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Certified Revenue Cycle Representative - CRCR (2024) Exam with complete solutions
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Certified Revenue Cycle Representative- CRCR (2024) Exam with complete
solutions
Which |of |the |following |statements |are |true |of |HFMA's |Financial |Communications |Best |Practices |- |
correct |answer |-The |best |practices |were |developed |specifically |to |help |patients |understand |the |
cost |of |services, |their |individual |insurance |benefits, |and |their |responsibility |for |balances |after |
insurance, |if |any.
The |patient |experience |includes |all |of |the |following |except: |- |correct |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: |- |correct |
answer |-All |of |the |above
Specific |to |Medicare |fee-for-service |patients, |which |of |the |following |payers |have |always |been |
liable |for |payment? |- |correct |answer |-Public |health |service |programs, |Federal |grant |programs, |
veteran |affairs |programs, |black |lung |program |services |and |work-related |injuries |and |accidents |
(worker' |compensation |claims)
Provider |policies |and |procedures |should |be |in |place |to |reduce |the |risk |of |ethics |violations. |
Examples |of |ethics |violations |include: |- |correct |answer |-All |of |the |above
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? |- |correct |answer |-To |eliminate |duplicate |services, |prevent |medical |errors |
and |ensure |appropriateness |of |care.
,Historically, |revenue |cycle |has |delt |with |contractual |adjustments, |bad |debt |and |charity |deductions |
from |gross |revenue. |Although |deductions |continue |to |exist, |the |definition |of |net |revenue |has |
been |modified |through |the |implementation |of |ASC |606. |Developed |by |the |Financial |Accounting |
Standards |Board |(FASB), |this |change |became |effective |in |2018.
What |is |the |new |terminology |now |employed |in |the |calculation |of |net |patient |services |revenues? |-
|correct |answer |-Explicit |prices |concessions |and |implicit |price |concessions
Key |performance |indicators |set |standards |for |A/R |and |provide |a |method |for |measuring |the |control
|and |collection |of |A/R.
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)? |- |correct |answer |-Elapsed |days |from |
discharge |to |final |bill |and |elapsed |days |from |final |bill |to |claim/bill |submission.
Consents |are |signed |as |part |of |the |post-services |process. |- |correct |answer |-True
**False
Patient |service |costs |are |calculated |in |the |pre-service |process |for |schedule |patients |- |correct |
answer |-**True
False
The |patient |is |scheduled |and |registered |for |service |is |a |time-of-service |activity |- |correct |answer |-
True
**False
The |patient |account |is |monitored |for |payment |is |a |time-of-service |activity |- |correct |answer |-True
**False
Case |management |and |discharge |planning |services |are |a |post-service |activty |- |correct |answer |-
True
**False
, Sending |the |bill |electronically |to |the |health |plan |is |a |time-of-service |activity |- |correct |answer |-True
**False
What |happens |during |the |post-service |stage? |- |correct |answer |-**A. |Final |coding |of |all |services, |
preparation |and |submission |of |claims, |payment |processing |and |balance |billing |and |resolution.
B. |Orders |are |entered, |results |are |reported, |charges |are |generated, |and |diagnostic |and |procedural
|coding |is |initiated.
C. |The |encounter |record |is |generated, |and |the |patient |and |guarantor |information |is |obtained |
and/or |updated |as |required.
D. |The |focus |is |on |the |patient |and |his/her |financial |care, |in |addition |to |the |clinical |care |provided |
for |the |patient.
The |following |statements |describe |best |practices |established |by |the |Medical |Debt |Task |Force. |
Check |the |box |next |to |the |True |statements |- |correct |answer |-**Educate |Patients
**Coordinate |to |avoid |duplicate |patient |contacts
Exercise |moderate |judgement |when |communicating |with |providers |about |scheduled |services
**Be |consistent |in |key |aspects |of |account |resolution
Report |to |healthcare |plans |when |the |patient's |account |is |transferred |to |collection |agency
**Follow |best |practices |for |communication
Which |option |is |NOT |a |main |HFMA |Healthcare |Dollars |& |Sense® |revenue |cycle |initiative? |- |correct
|answer |-A. |Patient |Financial |Communications
B. |Price |Transparency
C. |Medical |Account |Resolution
**D. |Process |Compliance
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