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HFMA CRCR 2024 WITH 100% ACCURATE ANSWERS
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HFMA CRCR 2024 WITH 100% ACCURATE ANSWERS
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HFMA CRCR 2024 WITH 100%ACCURATE ANSWERS
Through what document does a hospital establish compliance standards? - correct answerscode of
conduct
What is a primary responsibility of the recover audit contractor? - correct answersTo correctly identify
proper payments for Medicare part A and B claims
How must providers handle credit balances? - correct answersComply with state statutes concerning
reporting credit balance
What activities are completed when a scheduled pre-registered patient arrives for service? - correct
answersRegistering the patient and directing the patient to the service area
What is the purpose OIG work plant? - correct answersIdentify 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? -
correct answersNon-diagnostic service provided on Tuesday through Friday
What does a modifier allow a provider to do? - correct answersReport a specific circumstance that
affected a procedure or service without changing the code or its definition
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 - correct answersThey must be billed separately to the part B Carrier
what is a recurring or series registration? - correct answersOne registration record is created for
multiple days of service
,What are nonemergency patients who come for service without prior notification to the provider called?
- correct answersUnscheduled patients
Which of the following statement apply to the observation patient type? - correct answersIt is used to
evaluate the need for an inpatient admission
which services are hospice programs required to provide around the clock patient - correct
answersPhysician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what? - correct answersComplete the
scheduling process correctly based on service requeste
The Time needed to prepare the patient before service is the difference between the patients arrival
time and which of the following? - correct answersProcedure time
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
provided on the order must include: - correct answersDocumentation of the medical necessity for the
test
What is the advantage of a pre-registration program - correct answersIt reduces processing times at the
time of service
What date are required to establish a new MPI(Master patient Index) entry - correct answersThe
responsible party's full legal name, date of birth, and social security number
Which of the following statements is true about third-party payments? - correct answersThe payments
are received by the provider from the payer responsible for reimbursing the provider for the patient's
covered services.
Which provision protects the patient from medical expenses that exceed the pre-set level - correct
answersstop loss
, what documentation must a primary care physician send to HMO patient to authorize a visit to a
specialist for additional testing or care? - correct answersReferral
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? - correct answersMedical screening and
stabilizing treatment
Which of the following is a step in the discharge process? - correct answersHave a case management
service complete the discharge plan
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? - correct answersTo the approved APC payment rate
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? - correct answers$100.00
When is a patient considered to be medically indigent? - correct answersThe patient's outstanding
medical bills exceed a defined dollar amount or percentage of assets.
What patient assets are considered in the financial assistance application? - correct answersSources of
readily available funds , vehicles, campers, boats and saving accounts
If the patient cannot agree to payment arrangements, What is the next option? - correct answersWarn
the patient that unpaid accounts are placed with collection agencies for further processing
What core financial activities are resolved within patient access? - correct answersscheduling , pre-
registration, insurance verification and managed care processing
What is an unscheduled direct admission? - correct answersA patient who arrives at the hospital via
ambulance for treatment in the emergency department
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