CRCR exam 2023 with 100% correct answers

What do Case Managers do? Monitor high resource cases to ensure effective utilization What is HIM responsible for? all pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? manage cases: services correct, on time What are the three types of utilization review? Prospective, Concurrent, Retrospective Where can home health services be offered? Home, Assist Living, neighbors: just not SNF nor Hospital To receive -Care payments, what must a SNF have when receiving a pt from a hosp? A transfer agreement approved by -Care. Can a home health agency employ another agency to provide services? Yes, so long as at least one employee of the original agency provides care. What is the Net Collection Rate? how much cash was collected as a % of available to collect? What is the Net Collection Rate benchmark? 95% What is the benchmark for denials 2% on first submission Formual for cost to collect total PFS expenses/gross pt care collections What is the benchmark for cost to collect 2.25% What % of the UB-04 source of data is from pt access? 40% What % of the UB-04 source of data is from service depts? 11% What % of the UB-04 source of data is from HIM? 20% What % of the UB-04 source of data is from billing? 20% What % of the UB-04 source of data is not used? 9% What % of the CMS 1500 source of data is from pt access? 53% What % of the CMS 1500 source of data is from service? 14% What % of the CMS 1500 source of data is from HIM 7%