CRCR Exam Prep, Certified Revenue Cycle Representative - () Correct 100%

What are collection agency fees based on? - ANSWERSA percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - ANSWERSBirthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - ANSWERSCase rates What customer service improvements might improve the patient accounts department? - ANSWERSHolding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - 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? - ANSWERSBad debt adjustment What is the initial hospice benefit? - ANSWERSTwo 90-day periods and an unlimited number of subsequent periods When does a hospital add ambulance charges to the Medicare inpatient claim? - 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? - 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 - ANSWERSThey are not being processed in a timely manner What is an advantage of a preregistration program? - ANSWERSIt reduces processing times at the time of service What are the two statutory exclusions from hospice coverage? - ANSWERSMedically unnecessary services and custodial care What core financial activities are resolved within patient access? - ANSWERSScheduling, insurance verification, discharge processing, and payment of point-of-service receipts What statement applies to the scheduled outpatient? - ANSWERSThe services do not involve an overnight stay How is a mis-posted contractual allowance resolved? - 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? - ANSWERSObservation Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has received what? - 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$? - ANSWERSWhen the patient is the insured What are non-emergency patients who come for service without prior notification to the provider called? - ANSWERSUnscheduled patients If the insurance verification response reports that a subscriber has a single policy, what is the status of the subscriber's spouse? - ANSWERSNeither enrolled not entitled to benefits