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CRCR FINAL EXAM AND PRACTICE EXAM NEWEST 2024 REAL EXAM CMPLETE EXAM 280 QUESTIONS AND 100% CORRECT ANSWERS| AREADY GRADED A+|| BRAD NEW!!!$29.99
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CRCR FINAL EXAM AND PRACTICE EXAM NEWEST
2024 REAL EXAM CMPLETE EXAM 280 QUESTIONS
AND 100% CORRECT ANSWERS| AREADY GRADED
A+|| BRAD NEW!!!
Which of the following statements are true of HFMA's Patient Financial
Communications Best Practices? ✔✔✔✔✔✔ANSWER➖The best practices were
developed specifically to help patients understand the cost of services, their
individual insurance benefits and their responsibility for balance after insurance if
any
The patient experience includes all of the following except:
✔✔✔✔✔✔ANSWER➖The average number of positive mentions received by the
health system or practice and the public comments refuting unfriendly posts on
social media sites
Corporate compliance programs play an important role in protecting the integrity
of operations and ensuring compliance with federal and state requirements. The
Code of Conduct is: ✔✔✔✔✔✔ANSWER➖A critical tool to ensure the
compliance with the organization's compliance standards and procedures, an
essential and integral component of the organization's culture, fosters and
environment where concerns and questions may be raised without fear of
retaliation or retribution
Specific to Medicare fee-for-service patients, which of the following payers have
always been liable for payment? ✔✔✔✔✔✔ANSWER➖Public health service
,programs, federal grant programs, VA programs, black lung program services and
workers comp claims
Provider policies and procedures should be in plan to reduce the risk of ethics
violations. Examples of ethics violations are: ✔✔✔✔✔✔ANSWER➖Financial
misconduct, overcharging and miscoding claims, theft of property and falsifying
records to boost reimbursement, financial misconduct and applying policies in an
inconsistent manner
Providers are now being reimbursed with a focus on the value of the services
provided, rather than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery
system for a population of patients? ✔✔✔✔✔✔ANSWER➖To eliminate
duplicate services, prevent medical errors and ensure appropriateness of care
What is the new terminology now employed in the calculation of net patient
service revenues? ✔✔✔✔✔✔ANSWER➖Explicit price concessions and implicit
price concessions
What are the two KPIs used to monitor performance related to the production and
submission of claims to third party payers and patients (self-pay)?
✔✔✔✔✔✔ANSWER➖Elapsed days from discharge to final bill and elapsed days
from final bill to claim/bill submission
What are the three traditional steps of the Revenue Cycle?
✔✔✔✔✔✔ANSWER➖Pre-service, time-of-service and post-service
,What are the steps during pre-service? ✔✔✔✔✔✔ANSWER➖1. The patient is
scheduled and pre-registered for service
2. The encounter record is generated and the patient/guarantor information is
obtained or updated
3. The requested service is screened for med necessity; insurance is verified and
pre-auths obtained
4. The cost is identified and insurance benefits are used to calculate the price of the
services to the patient
5. If the service is deemed not med necessary additional processing is done
6. The patient is notified of their financial responsibility including
copay/deductible and their eligibility for financial assistance is assessed
What happens for scheduled patients at the time of service?
✔✔✔✔✔✔ANSWER➖1. Pre-registration record is activated, consents are signed
and copays/balances are collected
2. Positive patient identification is completed and an armband is given
3. Alternatively, scheduled patients can report to an express arrival desk
What happens for unscheduled patients at the time of service?
✔✔✔✔✔✔ANSWER➖Comprehensive registration and financial processing is
completed at the time-of-service. The process mirrors the work that was completed
for scheduled patients prior to service
What are the nine steps of time-of-service processing for unscheduled patients?
✔✔✔✔✔✔ANSWER➖1. Creation of the registration record
2. Order review to ensure compliance with the rules for what makes a complete
order
, 3. Validation of the health plan and identification of any amount the patient is
currently due
4. Completion of med necessity screening, if necessary
5. Review and completion of pre-cert requirements for the order
6. Identification of all charges related to the order and applied insurance benefits to
calculate amount due
7. If a balance is due, financial conversation occurs
8. If all is well, patient gets service
9. Charges are entered as services are rendered
What is the overview for the three steps of the revenue cycle?
✔✔✔✔✔✔ANSWER➖1. Pre-service: the patient is scheduled and registered for
service; patient service costs are calculated
2. Time-of-service: case management and discharge planning services are
provided; consents are signed
3. Post-service: Bill sent electronically to health plan, patient account is monitored
for payment
What are the goals of the engaged consumer portion of the rev cycle?
✔✔✔✔✔✔ANSWER➖Ease of access, improved customer service and improved
quality of care
What are the goals of the engaged patient portion of the rev cycle?
✔✔✔✔✔✔ANSWER➖Improve the information and choices for the patient
regarding care and financial decisions
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