HFMA CRCR Certified Revenue Cycle Representative Exam Bundle

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

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

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. ...

Net Days in AR - Measures how fast receivables are collected. It is a trending indicator of overall A/R performance & revenue cycle efficiency. A/R Aging - Reports divide the AR into 30, 60, 90, and 120 day categories, based on discharge. Credit Balances - Days Outstanding - The dolla...

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

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...

Important revenue cycle activities in the pre-service stage include; - Obtaining or updating patient and guarantor information In the pre-service stage, the cost of the scheduled service is identified and the patient's health plan and benefits are used to calculate; - The amount the patien...

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

Which of the following statements are true of HFMA's Patient 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 ...

Credit balances may be created by any of the following activities except: (Pre-Test 4) Credits to pharmacy charges posted before the claim final bills. 3 MULTIPLE CHOICE OPTIONS Which of the following statements represent common reasons for inpatient claim denials? (Pre-Test 4) Fai...

Under Title III of the Americans with Disabilities Act, hospitals are required to do what? (paf, customer experience) - Provide resources to eliminate barriers in communication. What is important when initiating a patient satisfaction survey? (paf, customer experience) - What data measures...

Types of Unscheduled Patients - Urgent (ED) patients, Walk-in OP, Observation patients, and newborns. Resource Coordination - The process of reserving rooms and/or equipment, ordering devices or supplies, and ensuring that professional staff (physicians, nurses, and/or technicians) are avai...

Which option is NOT a main HFMA Healthcare Dollars and Sense revenue cycle initiative? A) Patient Financial Communications B) Medical Account Resolution C) Price Transparency D) Process Compliance - D) Process Compliance Approximately what ______% of billing information is obtained during ...

Consents are signed as part of the post service process. (True or Flase) - False Patient service costs are calculated in the pre-service process for scheduled patients.(True or False) - True The patient is scheduled and registered for service is a time of service activity (True or False)...