CRCR Certification
Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by - Answer-The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid - Answer-Meet Income...
CRCR Certification
Overall aggregate payments made to a hospice are subject to a computed "cap amount"
calculated by - Answer-The Medicare Administrative Contractor (MAC) at the end of the hospice
cap period
Which of the following is required for participation in Medicaid - Answer-Meet Income and
Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost -
Answer-Respect the patients privacy
A nightly room charge will be incorrect if the patient's - Answer-Transfer 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 - Answer-Purchase qualified health benefit plans
regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes: -
Answer-Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from
Medicare? - Answer-Revenue 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 - Answer-
Patient 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 - Answer-Case
management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act)
violation? - Answer-Registration 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 - Answer-The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all examples of -
Answer-Control points for cash posting
What are some core elements if a board-approved financial assistance policy? - Answer-
Eligibility, application process, and nonpayment collection activities
, A recurring/series registration is characterized by - Answer-The 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 - Answer-Assist patients
in understanding their insurance coverage and their financial obligation
The purpose of a financial report is to: - Answer-Present financial information to decision
makers
Patient financial communications best practices produce communications that are - Answer-
Consistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD) and
National Coverage Determinations (NCD) that establish - Answer-What 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 - Answer-The
Provider Reimbursement Review Board
Concurrent review and discharge planning - Answer-Occurs during service
Duplicate payments occur: - Answer-When 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 - Answer-A
beneficiary appeal
Insurance verification results in which of the following - Answer-The 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: - Answer-Judicial 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? - Answer-Medical
screening and stabilizing treatment
Ambulance services are billed directly to the health plan for - Answer-Services provided before
a patient is admitted and for ambulance rides arranged to pick up the patient from the hospital
after discharge to take him/her home or to another facility
Key performance indicators (KPIs) set standards for accounts receivables (A/R) and - Answer-
Provide a method of measuring the collection and control of A/R
he patient discharge process begins when - Answer-The physician writes the discharge orders
The nightly room charge will be incorrect if the patient's - Answer-Transfer from ICU to the
Medical/Surgical floor is not reflected in the registration system.
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