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Exam (elaborations)

HFMA CRCR; Q’s & A’s

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  • Certified Revenue Cycle Representative - CRCR
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  • Certified Revenue Cycle Representative - CRCR

HFMA CRCR; Q’s & A’s Through what document does a hospital establish compliance standards? code of conduct What is the purpose OIG work plant? Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the ...

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  • August 25, 2024
  • 37
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Certified Revenue Cycle Representative - CRCR
  • Certified Revenue Cycle Representative - CRCR
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HFMA CRCR; Q’s & A’s
Through what document does a hospital establish compliance standards?

✔✔code of conduct


What is the purpose OIG work plant? ✔✔Identify Acceptable compliance

programs in various


provider setting


If a Medicare patient is admitted on Friday, what services fall within the three-

day DRG window


rule? ✔✔Non-diagnostic service provided on Tuesday through Friday


What does a modifier allow a provider to do? ✔✔Report a specific circumstance

that affected a


procedure or service without changing the code or its definition


IF outpatient diagnostic services are provided within three days of the admission

of a Medicare


beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what

must happen to


these charges ✔✔They must be billed separately to the part B Carrier

, HFMA CRCR; Q’s & A’s
what is a recurring or series registration? ✔✔One registration record is created

for multiple days


of service


What are nonemergency patients who come for service without prior

notification to the provider


called? ✔✔Unscheduled patients


Which of the following statement apply to the observation patient type? ✔✔It is

used to evaluate


the need for an inpatient admission


which services are hospice programs required to provide around the clock

patient ✔✔Physician,


Nursing, Pharmacy


Scheduler instructions are used to prompt the scheduler to do what?

✔✔Complete the scheduling


process correctly based on service requeste

, HFMA CRCR; Q’s & A’s
The Time needed to prepare the patient before service is the difference between

the patients


arrival time and which of the following? ✔✔Procedure time


Medicare guidelines require that when a test is ordered for a LCD or NCD exists,

the information


provided on the order must include: ✔✔Documentation of the medical

necessity for the test


What is the advantage of a pre-registration program ✔✔It reduces processing

times at the time of

service


What date are required to establish a new MPI(Master patient Index) entry

✔✔The responsible


party's full legal name, date of birth, and social security number


Which of the following statements is true about third-party payments? ✔✔The

payments are

, HFMA CRCR; Q’s & A’s
received by the provider from the payer responsible for reimbursing the

provider for the patient's


covered services.


Which provision protects the patient from medical expenses that exceed the

pre-set level ✔✔stop


loss


what documentation must a primary care physician send to HMO patient to

authorize a visit to a


specialist for additional testing or care? ✔✔Referral


Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the

provider may


not ask about a patient's insurance information if it would delay what?

✔✔Medical screening and


stabilizing treatment


Which of the following is a step in the discharge process? ✔✔Have a case

management service

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