Exam (elaborations)
Certified Revenue Cycle Representative - CRCR (2021)
Certified Revenue Cycle Representative - CRCR (2021)
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Certified Revenue Cycle Representative -CRCR (2021)
Which of the following statements are true of HFMA's Financial
Communications Best Practices - -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: - -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: - -All of the above
-Specific to Medicare fee-for-service patients, which of the following payers
have always been liable for payment? - -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: - -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? - -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? - -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)? - -
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. - -True
**False
-Patient service costs are calculated in the pre-service process for schedule
patients - -**True
False
-The patient is scheduled and registered for service is a time-of-service
activity - -True
**False
-The patient account is monitored for payment is a time-of-service activity -
-True
**False
-Case management and discharge planning services are a post-service
activty - -True
**False
-Sending the bill electronically to the health plan is a time-of-service activity
- -True
**False
-What happens during the post-service stage? - -**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 - -**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? - -A. Patient Financial Communications
B. Price Transparency
C. Medical Account Resolution
**D. Process Compliance
-What is the objective of the HCAHPS initiative? - -**A. To provide a
standardized method for evaluating patients' perspective on hospital care.
B. To provide clear communication and good customer service, which will
give the provider a competitive edge.
C. To conduct evaluations concerning patients' perspective on hospital care.
D. To make certain that during registration key information is verified by
means of a picture ID and an insurance card.
-Which option is NOT a department that supports and collaborates with the
revenue cycle? - -A. Information Technology
B. Clinical Services
C. Finance
**D. Assisted Living Services
-Which option is NOT a continuum of care provider? - -A. Physician
**B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
-Which of the following are essential elements of an effective compliance
program? - -**Reasonable methods to achieve compliance with standards,
including monitoring systems and hotlines
**Established compliance standards and procedures
Automatic dismissal of any employee excluded from participation in a federal
healthcare program
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