Certified Revenue Cycle Representative

What are collection agency fees based on? correct answers A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? correct answers Birthday In what type of payment methodology is a lump sum or bundled payment negoti...

Patient Centric Revenue Cycle correct answers This includes all the major processing steps required to process a pt account from the request for service through closing the account with a zero balance and purging it from the system pre-service correct answers this is the period in which schedulin...

Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by correct answers The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid correct answers Meet Income and As...

What do Case Managers do? correct answers Monitor high resource cases to ensure effective utilization What is HIM responsible for? correct answers all pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? co...

Which of the following statements are true of HFMA's Patient Financial Communications Best Practices? correct answers The best practices were developed specifically to help patients understand the cost of services, their individual insurance benefits, and their responsibility for balances after ins...

835 Record correct answers A standard electronic message between a health plan and provider sending remittance data on a claim to the provider. 837 Record correct answers A standard electronic message between a provider and health plan sending data on a claim to the health plan. AAR correct an...

code of conduct correct answers hospital establish compliance standards Purpose of OIG work plan? correct answers communicate issues that will be reviewed during the year for compliance with Medicare regulations Medicare pt. admitted on Friday, what services fall within the three day window ru...

The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of the following activities? A. Complete a community needs assessment and develop a discount program for patient balances after insurance payment. B. Pursue extraordinary collection activities with all patients eligible...

Which of the following statements are true of HFMA's Financial Communications Best Practices correct answers 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, i...

Through what document does a hospital establish compliance standards? correct answers code of conduct What is the purpose OIG work plant? correct answers Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within t...

What happens during the post service stage? correct answers Final coding of all services, preparation and submission of claims, payment processing and balance billing resolution. Acc correct answers Ambulatory care center AAR correct answers After hours activity report 837 record correct an...

Time-of-Service collection steps (The Program) correct answers 1. Begin interview with a simple greeting to the patient. 2. Provide your name and explain why you are meeting at this time. 3. Treat the patient with respect and dignity trying to develop a rapport. 4. Inquire if the timing of the vi...

The liens types correct answers agreement, judicial process, statue The third party payer follow up and account resolution activities include correct answers electronic work list after untimely non payments, comparison of actual and expected reimbursement, adjustment posts, submitting secondary c...