CRCR Multiple Choice/ 140+ Qs & Ans/ . Terms like:
Case Management requires that a case manager be assigned
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual agreement - Answ...
CRCR Multiple Choice/ 140+ Qs & Ans/ 2024-
2025.
Case Management requires that a case manager be assigned
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual agreement - Answer: B
Pricing transparency is defined as readily available information on the price of
healthcare services, that together with other information, help define the value of
those
services and enable consumers to
a) Identify, compare, and choose providers that offer the desired
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,level of value
b) Customize health care with a personally chosen mix of providers
c) Negotiate the cost of health plan premiums
d) Verify the cost of individual clinicians - Answer: A
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons based on a
monthly fee is known as a
a) MSO
b) HMO
c) PPO
d) GPO - Answer: B
In a Chapter 7 Straight Bankruptcy filing
a) The court liquidates the debtor's nonexempt property, pays
creditors, and discharges the debtor from the debt
b) The court liquidates the debtor's nonexempt property, pays
creditors, and begins to pay off the largest claims first. All claims
are paid some portion of the amount owed
c) The court vacates all claims against a debtor with the
understanding that the debtor may not apply for credit without
court supervision
d) The court establishes a creditor payment schedule with the
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,longest outstanding claims paid first - Answer: A
The core financial activities resolved within patient access include:
a) Scheduling, pre-registration, insurance verification and managed
care processing
b) Scheduling, insurance verification, clinical discharge processing
and payment posting of point of service receipts
c) Scheduling, registration, charge entry and managed care
processing
d) Scheduling, pre-registration, registration, medical necessity
screening and patient refunds - Answer: A
Which of the following is NOT contained in a collection agency agreement?
a) A clear understanding that the provider retains ownership of any
outsourced activities
b) Specific language as to who will pay legal fees, if needed
c) An annual renewal clause
d) A mutual hold-harmless clause - Answer: D
Maintaining routine contact with the health plan or liability payer, making sure all
required information is provided and all needed approvals are obtained is the
responsibility of:
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, a) Patient Accounts
b) Managed Care Contract Staff
c) HIM staff
d) Case Management - Answer: D
What is required for the UB-04/837-I, used by Rural Health Clinics to generate
payment
from Medicare?
a) Revenue codes
b) Correct Part A and B procedural codes
c) The CMS 1500 Part B attachment
d) Medical necessity documentation - Answer: A
The disadvantages of outsourcing include all of the following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff - Answer: D
The Medicare fee-for service appeal process for both beneficiaries and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
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