CRCR EXAM 154 Questions and Answers 2023,100% CORRECT
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Module
CRCR
Institution
CRCR
CRCR EXAM 154 Questions and Answers 2023
What do Case Managers do? - CORRECT ANSWERSMonitor high resource cases to ensure effective utilization
What is HIM responsible for? - CORRECT ANSWERSall pt medical records: transcribe, coding, release to biling, answer requests for documentation
Wha...
CRCR EXAM 154 Questions and Answers 2023
What do Case Managers do? - CORRECT ANSWERSMonitor high resource cases to
ensure effective utilization
What is HIM responsible for? - CORRECT ANSWERSall pt medical records:
transcribe, coding, release to biling, answer requests for documentation
What is utilization management responsible for? - CORRECT ANSWERSmanage
cases: services correct, on time
What are the three types of utilization review? - CORRECT ANSWERSProspective,
Concurrent, Retrospective
Where can home health services be offered? - CORRECT ANSWERSHome, Assist
Living, neighbors: just not SNF nor Hospital
To receive -Care payments, what must a SNF have when receiving a pt from a
hosp? - CORRECT ANSWERSA transfer agreement approved by -Care.
Can a home health agency employ another agency to provide services? - CORRECT
ANSWERSYes, so long as at least one employee of the original agency provides
care.
What is the Net Collection Rate? - CORRECT ANSWERShow much cash was
collected as a % of available to collect?
What is the Net Collection Rate benchmark? - CORRECT ANSWERS95%
What is the benchmark for denials - CORRECT ANSWERS<2% on first submission
Formual for cost to collect - CORRECT ANSWERStotal PFS expenses/gross pt care
collections
What is the benchmark for cost to collect - CORRECT ANSWERS2.25%
, What % of the UB-04 source of data is from pt access? - CORRECT ANSWERS40%
What % of the UB-04 source of data is from service depts? - CORRECT
ANSWERS11%
What % of the UB-04 source of data is from HIM? - CORRECT ANSWERS20%
What % of the UB-04 source of data is from billing? - CORRECT ANSWERS20%
What % of the UB-04 source of data is not used? - CORRECT ANSWERS9%
What % of the CMS 1500 source of data is from pt access? - CORRECT
ANSWERS53%
What % of the CMS 1500 source of data is from service? - CORRECT ANSWERS14%
What % of the CMS 1500 source of data is from HIM - CORRECT ANSWERS7%
What % of the CMS 1500 source of data is from billing? - CORRECT ANSWERS26%
From whom is the UB-04 directed? - CORRECT ANSWERSinstitutional: hospitals,
SNF, hospice
From whom is the CMS 1500? - CORRECT ANSWERSnon-institutional: physicians,
DME
In the FDCA, what is Title I - CORRECT ANSWERSTruth in Lending Act
What is the Truth in Lending Act - CORRECT ANSWERS5 points must be triggered
(such as interest will be charged), then must disclose APR, total payments, late
payment charges, etc.
What are the penalties for violating the FDCA? - CORRECT ANSWERScreditors can
be sued
Who enforces the FDCA for hospitals? - CORRECT ANSWERSFTC
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