HFMA CRCR EXAM/HFMA CRCR EXAM 2024 REAL
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS(100% CORRECT DETAILED ANSWERS)
ALREADY GRADED A+
During pre-registration, a search for the patient's MRI number is initiated using
which of the following data sets: - ANSWER-Patient's full legal name and date of
birth or the patient's Social Security number
To maximize the value derived from customer complaints, all consumer
complaints should be: - ANSWER-Tracked and shared to improve the customer
experience
The Business ethics, or organizational ethics represent: - ANSWER-The principles
and standards by which organizations operate
Providers are advised that it is best to establish patient financial responsibility and
assistance policies and make sure they are followed internally and by: - ANSWER-
Third-party payers
The advantage to using a third-part, collection agency includes all of the following
EXCEPT: - ANSWER-Providers pay pennies on each dollar collected.
,Local Coverage Determination (LCD) and National Coverage Determinations (NCD)
are Medicare established guidelines used to determine: - ANSWER-Which
diagnosis, signs, or symptoms are reimbursable
Claims with the dates of service received later than one calendar year beyond the
date of service will be: - ANSWER-Denied by Medicare
in the pre-service stage, the requested service is screened for medical necessity,
health plan coverage and benefits are verified and: - ANSWER-Pre-authorization
are obtained
For scheduled patients, important revenue cycle activities in the time-of -service
stage DO NOT include: - ANSWER-Final bill is presented for payment
If a medical service authorization, who is typically responsible for obtaining the
authorization: - ANSWER-The provider scheduling
Concurrent review and discharge planning - ANSWER-Occurs during service
The fundamental approach in managing denials is: - ANSWER-To analyze the type
and sources of denials and consider process changes to eliminate further denials
The first thing a health plan does when processing a claim is: - ANSWER-Check if
the patient is a health plan beneficiary and what is the coverage
, Outsourcing options should be evaluated as - ANSWER-Any other business service
purchase
Insurance verification results in which of the following: - ANSWER-The accurate
identification of the patient's eligibility and benefits
EMTLA and HFMA best practices specify that in an Emergency Department setting:
- ANSWER-No patient financial discussions should occur before a patient is
screened and stabilized
Through what document does a hospital establish compliance standards? -
ANSWER-code of conduct
What is the purpose OIG work plant? - ANSWER-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? - ANSWER-Non-diagnostic service provided on Tuesday
through Friday
What does a modifier allow a provider to do? - ANSWER-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 - ANSWER-They must be billed
separately to the part B Carrier
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