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CRCR Exam Prep/146 Questions and Answers
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CRCR Exam Prep/146 Questions and Answers
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CRCR Exam Prep/146 Questions and AnswersWhat are collection agency fees based on? - -A percentage of dollars
collected
-Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? - -Birthday
-In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? - -Case rates
-What customer service improvements might improve the patient accounts
department? - -Holding staff accountable for customer service during
performance reviews
-What is an ABN (Advance Beneficiary Notice of Non-coverage) required to
do? - -Inform 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? - -Bad debt adjustment
-What is the initial hospice benefit? - -Two 90-day periods and an unlimited
number of subsequent periods
-When does a hospital add ambulance charges to the Medicare inpatient
claim? - -If 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? - -Post 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 - -They are not being processed in a timely
manner
-What is an advantage of a preregistration program? - -It reduces
processing times at the time of service
-What are the two statutory exclusions from hospice coverage? - -Medically
unnecessary services and custodial care
-What core financial activities are resolved within patient access? - -
Scheduling, insurance verification, discharge processing, and payment of
point-of-service receipts
, -What statement applies to the scheduled outpatient? - -The services do not
involve an overnight stay
-How is a mis-posted contractual allowance resolved? - -Comparing 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? - -Observation
-Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? - -Medically 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$?
- -When the patient is the insured
-What are non-emergency patients who come for service without prior
notification to the provider called? - -Unscheduled patients
-If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? - -Neither enrolled not
entitled to benefits
-Regulation Z of the Consumer Credit Protection Act, also known as the
Truth in Lending Act, establishes what? - -Disclosure rules for consumer
credit sales and consumer loans
-What is a principal diagnosis? - -Primary reason for the patient's admission
-Collecting patient liability dollars after service leads to what? - -Lower
accounts receivable levels
-What is the daily out-of-pocket amount for each lifetime reserve day used?
- -50% of the current deductible amount
-What service provided to a Medicare beneficiary in a rural health clinic
(RHC) is not billable as an RHC services? - -Inpatient care
-What code indicates the disposition of the patient at the conclusion of
service? - -Patient discharge status code
-What are hospitals required to do for Medicare credit balance accounts? - -
They result in lost reimbursement and additional cost to collect
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