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CRCR EXAM TEST BANK LATEST WITH 200+ QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) 100% COMPLETE//ALREADY GRADED A+ Which of the following statements are true of HFMA's Patient Financial Communications Best Practices? $20.49
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CRCR EXAM TEST BANK LATEST WITH 200+ QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) 100% COMPLETE//ALREADY GRADED A+ Which of the following statements are true of HFMA's Patient Financial Communications Best Practices?
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CRCR EXA
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CRCR EXA
CRCR EXAM TEST BANK LATEST WITH 200+
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
100% COMPLETE//ALREADY GRADED A+
Which of the following statements are true of HFMA's Patient Financial Communications Best Practices?
CRCR EXAM TEST BANK LATEST WITH 200+
QUESTIONS AND CORRECT ANSWERS ...
CRCR EXAM TEST BANK LATEST 2023-2025 WITH 200+
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
100% COMPLETE//ALREADY GRADED A+
Which of the following statements are true of HFMA's Patient Financial Communications Best Practices?
- ANSWER-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: - ANSWER-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: - ANSWER-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? - ANSWER-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: - ANSWER-Financial misconduct, overcharging and miscoding claims, theft of
property and falsifying records to boost reimbursement, financial misconduct and applying policies in an
inconsistent manner
What is the intended outcome of collaborations made through an ACO delivery system for a population
of patients? - ANSWER-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? -
ANSWER-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)? - ANSWER-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? - ANSWER-Pre-service, time-of-service and
post-service
What are the steps during pre-service? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-1. Creation
of the registration record
2. Order review to ensure compliance with the rules for what makes a complete order
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? - ANSWER-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? - ANSWER-Ease of access,
improved customer service and improved quality of care
What are the goals of the engaged patient portion of the rev cycle? - ANSWER-Improve the information
and choices for the patient regarding care and financial decisions
What are the goals of the satisfied customer portion of the rev cycle? - ANSWER-Appropriate payment,
effective and efficient account resolution and decreased cost to collect
What are the Healthcare Dollar and Sense initiatives? - ANSWER-Patient financial communication best
practices, best practices for price transparency, medical account resolution. Overall to help make sense
of price and value in healthcare
What is the best practice for when and where to have patient financial discussions? - ANSWER-1. No
discussion before patient is screened and stabilized in the ER
2. If in an emergency medical condition, the conversation occurs in the discharge process
3. In a non-emergency situation, occurs in registration or discharge process in an area that does not
disturb others
4. When possible, have financial conversations before services are rendered
5. Have discussions as early as possible
, What are the typical elements of the best practices of financial discussions? - ANSWER-In ED settings,
inform patients that quality of care will not be affected by prior balances or insurance status. For
elective services, patients are expected to make payments toward past balances. Once patient is
stabilized, information can be collected and reviewed for insurance benefits and financial assistance
programs.
What are the best practices for financial counseling? - ANSWER-1. Discussing patient share: Patient
should be provided list of providers that require separate payments and told that estimates may vary
from actual cost. Patients should be asked if they want info about payment/financial assistance options
2. Prior balance policies: Clear policies about prior balances that should be available to the public
3. Balance resolution: Policies that work toward amicable resolution with the patient
What are the best practices for the provider/patient conversation? - ANSWER-Have compassion, use
standard language and have written follow-up
What is the framework for complying with the best practices for financial conversations? - ANSWER-
Annual training, training included well rounded material, annual observation/tracking of process,
metrics reporting, technology support verification and feedback/response
What is price transparency? - ANSWER-Pricing information available to patients based on hospital
service based on CPT/DRG, the patient's health plan and the patient's benefit plan
What is the ACA? (not the affordable care act) - ANSWER-The Association of Credit and Collections
Professionals International
What is the workflow for medical account resolution? - ANSWER-1. Educate patients and follow best
practices for communication
2. Make all bills and other communications clear, concise, correct and patient-friendly
3. Establish policies and make sure they are followed internally and by business affiliates
4. Be consistent in key aspects of account resolution- from billing disputes to payment application
5. Coordinate with business affiliates to avoid duplicative patient contacts
6. Exercise good judgement about the best ways to communicate with patients about bills
7. Start the account resolution clock when the first statement is sent to the patient
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