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CRCR Exam Review Questions and Verified Answers (2024 / 2025) 100% Guarantee Pass
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CRCR Exam Review Questions and Verified Answers (2024 / 2025) 100% Guarantee Pass
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CRCR EXAM REVIEW/ 250 QUESTIONS WITHVERIFIED ANSWERS (2024 2025) 100%
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1. 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 balance after
insurance if any
2. The patient experience includes all of the following except:: The
average number of positive mentions received by the health system or
practice and the public comments refuting unfriendly posts on social media
sites
3. Corporate compliance programs play an important role in
protecting the integrity of operations and ensuring compliance with
federal and state requirements. The Code of Conduct is:: A critical tool
to ensure the compliance with the organization's compliance standards and
procedures, an essential and integral component of the organization's
culture, fosters and environment where concerns and questions may be
raised without fear of retaliation or retribution
4. Specific to Medicare fee-for-service patients, which of the
following payers have always been liable for payment?: Public health
service programs, federal grant programs, VA programs, black lung program
services and workers comp claims
5. Provider policies and procedures should be in plan to reduce the
risk of ethics violations. Examples of ethics violations are:: Financial
misconduct, overcharging and miscoding claims, theft of property and
falsifying records to boost reimbursement, financial misconduct and
applying policies in an inconsistent manner
6. Providers are now being reimbursed with a focus on the value of
the services provided, rather than volume, which requires collaboration
among providers.
What is the intended outcome of collaborations made through an ACO
delivery system for a population of patients?: To eliminate duplicate
services, prevent medical errors and ensure appropriateness of care
7. What is the new terminology now employed in the calculation of
net patient service revenues?: Explicit price concessions and implicit price
concessions
,8. What are the two KPIs used to monitor performance related to
the production and submission of claims to third party payers and
patients (self-pay)?: Elapsed days from discharge to final bill and elapsed
days from final bill to claim/bill submission
9. What are the three traditional steps of the Revenue Cycle?: Pre-
service, time-of-service and post-service
10. What are the steps during pre-service?: 1. The patient is scheduled
and pre-registered for service
2. The encounter record is generated and the patient/guarantor information
is obtained or updated
3. The requested service is screened for med necessity; insurance is verified
and pre-auths obtained
4. The cost is identified and insurance benefits are used to calculate the
price of the services to the patient
5. If the service is deemed not med necessary additional processing is done
6. The patient is notified of their financial responsibility including
copay/deductible and their eligibility for financial assistance is assessed
11. What happens for scheduled patients at the time of service?: 1. Pre-
registration record is activated, consents are signed and copays/balances are
collected
2. Positive patient identification is completed and an armband is given
3. Alternatively, scheduled patients can report to an express arrival desk
12. What happens for unscheduled patients at the time of service?:
Comprehensive registration and financial processing is completed at the
time-of-service. The process mirrors the work that was completed for
scheduled patients prior to service
13. What are the nine steps of time-of-service processing for
unscheduled patients?: 1. Creation of the registration record
2. Order review to ensure compliance with the rules for what makes a
complete order 3. Validation of the health plan and identification of any
amount the patient is currently due
4. Completion of med necessity screening, if necessary
5. Review and completion of pre-cert requirements for the order
6. Identification of all charges related to the order and applied insurance
benefits to calculate amount due
7. If a balance is due, financial conversation occurs
8. If all is well, patient gets service
9. Charges are entered as services are rendered
, .
14. What is the overview for the three steps of the revenue cycle?: 1. Pre-
service: the patient is scheduled and registered for service; patient service
costs are calculated
2. Time-of-service: case management and discharge planning services
are provided; consents are signed
3. Post-service: Bill sent electronically to health plan, patient account is
monitored for payment
15. What are the goals of the engaged consumer portion of the rev
cycle?: Ease of access, improved customer service and improved quality of
care
16 What are the goals of the engaged patient portion of the rev cycle?:
Improve the information and choices for the patient regarding care and
financial decisions
17. What are the goals of the satisfied customer portion of the rev
cycle?: Appropriate payment, effective and efficient account resolution and
decreased cost to collect
18. What are the Healthcare Dollar and Sense initiatives?: Patient
financial communication best practices, best practices for price
transparency, medical account resolution. Overall to help make sense of
price and value in healthcare
19. What is the best practice for when and where to have patient
financial discussions?: 1. No discussion before patient is screened and
stabilized in the ER 2. If in an emergency medical condition, the
conversation occurs in the discharge process
3. In a non-emergency situation, occurs in registration or discharge process
in an area that does not disturb others
4. When possible, have financial conversations before services are rendered
5. Have discussions as early as possible
20. What are the typical elements of the best practices of financial
discussions?: In ED settings, inform patients that quality of care will not be
affected by prior balances or insurance status. For elective services, patients
are expected to make payments toward past balances. Once patient is
stabilized, information can be collected and reviewed for insurance benefits
and financial assistance programs.
21. What are the best practices for financial counseling?: 1.
Discussing patient share: Patient should be provided list of providers that
require separate payments and told that estimates may vary from actual cost.
Patients should be asked if they want info about payment/financial
assistance options
, 2. Prior balance policies: Clear policies about prior balances that should
be available to the public
3. Balance resolution: Policies that work toward amicable resolution
with the patient
22. What are the best practices for the provider/patient conversation?:
Have compassion, use standard language and have written follow-up
23. What is the framework for complying with the best practices for
financial conversations?: Annual training, training included well rounded
material, annual observation/tracking of process, metrics reporting,
technology support verification and feedback/response
24. What is price transparency?: Pricing information available to
patients based on hospital service based on CPT/DRG, the patient's health
plan and the patient's benefit plan
25. What is the ACA? (not the affordable care act): The Association of
Credit and Collections Professionals International
26. What is the workflow for medical account resolution?: 1. Educate
patients and follow best practices for communication
2. Make all bills and other communications clear, concise, correct and
patient-friendly
3. Establish policies and make sure they are followed internally and by
business affiliates
4. Be consistent in key aspects of account resolution- from billing disputes
to payment application
5. Coordinate with business affiliates to avoid duplicative patient contacts
6. Exercise good judgement about the best ways to communicate with
patients about bills
7. Start the account resolution clock when the first statement is sent to the
patient8. Report to credit bureaus when an account is resolved (if
necessary). Track all consumer complaints
27. What does HCAHPS mean?: Hospital Consumer Assessment of
Healthcare Providers and Systems
28. What is the HCAHPS initiative?: To produce a national standard for
collecting/reporting patient perspectives that supports valid comparisons
among all providers
29. What are the rev cycle team member's roles in patient
satisfaction?: 1. Implement: implement processed that are patient-centric
and efficient (especially in registration, admitting and financial counseling)
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