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Exam (elaborations)

CRCR Exam; Questions with Complete Solutions (Latest Update)

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  • Course
  • Certified Revenue Cycle Representative - CRCR
  • Institution
  • Certified Revenue Cycle Representative - CRCR

CRCR Exam; Questions with Complete Solutions (Latest Update) What do Case Managers do? Monitor high resource cases to ensure effective utilization What is HIM responsible for? all pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utili...

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  • August 25, 2024
  • 27
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Certified Revenue Cycle Representative - CRCR
  • Certified Revenue Cycle Representative - CRCR
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CRCR Exam; Questions with Complete
Solutions (Latest Update)
What do Case Managers do? ✔✔ Monitor high resource cases to ensure

effective


utilization


What is HIM responsible for? ✔✔ all pt medical records: transcribe, coding,

release to

biling, answer requests for documentation


What is utilization management responsible for? ✔✔ manage cases: services

correct,


on time


What are the three types of utilization review? ✔✔ Prospective, Concurrent,


Retrospective


Where can home health services be offered? ✔✔ Home, Assist Living, neighbors:

just


not SNF nor Hospital

, CRCR Exam; Questions with Complete
Solutions (Latest Update)
To receive -Care payments, what must a SNF have when receiving a pt from a

hosp?


✔✔ A transfer agreement approved by -Care.


Can a home health agency employ another agency to provide services? ✔✔ Yes,

so

long as at least one employee of the original agency provides care.


What is the Net Collection Rate? ✔✔ how much cash was collected as a % of

available


to collect?


What is the Net Collection Rate benchmark? ✔✔ 95%


What is the benchmark for denials ✔✔ <2% on first submission


Formual for cost to collect ✔✔ total PFS expenses/gross pt care collections


What is the benchmark for cost to collect ✔✔ 2.25%


What % of the UB-04 source of data is from pt access? ✔✔ 40%

, CRCR Exam; Questions with Complete
Solutions (Latest Update)
What % of the UB-04 source of data is from service depts? ✔✔ 11%


What % of the UB-04 source of data is from HIM? ✔✔ 20%


What % of the UB-04 source of data is from billing? ✔✔ 20%


What % of the UB-04 source of data is not used? ✔✔ 9%


What % of the CMS 1500 source of data is from pt access? ✔✔ 53%


What % of the CMS 1500 source of data is from service? ✔✔ 14%


What % of the CMS 1500 source of data is from HIM ✔✔ 7%


What % of the CMS 1500 source of data is from billing? ✔✔ 26%


From whom is the UB-04 directed? ✔✔ institutional: hospitals, SNF, hospice


From whom is the CMS 1500? ✔✔ non-institutional: physicians, DME


In the FDCA, what is Title I ✔✔ Truth in Lending Act


What is the Truth in Lending Act ✔✔ 5 points must be triggered (such as interest

will be


charged), then must disclose APR, total payments, late payment charges, etc.

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