconduct, overcharging and miscoding claims, theft of property and falsifying
records to boost reimbursement, financial misconduct and applying policies in an inconsistent
manner
Providers are now being reimbursed with a focus on the value of the services provided,
rather than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery system for a
population of patients?
o :## To eliminate duplicate services, prevent medical errors and ensure appropriateness of
care
What is the new terminology now employed in the calculation of net patient service
revenues?
o :## Explicit price concessions and implicit price concessions
What are the two KPIs used to monitor performance related to the production and
submission of claims to third party payers and patients (self-pay)?
o :## Elapsed days from discharge to final bill and elapsed days from final bill to claim/bill
submission
What are the three traditional steps of the Revenue Cycle?
o :## Pre-service, time-of-service and post-service
What are the steps during pre-service?
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o :## 1. The patient is scheduled and pre-registered for service
2. The encounter record is generated and the patient/guarantor information is obtained or
updated
3. The requested service is screened for med necessity; insurance is verified and pre-auths
obtained
4. The cost is identified and insurance benefits are used to calculate the price of the services
to the patient
5. If the service is deemed not med necessary additional processing is done
6. The patient is notified of their financial responsibility including copay/deductible and their
eligibility for financial assistance is assessed
What happens for scheduled patients at the time of service?
o :## 1. Pre-registration record is activated, consents are signed and copays/balances are
collected
2. Positive patient identification is completed and an armband is given
3. Alternatively, scheduled patients can report to an express arrival desk
What happens for unscheduled patients at the time of service?
o :## Comprehensive registration and financial processing is completed at the time-of-service.
The process mirrors the work that was completed for scheduled patients prior to service
What are the nine steps of time-of-service processing for unscheduled patients?
o :## 1. Creation of the registration record
2. Order review to ensure compliance with the rules for what makes a complete order
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3. Validation of the health plan and identification of any amount the patient is currently due
4. Completion of med necessity screening, if necessary
5. Review and completion of pre-cert requirements for the order
6. Identification of all charges related to the order and applied insurance benefits to
calculate amount due
7. If a balance is due, financial conversation occurs
8. If all is well, patient gets service
9. Charges are entered as services are rendered
What is the overview for the three steps of the revenue cycle?
o :## 1. Pre-service: the patient is scheduled and registered for service; patient service costs
are calculated
2. Time-of-service: case management and discharge planning services are provided;
consents are signed
3. Post-service: Bill sent electronically to health plan, patient account is monitored for
payment
What are the goals of the engaged consumer portion of the rev cycle?
o :## Ease of access, improved customer service and improved quality of care
What are the goals of the engaged patient portion of the rev cycle?
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