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HFMA CRCR FINAL EXAM 2024/2025 QUESTIONS AND ANSWERS LATEST UPDATE
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HFMA CRCR FINAL EXAM 2024/2025 QUESTIONS AND ANSWERS LATEST UPDATE
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HFMA CRCR FINAL EXAM 2024/2025QUESTIONS AND ANSWERS LATEST
UPDATE
Through what document does a hospital establish compliance standards?
Answer: code of conduct
What is the purpose OIG work plant? Answer: Identify 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? Answer: Non-diagnostic service
provided on Tuesday through Friday
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
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
what is a recurring or series registration? Answer: One registration
record is created for multiple days of service
,What are nonemergency patients who come for service without prior
notification to the provider called? Answer: Unscheduled patients
Which of the following statement apply to the observation patient type?
Answer: It is used to evaluate the need for an inpatient admission
which services are hospice programs required to provide around the
clock patient Answer: Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what?
Answer: Complete 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? Answer:
Procedure time
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
What is the advantage of a pre-registration program Answer: It
reduces processing times at the time of service
, 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
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.
Which provision protects the patient from medical expenses that exceed
the pre-set level Answer: stop loss
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
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
Which of the following is a step in the discharge process? Answer:
Have a case management service complete the discharge plan
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