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CRCR Certification 2024/2025 already graded A+
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Overall aggregate payments made to a hospice are subject to a computed "cap amount"calculated by - ANSThe Medicare Administrative Contractor (MAC) at the end of the hospice
cap period
Which of the following is required for participation in Medicaid - ANSMeet Income and Assets
Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost -
ANSRespect the patients privacy
A nightly room charge will be incorrect if the patient's - ANSTransfer from ICU (intensive care
unit) to the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance Exchanges, where
individuals and small businesses can - ANSPurchase qualified health benefit plans regardless
of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes: -
ANSCharitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from
Medicare? - ANSRevenue codes
This directive was developed to promote and ensure healthcare quality and value and also to
protect consumers and workers in the healthcare system. This directive is called - ANSPatient
bill of rights
The activity which results in the accurate recording of patient bed and level of care assessment,
patient transfer and patient discharge status on a real-time basis is known as - ANSCase
management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation?
- ANSRegistration staff may routinely contact managed are plans for prior authorizations before
the patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions
to identify the employer of an individual described in a transaction EIN's are
assigned by - ANSThe Internal Revenue Service
, Checks received through mail, cash received through mail, and lock box are all examples of -
ANSControl points for cash posting
What are some core elements if a board-approved financial assistance policy? - ANSEligibility,
application process, and nonpayment collection activities
A recurring/series registration is characterized by - ANSThe creation of one registration record
for multiple days of service
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of
Medicaid in some states, it is more important than ever for hospitals to - ANSAssist patients in
understanding their insurance coverage and their financial obligation
The purpose of a financial report is to: - ANSPresent financial information to decision makers
Patient financial communications best practices produce communications that are -
ANSConsistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD) and
National Coverage Determinations (NCD) that establish - ANSWhat services or healthcare items
are covered under Medicare
Any provider that has filed a timely cost report may appeal an adverse final decision received
from the Medicare Administrative Contractor (MAC). This appeal may be filed with - ANSThe
Provider Reimbursement Review Board
Concurrent review and discharge planning - ANSOccurs during service
Duplicate payments occur: - ANSWhen providers re-bill claims based on nonpayment from the
initial bill submission
An individual enrolled in Medicare who is dissatisfied with the government's claim determination
is entitled to reconsideration of the decision. This type of appeal is known as - ANSA beneficiary
appeal
Insurance verification results in which of the following - ANSThe accurate identification of the
patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers includes all of
the following levels EXCEPT: - ANSJudicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not
ask about a patient's insurance information if it would delay what? - ANSMedical screening and
stabilizing treatment
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