HFMA CRCR EXAM 172 Questions with Answers
2024,100% CORRECT
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
, HFMA CRCR EXAM 172 Questions with Answers
2024,100% CORRECT
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.
, HFMA CRCR EXAM 172 Questions with Answers
2024,100% CORRECT
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
The hospital has a APC based contract for the payment of outpatient
services. Total anticipated charges for the visit are $2,380. The approved
APC payment rate is $780. Where will the patients benefit package be
applied? - ANSWER--To the approved APC payment rate
A patient has met the $200 individual deductible and $900 of the $1000 co-
insurance responsibility. The co-insurance rate is 20%. The estimated
insurance plan responsibility is $1975.00. What amount of coinsurance is
due from the patient? - ANSWER--$100.00
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller erickarimi. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
