Exam (elaborations)
Certified Revenue Cycle Specialist (CRCS) 2024/2025 graded A+ by experts
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Certified Revenue Cycle Specialist (CRCS) 2024/2025 graded A+ by experts
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Certified Revenue Cycle Specialist(CRCS)
1-Day Rule - ANSrequirement that all diagnostic or outpatient services furnished in connection
with the principle admitting diagnosis within on day prior to the hospital admission are bundled
with the inpatient services for Medicare billing
3-Day Rule - ANSrequirement that all diagnostic or outpatient services furnished in connection
with the principle admitting diagnosis within three days prior to the hospital admission are
bundled with the inpatient services for Medicare billing.
5010A1 - ANSThe American National Standards Institute transaction for a professional claim
(the electronic equivalent of the CMS 15000), formerly the 837P
837I - ANSthe American National Standards Institute transaction for an institutional claim; as a
result of HIPAA , it is replacing the electronic UB-04
837P - ANSa former American National Standards Institute transaction for a professional claim
(the electronic equivalent of the CMS 15000), since replaced by the 5010A1
AMN - ANSthe Advance Beneficiary Notice of Non-coverage; a form given to a Medicare
beneficiary before services are furnished when a service does not meet or is not expected to
meet medical necessity.
Abuse - ANSthe misuse of a person, substance, service, or financial matter such that harm is
caused; some forms of healthcare abuse include excessive or unwarranted use of technology,
pharmaceuticals, and services; abuse of authority; and abuse of privacy, confidentiality, or duty
to care; it also includes improper billing practices (like billing Medicare instead of primary
insurer), increasing charges to Medicare beneficiaries but not to other patients, unbundling of
services, and unnecessary transfers of patients.
Accounts Receivable (AR) Days Outstanding - ANSan estimate, using average current
revenues, of the days required to turn over the accounts receivable under normal operating
conditions; in simple terms, this is an estimate of the time needed to collect the accounts
receivable.
ACF - ANSAdministration for Children and Families; one of the DHHS Operating Divisions
ACL - ANSAdministration for Community Living; one of the DHHS Operating Divisions
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