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Exam (elaborations)

CRCR Exam Prep WITH SOLVED QUESTIONS

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Exam of 11 pages for the course crcr at crcr (CRCR Exam Prep)

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  • April 8, 2024
  • 11
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
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CRCR Exam Prep




What are collection agency fees based on? - answerA percentage of dollars collected

Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule? - answerBirthday

In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers? - answerCase rates

What customer service improvements might improve the patient accounts department?
- answerHolding staff accountable for customer service during performance reviews

What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -
answerInform 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? - answerBad debt adjustment

What is the initial hospice benefit? - answerTwo 90-day periods and an unlimited
number of subsequent periods

When does a hospital add ambulance charges to the Medicare inpatient claim? -
answerIf 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? -
answerPost 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 - answerThey are not being processed in a timely manner

What is an advantage of a preregistration program? - answerIt reduces processing
times at the time of service

, What are the two statutory exclusions from hospice coverage? - answerMedically
unnecessary services and custodial care

What core financial activities are resolved within patient access? - answerScheduling,
insurance verification, discharge processing, and payment of point-of-service receipts

What statement applies to the scheduled outpatient? - answerThe services do not
involve an overnight stay

How is a mis-posted contractual allowance resolved? - answerComparing 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? -
answerObservation

Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what? - answerMedically 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$? -
answerWhen the patient is the insured

What are non-emergency patients who come for service without prior notification to the
provider called? - answerUnscheduled patients

If the insurance verification response reports that a subscriber has a single policy, what
is the status of the subscriber's spouse? - answerNeither enrolled not entitled to benefits

Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending
Act, establishes what? - answerDisclosure rules for consumer credit sales and
consumer loans

What is a principal diagnosis? - answerPrimary reason for the patient's admission

Collecting patient liability dollars after service leads to what? - answerLower accounts
receivable levels

What is the daily out-of-pocket amount for each lifetime reserve day used? -
answer50% 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? - answerInpatient care

What code indicates the disposition of the patient at the conclusion of service? -
answerPatient discharge status code

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