CRCR Exam Prep/ 145+ Qs & Ans/ Updated . Terms like:
What are the two statutory exclusions from hospice coverage? - Answer: Medically unnecessary services and custodial care
What core financial activities are resolved within patient access? - Answer: Scheduling, insurance verification, disch...
What are the two statutory exclusions from hospice coverage? - Answer:
Medically unnecessary services and custodial care
What core financial activities are resolved within patient access? - Answer:
Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
What statement applies to the scheduled outpatient? - Answer: The services do
not involve an overnight stay
Page 1 of 21
,How is a mis-posted contractual allowance resolved? - Answer: Comparing the
contract reimbursement rates with the contract on the admittance advice to
identify the correct amount
What type of patient status is used to evaluate the patient's need for inpatient
care? - Answer: Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require
that the beneficiary has received what? - Answer: Medically necessary inpatient
hospital services for at least 3 consecutive days before the skilled nursing care
admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? -
Answer: When the patient is the insured
What are non-emergency patients who come for service without prior notification
to the provider called? - Answer: Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse? - Answer: Neither enrolled not
entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what? - Answer: Disclosure rules for consumer credit
sales and consumer loans
Page 2 of 21
, What is a principal diagnosis? - Answer: Primary reason for the patient's
admission
Collecting patient liability dollars after service leads to what? - Answer: Lower
accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? -
Answer: 50% of the current deductible amount
What service provided to a Medicare beneficiary in a rural health clinic (RHC) is
not billable as an RHC services? - Answer: Inpatient care
What code indicates the disposition of the patient at the conclusion of service? -
Answer: Patient discharge status code
What are hospitals required to do for Medicare credit balance accounts? -
Answer: They result in lost reimbursement and additional cost to collect
When an undue delay of payment results from a dispute between the patient and
the third party payer, who is responsible for payment? - Answer: Patient
Medicare guidelines require that when a test is ordered for a LCD or NCD exists,
the information provided on the order must include: - Answer: A valid CPT or
HCPCS code
Page 3 of 21
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Benzo. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.99. You're not tied to anything after your purchase.
