CRCR EXAM 146 Questions with Answers
What are collection agency fees based on? - CORRECT ANSWERSA percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - CORRECT ANSWERSBirthday
In what type of payment methodol...
self funded benefit plans may choose to coordinate benefits using the gender rule or what other rule
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CRCR EXAM 146 Questions with Answers
What are collection agency fees based on? - CORRECT ANSWERSA percentage of
dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule
or what other rule? - CORRECT ANSWERSBirthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? - CORRECT
ANSWERSCase rates
What customer service improvements might improve the patient accounts
department? - CORRECT ANSWERSHolding staff accountable for customer service
during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -
CORRECT ANSWERSInform a Medicare beneficiary that Medicare may not pay for
the order or service
What type of account adjustment results from the patient's unwillingness to pay
for a self-pay balance? - CORRECT ANSWERSBad debt adjustment
What is the initial hospice benefit? - CORRECT ANSWERSTwo 90-day periods and
an unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? -
CORRECT ANSWERSIf the patient requires ambulance transportation to a skilled
nursing facility
How should a provider resolve a late-charge credit posted after an account is
billed? - CORRECT ANSWERSPost a late-charge adjustment to the account
An increase in the dollars aged greater than 90 days from date of service indicate
what about accounts - CORRECT ANSWERSThey are not being processed in a
timely manner
, What is an advantage of a preregistration program? - CORRECT ANSWERSIt
reduces processing times at the time of service
What are the two statutory exclusions from hospice coverage? - CORRECT
ANSWERSMedically unnecessary services and custodial care
What core financial activities are resolved within patient access? - CORRECT
ANSWERSScheduling, insurance verification, discharge processing, and payment
of point-of-service receipts
What statement applies to the scheduled outpatient? - CORRECT ANSWERSThe
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? - CORRECT
ANSWERSComparing the contract reimbursement rates with the contract on the
admittance advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for inpatient
care? - CORRECT ANSWERSObservation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require
that the beneficiary has received what? - CORRECT ANSWERSMedically necessary
inpatient hospital services for at least 3 consecutive days before the skilled
nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? -
CORRECT ANSWERSWhen the patient is the insured
What are non-emergency patients who come for service without prior notification
to the provider called? - CORRECT ANSWERSUnscheduled patients
If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse? - CORRECT ANSWERSNeither
enrolled not entitled to benefits
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