Exam (elaborations)
HFMA CRCR EXAM WITH OVER 300 QUESTIONS AND ANSWERS (VERIFIED ANSWERS) LATEST EXAM RATIONALE
- Course
- Institution
HFMA CRCR EXAM WITH OVER 300 QUESTIONS AND ANSWERS (VERIFIED ANSWERS) LATEST EXAM RATIONALE
[Show more]
Content preview
HFMA CRCR EXAM WITH OVER 300 QUESTIONS AND ANSWERS(VERIFIED ANSWERS) LATEST EXAM RATIONALE
What are collection agency fees based on? - CORRECT ANSWER A percentage
of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule
or what other rule? - CORRECT ANSWER Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? - CORRECT ANSWER
Case rates
What customer service improvements might improve the patient accounts
department? - CORRECT ANSWER Holding staff accountable for customer
service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -
CORRECT ANSWER Inform a Medicare beneficiary that Medicare may not pay
for the order or service
What type of account adjustment results from the patient's unwillingness to pay for
a self-pay balance? - CORRECT ANSWER Bad debt adjustment
What is the initial hospice benefit? - CORRECT ANSWER Two 90-day periods
and an unlimited number of subsequent periods
,When does a hospital add ambulance charges to the Medicare inpatient claim? -
CORRECT ANSWER If the patient requires ambulance transportation to a skilled
nursing facility
How should a provider resolve a late-charge credit posted after an account is
billed? - CORRECT ANSWER Post a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service indicate
what about accounts - CORRECT ANSWER They are not being processed in a
timely manner
What is an advantage of a preregistration program? - CORRECT ANSWER It
reduces processing times at the time of service
What are the two statutory exclusions from hospice coverage? - CORRECT
ANSWER Medically unnecessary services and custodial care
What core financial activities are resolved within patient access? - CORRECT
ANSWER Scheduling, insurance verification, discharge processing, and payment
of point-of-service receipts
What statement applies to the scheduled outpatient? - CORRECT ANSWER The
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? - CORRECT ANSWER
Comparing the contract reimbursement rates with the contract on the admittance
advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for inpatient care?
- CORRECT ANSWER Observation
,Coverage rules for Medicare beneficiaries receiving skilled nursing care require
that the beneficiary has received what? - CORRECT ANSWER Medically
necessary inpatient hospital services for at least 3 consecutive days before the
skilled nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? -
CORRECT ANSWER When the patient is the insured
What are non-emergency patients who come for service without prior notification
to the provider called? - CORRECT ANSWER Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse? - CORRECT ANSWER Neither
enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what? - CORRECT ANSWER Disclosure rules for
consumer credit sales and consumer loans
What is a principal diagnosis? - CORRECT ANSWER Primary reason for the
patient's admission
Collecting patient liability dollars after service leads to what? - CORRECT
ANSWER Lower accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? -
CORRECT ANSWER 50% of the current deductible amount
, What service provided to a Medicare beneficiary in a rural health clinic (RHC) is
not billable as an RHC services? - CORRECT ANSWER Inpatient care
What code indicates the disposition of the patient at the conclusion of service? -
CORRECT ANSWER Patient discharge status code
What are hospitals required to do for Medicare credit balance accounts? -
CORRECT ANSWER They result in lost reimbursement and additional cost to
collect
When an undue delay of payment results from a dispute between the patient and
the third party payer, who is responsible for payment? - CORRECT ANSWER
Patient
Medicare guidelines require that when a test is ordered for a LCD or NCD exists,
the information provided on the order must include: - CORRECT ANSWER A
valid CPT or HCPCS code
With advances in internet security and encryption, revenue-cycle processes are
expanding to allow patients to do what? - CORRECT ANSWER Access their
information and perform functions on-line
What date is required on all CMS 1500 claim forms? - CORRECT ANSWER
onset date of current illness
What does scheduling allow provider staff to do - CORRECT ANSWER Review
appropriateness of the service request
What code is used to report the provider's most common semiprivate room rate? -
CORRECT ANSWER Condition code
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller tutorWADE. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $22.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79373 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now
