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Exam (elaborations)

CRCR study guide

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Exam of 1 pages for the course Certified Revenue Cycle Representative at Certified Revenue Cycle Representative (CRCR study guide)

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  • June 24, 2024
  • 1
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
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CRCR study guide

Through which document does a hospital establish compliance standards ? - ANS-Code
of conduct

What is the purpose of the OIG work plan - ANS-Identify acceptable compliance
programs in various provider settings.

If a Medicare patient is admitted on Friday what services fall within the three day DRG
window rule? - ANS-Diagnostic and clinically related non diagnostic charges provided
on the Tuesday, Wednesday, Thursday and Friday before admission.

What does a modifier allow a provider to do? - ANS-Report a specific circumstance that
affected a procedure or service without changing the code or it's definition.

If outpatient diagnostic services are provided within three days of the admission of a
Medicare beneficiary to an IPPS hospital, what must happen to these charges ? -
ANS-They must be combined with the inpatient bill paid under the MS-DRG system

Why is the OIG pursuing the Medicare secondary payer initiative? - ANS-It reviews
Medicare payments for beneficiaries who have other insurance and assessed the
effectiveness of procedures in preventing inappropriate Medicare payments for
beneficiaries with other insurance coverage.

What is a reoccurring or series registration? - ANS-One registration record is created for
multiple days of service

What are nonemergency patients who come for service without prior notification to the
provider called ? - ANS-Unscheduled patients

Which of the following statements apply to the observation patient type ? - ANS-It is
used to evaluate the need for an inpatient admission

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