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HFMA CRCR EXAM LATEST EXAM 170+ QUESTIONS WITH 100%VERIFIED ANSWERS ALREADY PASSED!!!A+GRADED CA$17.27   Add to cart
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HFMA CRCR EXAM LATEST EXAM 170+ QUESTIONS WITH 100%VERIFIED ANSWERS ALREADY PASSED!!!A+GRADED
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HFMA CRCR EXAM LATEST EXAM 170+ QUESTIONS WITH 100%VERIFIED ANSWERS ALREADY PASSED!!!A+GRADED 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? - ...

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  • August 5, 2024
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  • 2024/2025
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HFMA CRCR EXAM LATEST EXAM 170+ QUESTIONS
WITH 100%VERIFIED ANSWERS ALREADY
PASSED!!!A+GRADED
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




A GRADESOLUTIONS

,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



A GRADESOLUTIONS

,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

Regulations and requirements for coding accountable care organizations, which allows
providers to begin creating these organizations, were finalized in: - correct answer...✔
✔2012

What is a primary responsibility of the Recover Audit Contractor? - correct answer...✔✔
To correctly identify proper payments for Medicare Part A & B claims

How must providers handle credit balances? - correct answer...✔✔Comply with state
statutes concerning reporting credit balance

Insurance verification results in what? - correct answer...✔✔The accurate identification
of the patient's eligibility and benefits

What form is used to bill Medicare for rural health clinics? - correct answer...✔✔CMS
1500

What activities are completed when a scheduled pre-registered patient arrives for
service? - correct answer...✔✔Registering the patient and directing the patient to the
service area


A GRADESOLUTIONS

, In addition to being supported by information found in the patient's chart, a CMS 1500
claim must be coded using what? - correct answer...✔✔HCPCS (Healthcare Common
Procedure Coding system)

What results from a denied claim? - correct answer...✔✔The provider incurs rework
and appeal costs

Why does the financial counselor need pricing for services? - correct answer...✔✔To
calculate the patient's financial responsibility

What type of provider bills third-party payers using CMS 1500 form - correct answer...✔
✔Hospital-based mammography centers

How are disputes with nongovernmental payers resolved? - correct answer...✔✔
Appeal conditions specified in the individual payer's contract

The important message from Medicare provides beneficiaries with information
concerning what? - correct answer...✔✔Right to appeal a discharge decision if the
patient disagrees with the services

Why do managed care plans have agreements with hospitals, physicians, and other
healthcare providers to offer a range of services to plan members? - correct answer...✔
✔To improve access to quality healthcare

If a patient remains an inpatient of an SNF (skilled nursing facility for more than 30
days, what is the SNF permitted to do? - correct answer...✔✔Submit interim bills to the
Medicare program.

90. MSP (Medicare Secondary Payer) rules allow providers to bill Medicare for liability
claims after what happens? - correct answer...✔✔120 days passes, but the claim then
be withdrawn from the liability carrier

What data are required to establish a new MPI entry? - correct answer...✔✔The
patient's full legal name, date of birth, and sex

What should the provider do if both of the patient's insurance plans pay as primary? -
correct answer...✔✔Determine the correct payer and notify the incorrect payer of the
processing error

What do EMTALA regulations require on-call physicians to do? - correct answer...✔✔
Personally appear in the emergency department and attend to the patient within a
reasonable time




A GRADESOLUTIONS

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