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