CRCR Exam 2023 With 100% Correct Answers

CRCR Exam 2023 Patient Centric Revenue Cycle - Correct answer-This includes all the major processing steps required to process a pt account from the request for service through closing the account with a zero balance and purging it from the system pre-service - Correct answer-this is the period in which scheduling and pre-access takes place, including different steps that will be completed pre-service - Correct answer-what is it when the requested service is screened for medical necessity, health plan coverage & benefits are verified, and pre-auth is obtained scheduled patient- Time of Service - Correct answer-what is it when a final account review is completed prior to the patient's arrival? (Pre-reg record is activated, consents are signed, and co-payments and other amounts are collected) express arrival - Correct answer-pre-processed patient's can report to this, which is a desk located in a centralized access, upon their arrival. post-service - Correct answer-this includes account activities that occur after the patient is d/c until the account reaches a zero balance post-service - Correct answer-Final coding of all services, perparation and submission of claims, payment processing and balance billing are all included and finalized when? Patient Financial Communications Best Practices - Correct answer-This brings consistency, clarity, and transparency to patient financial communications Patient Financial Communications Best Practices - Correct answer-this outlines steps to help patient's understand the cost of services they receive, their insurance coverage, and their individual responsibility (review Patient Financial Comm. Best Practice document) true - Correct answer-true or false: Conversations should occur in a location and manner that are sensitive to the patient's needs timely discussions - Correct answer-this type of discussion will help ensure that patient's understand their financial obligation and that providers are aware of the patient's ability to pay guarantor - Correct answer-the person responsible for payment of the bill true - Correct answer-true or false: A financial counselor or supervisor should be involved for complex situations such as uninsured or underinsured patient's false; NO patient financial discussions should occur before a patient is screened and stabilized - Correct answer-true or false: You MUST obtain basic registration info and insurance coverage before the patient is cared for in the ED. true - Correct answer-true or false: When the provider takes the initiative to communicate financial matters with the patient, it actually take a burden off the patient. false; Technology evaluation may be performed by ANY qualified individual or organization, internal or external - Correct answer-true or false: Technology evaluation can ONLY be done by a qualified individual, internal to the facililty HFMA's Adopter Program - Correct answer-this program is a recognition for providers who implement and support the best practices are eligible and encouraged to apply Code of Conduct - Correct answer-Through what document does a hospital est. compliance standards? Identify acceptable compliance programs in various provider setting - Correct answer- what is the purpose OIG work plan? non-diagnostic services provided on Tuesday through Friday - Correct answer-If a Medicare pt is admitted on Friday, what services fall within the 3-day DRG window rule? reports a specific circumstance that affects a procedure or service without changing the code or its definition. - Correct answer-What does a modifier allow a provider to do? they must be billed separately to the Part B carrier - Correct answer-if OP diagnostic services are provided within 3 day of admission of a medicare beneficiary to an IPPS (Inpatient Prospective Payment system) hospital, what must happen? One registration record is created for multiple days of service - Correct answer-What is recurring or series registration? unscheduled patients - Correct answer-what are non-emergency pt who come for service w/o prior notification to the provider called? used to evaluate the need for an IP admission - Correct answer-Which of the following statements apply to the Obs patient type? physician, nursing, and pharmacy - Correct answer-which services are hospice programs required to provide on a around-the-clock patient?q complete the scheduling process correctly based on service requested - Correct answer-Scheduler instructions are used to prompt the scheduler to do what? procedure time - Correct answer-This is the time needed to prepare the patient before services is the difference between the patients arrival time? Documentation of the medical necessity for the test - Correct answer-Medicare guidelines require that when a test is ordered for which an LCD (local cover determination) or NCD (national coverage determination) exists, the info on the order must include what? it reduces processing times at the time of service - Correct answer-what is an advantage of a pre-registration program? the responsible party's full legal name, DOB, and SSN - Correct answer-what data is required to est. a new MPI (Master patient index) entry? parents are received by the provider from the payer responsible for reimbursing the provider for the pt covered services - Correct answer-which of the following statements is true about third-party payments? stop loss - Correct answer-which provision protects the patient from medical expenses that exceed pre-set level? referral - Correct answer-What is it called when a PCP send an HMO (health maintenance organization) pt to authorize a visit to a specialist for additional testing or care? Medical screening and stabilizing - Correct answer-under the EMTALA (emergency medical treatment and labor act) regulations, the provider may not ask the patient about their ins info if it would delay what?