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HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM 320 QUESTIONS AND CORRECT DETAILED ANSWERS$24.99
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10/23/24, 6:36 AM HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM 320 QUE…
HFMA CRCR EXAM, CERTIFICATION EXAM,
PRACTICE EXAM AND A STUDY GUIDE LATEST
2024 ACTUAL EXAM 320 QUESTIONS AND
CORRECT DETAILED ANSWERS
Terms in this set (329)
1. Requested service is screened for med necessity,
health coverage/benefits verified, preauthorization
obtained and estimate to patient oop costs generated
within guidelines of NSA and state regulations.
2. Patient notified of financial responsibility including
copayment and health plan deductibles, eligibility of
financial assistance assessed.
Pre-Service activities 3. Patient is scheduled
4. Encounter record is generated and patient and
guarantor info is obtained and updates as part of
preregistration.
5. Cost of the scheduled service identified patients
health plan benefits are used to calculate the price of
the services to the patient. - includes deductible,
coinsurance and or copayment amounts.
,10/23/24, 6:36 AM HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM 320 QUE…
Financial account review is completed prior to patient
visit.
Patient arrives at service unit where pre-registration
record is activated, consents are signed, copayments
and agreed upon amounts are collected.
Time of service
Positive identification is completed, and the patient is
given an armband with acct number.
Scheduled preprocessed patients report to
designated express arrival desk located in centralized
area upon arrival.
Comprehensive registration and financial processing
is completed at time of service. Mirroring scheduled
Unscheduled patients - patients who is OON with provider furnishing services
Time of Service during their encounter all federal and state
transparency and NSA provisions are followed to
provide consent to patient of their rights
Case management and discharge planning are
provided.
Orders are entered.
Results are reported.
Charges are generated.
Diagnostic and procedural coding is completed.
ONGOING:
Time of Service steps
Monitor of charges
Managed care resolution
Patient liabilities resolution, as needed.
Ensure health plan requirements and liability
calculations change - vet the changes against
fed/state guidelines. Consent and updated estimates
are communicated to patient and health plan.
Includes the account activities that occur after the
patient is discharged until the acct reaches zero
Post Service balance, such as final coding of all services,
preparation and submission of claims, payment
processing and balance billing and resolution.
, 10/23/24, 6:36 AM HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM 320 QUE…
Best practices recognize
all three critical segments
of the contemporary
revenue cycle. Each
segment includes a series
of processes which are
specifically designed to
ensure accurate data
collection, consistent
quality, and a high level of
patient satisfaction.
Preservice - patient is
scheduled and registered
for service. Patients
service costs are
calculated.
Time of service - Case
mgmt and discharge
planing services are
provided. Consents are
signed.
Post Service - Bill sent
electronically to
Each segment of the revenue cycle interacts involving
Consumer Experience patients. The key to success is establishing a clear and
ever present focus on the patient.
Patients are demanding info and choices.
Regulations are demanding price transparency. For all
known charges - even those not employed by the
provider.
Patient Experience
Expect quality - health care and financial care.
Health plans care about quality - HCACPS stars is a
measure of satisfaction.
With poor scores - Medicare will be reduced.
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