Exam (elaborations)
CRCR Unit 1 Review Exam questions with best solutions
- Course
- Institution
CRCR Unit 1 Review Exam
[Show more]
Seller
Follow
SALVADO
Content preview
CRCR Unit 1 ReviewThe 3 patient-centric revenue cycle processing steps - answerPre-service, time-of-
service, post-service
Pre-service steps - answerPatient scheduled and pre-registered, encounter record
generated, patient and guarantor information is obtained, medical necesity-health plan
coverage verified-pre-auth, cost of service determined, additional processing for not
medically necessary procedures, explanation of patients financial responsibility
Time of service steps - answerPatient arrives and pre-registered information is pulled
up. Consents signed and amounts collected. Positive ID completed and armband given.
Post service steps - answerAfter the patient is discharged until the account reaches a
zero balance such as final coding, prep and submission of claims, payment processing
and balance billing
What happens during the post-service stage? - answerFinal coding of all services,
preparation and submission of claims, payment processing and balance billing and
resolution.
What happens during the pre-service segment? - answerScheduling and pre-access
processing is completed. The patient is scheduled, pre-registered for service and the
required data is collected.
What happens during time-of-service segment? - answerFinal account review is
completed for a scheduled patient prior to arrival. Upon arrival, patient is positively
identified, pre-registration record activated, consents are signed, copays collected.
What is done at time-of-service for unscheduled patients? - answerComprehensive
registration and financial processing is completed which mirrors the work that was
completed for scheduled patients.
, 3 components to Healthcare Dollars and Sense Revenue Cycle initiative? -
answerMedical Account Resolution, Pricing Transparency, Patient Financial
Communications
When is it appropriate to discuss financial items for a ED patient? - answerAfter the
patient has been stabilized or during the discharge process. As long as it does not
interfere with the patients care.
What is the objective of the HCAHPS initiative? - answerTo provide a standardized
method for evaluating patients' perspective on hospital care.
Examples of a continuum of care provider? - answerSkilled Nursing Facility, Physician,
Hospice
What are types of OIG compliance issues published? - answerMedical devices, provider
based status, reconciliation of outlier payments
3 goals of HIPAA - answerExpand health coverage by improving portability, give
patients access to health files and the right to request amendments or make
corrections, facilitate the electronic exchange of medical information.
CMS developed in order to promote the use of correct coding methods on a national
basis. - answerCorrect Coding Initiative (CCI)
Three-Day DRG Window Rule - answerRequires certain outpatient services that are
provided within three days of the admit date to be billed as part of an inpatient stay.
Purpose of the ABN - answerTo inform Medicare beneficiary what Medicare will not pay
for.
4 situations where Medicare acts as secondary payer - answerWorking Aged, Accident
or other liability, disability, End stage renal disease (ESRD)
What is the intended outcome of collaborations made through an ACO delivery system?
- answerTo ensure appropriateness of care, elimination of duplicate services, and
prevention of medical errors for a population of patients.
3 types of reserve amounts on a providers financial statement - answerBad Debt,
contractual allowance accounts, charity care
4 reasons why ACA was passed and signed into law - answerImprove the quality of
care, reform the healthcare delivery system, encourage pricing transparency and
modernized financing systems, address the issue of waste, fraud, and abuse.
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 SALVADO. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
63613 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now