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HFMA CRCR Test Questions and 100% Correct Answers/ HFMA CRCR Test Question Updated
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HFMA CRCR Test Questions and 100% Correct Answers/ HFMA CRCR Test Question Updated
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HFMA CRCR Test Q uestions and 100% Correct Answers / HFMA CRCR Test Question Updated 2023 -2024 What do Case Managers do? -------- Correct Answer -------- Monitor high resource cases to ensure effective utilization What is HIM responsible for? -------- Correct Answer -------- all pt medical records: transcribe, coding, release to biling, answer requ ests for documentation What is utilization management responsible for? -------- Correct Answer -------- manage cases: services correct, on time What are the three types of utilization review? -------- Correct Answer -------- Prospective, Concurrent, Retr ospective Where can home health services be offered? -------- Correct Answer -------- Home, Assist Living, neighbors: just not SNF nor Hospital To receive -Care payments, what must a SNF have when receiving a pt from a hosp? -------- Correct Answer -------- A transfer agreement approved by -Care. Can a home health agency employ another agency to provide services? -------- Correct Answer -------- Yes, so long as at least one employee of the original agency provides care. What is the Net Collection Rate? -------- Correct Answer -------- how much cash was collected as a % of available to collect? What is the Net Collection Rate benchmark? -------- Correct Answer -------- 95% What is the benchmark for denials -------- Correct Answer -------- <2% on first submission Formual for cost to collect -------- Correct Answer -------- total PFS expenses/gross pt care collections What is the benchmark for cost to collect -------- Correct Answer -------- 2.25% What % of the UB -04 source of data is from pt access? -------- Correct Answer -------- 40% What % of the UB -04 source of data is from service depts? -------- Correct Answer -------
- 11% What % of the UB -04 source of data is from HIM? -------- Correct Answer -------- 20% What % of the UB -04 source of data is from billing? -------- Correct Answer -------- 20% What % of the UB -04 source of data is not used? -------- Correct Answer -------- 9% What % of the CMS 1500 source of data is from pt access? -------- Correct Answer -------
- 53% What % of the CMS 1500 source of data is from service? -------- Correct Answer -------- 14% What % of the CMS 1500 source of data is from HIM -------- Correct Answer -------- 7% What % of the CMS 1500 source of data is from billing? -------- Correct Answer -------- 26% From whom is the UB -04 directed? -------- Correct Answer -------- institutional: hospitals, SNF, hospice From whom is the CMS 1500? -------- Correct Answer -------- non-institutional: physicians, DME In the FDCA, what is Title I -------- Correct Answer -------- Truth in Lending Act What is the Truth in Lending Act -------- Correct Answer -------- 5 points must be triggered (such as interes t will be charged), then must disclose APR, total payments, late payment charges, etc. What are the penalties for violating the FDCA? -------- Correct Answer -------- creditors can be sued Who enforces the FDCA for hospitals? -------- Correct Answer -------- FTC In the FDCA, what is Title III -------- Correct Answer -------- limits garnishments In the FDCA, what is Title IV -------- Correct Answer -------- Fair Credit Reporting Act What is the Fair Credit Reporting Act? -------- Correct Answer -------- provides consumer rights in reporting loans Are there rules for how a debt collector communicates with debtor? -------- Correct Answer -------- Yes, eg no profane language, can't cont act before 8 AM
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