Exam (elaborations)
CRCR STUDY QUESTIONS AND ANSWERS graded A+ 2024/2025
- Course
- Institution
CRCR STUDY QUESTIONS AND ANSWERS graded A+ 2024/2025
[Show more]
Content preview
CRCRSTUDY
QUESTIONS
AND
ANSWERS
code
of
conduct
-
ANShospital
establish
compliance
standards
Purpose
of
OIG
work
plan?
-
ANScommunicate
issues
that
will
be
reviewed
during
the
year
for
compliance
with
Medicare
regulations
Medicare
pt.
admitted
on
Friday,
what
services
fall
within
the
three
day
window
rule?
-
ANSDx
services
and
related
charges
provided
on
the
W,R,
and
F
before
adm.
What
does
modifier
allow
a
provider
to
do?
-
ANSReport
a
specific
circumstance
that
affected
a
procedure
or
service
without
changing
the
code
or
its
definition
Out
pt.
dx
services
provided
within
3
days
of
adm.
of
a
medicare
benef.
to
an
IPPS
hospt,
what
must
happen
to
these
charges
-
ANScombined
with
the
in
pt.
bill
and
paid
under
the
MS-DRG
system
Why
is
OIG
pursuing
the
medicare
Secondary
Payer
-
ANSreviews
medicare
payments
for
beneficiaries
who
have
other
insurance
and
assesses
the
effect.
of
procedures
in
preventing
inappro.
medcare
payments
for
benef.
with
other
ins.
coverage
Recurring
or
series
registration?
-
ANSone
reg.
record
is
created
for
multi
days
of
service
Nonemergency
pt.
who
comes
for
service
w/out
prior
notif.
to
the
provider
called?
-
ANSunscheduled
pt.
stmnts
apply
to
observ.
pt.
type
-
ANSused
to
evaluate
the
need
for
an
in
pt.
adm.
which
services
are
hospice
programs
required
to
provide
on
an
around
the
clock
basis
-
ANSphysician,
nursing,
pharmacy
purpose
of
initial
step
in
put
pt.
testing
scheduling
process
-
ANSidentifying
the
correct
pt.
in
the
providers
database
or
add
the
pt.
to
the
database
scheduler
instructions
are
used
to
prompt
the
scheduler
to
do
what?
-
ANScomplete
the
scheduling
process
correctly
based
on
service
requested medicare
guidelines
require
that
when
a
test
is
ordered
for
which
an
LCD
or
NCD
exists,
the
info
provided
on
the
order
must
include
which
of
the
following?
-
ANSdocumentation
of
the
medical
necessity
for
the
test
advantage
of
pre
reg.
program?
-
ANSreduces
processing
times
at
the
time
of
serivce
what
data
are
required
to
est.
a
new
MPI
entry?
-
ANSpts.
name,
DOB,
sex
Which
HIPAA
trans.
set
provides
electronic
processing
of
ins,
verif
requests
and
responses?
-
ANSthe
270-271
set
a
mother
and
father
both
cover
their
16
yo
child
as
a
dep.
on
their
health
ins,
plans,
which
both
follow
the
bday
rule.
mothers
dob
is
1-19-68
and
fathers
dob
is
7-19-67;
whose
plan
is
primary
-
ANSmothers
true
about
third
party
payers?
-
ANSpayments
received
by
the
provider
from
the
payer
respon.
for
reimbursing
the
provider
for
the
pts.
covered
services
co-payment?
-
ANSfixed
amt.
that
is
due
for
a
specific
service
pts
annual
out
of
limitation
is
3000,
excluding
deduct.
to
date
this
cal.
year
the
pt
has
satisfied
the
500
deduct.
and
has
paid
2300
in
co
insurance
to
various
providers.
max
amount
of
coinsurance
the
pt
will
owe
-
ANS700
type
of
plan
that
allows
the
subscriber
to
pay
lower
premium
costs
in
return
for
a
higher
deductible?
-
ANSconsumer
directed
health
plan
characteristic
of
a
managed
care
contracted
methodology
-
ANSprospectively
set
rates
for
in
pt.
and
out
pt.
services
which
provision
protects
the
pt.
from
medical
expenses
that
exceed
a
pre
set
level
-
ANSstop
loss
what
document
must
a
primary
care
phys.
send
to
an
HMO
pt.
to
authorize
a
visit
to
a
specialist
for
add.
testing
or
care?
-
ANSreferral
activities
are
completed
when
a
scheduled,
pre
reg
pt.
arrives
for
service?
-
ANSactivating
the
record,
obtaining
signatures,
and
finalizing
financial
issues
under
EMTALA
reg.,
the
provider
may
not
ask
about
a
pts.
ins.
info
if
it
would
delay
what
-
ANSmedical
screening
and
stabilizing
treatment
collecting
pt
liability
dollars
after
service
leads
to
what
-
ANSincreased
efforts
by
pt
acct
staff
to
resolve
these
balanaces
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 AllLegitExams. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81989 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now