CRCR Certification (Certified Revenue Cycle Representative) exam
A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of regulations imposed by a ...
CRCR Certification (Certified Revenue Cycle
Representative) exam
A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of
regulations imposed by a government
agency are being met
d) The development of operational policies that correspond to
regulations Correct Answer c) Systematic procedures to ensure
that the provisions of regulations imposed by a government
10. 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 Correct Answer b) To a select patient group
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
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 Correct Answer a)
Identify, compare, and choose providers that offer the desired
level of value
,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 Correct Answer b) HMO
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
longest outstanding claims paid
first Correct Answer a) The court liquidates the debtor's
nonexempt property, pays creditors, and discharges the debtor
from the debt
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 Correct Answer a) Scheduling, pre-
registration, insurance verification and managed care processing
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 Correct Answer d) A mutual
hold-harmless clause
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:
a) Patient Accounts
b) Managed Care Contract Staff
c) HIM staff
d) Case Management Correct Answer d) Case Management
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 Correct Answer a) Revenue
codes
Before classifying and subsequently writing off an account to
financial assistance or bad
, debt, the hospital must establish policy, define appropriate
criteria, implement procedures for identifying and processing
accounts:
a) Monitor compliance
b) Have the account triaged for any partial payment possibilities
c) Assist in arranging for a commercial bank loan
d) Obtain the patients income tax statements from the prior 2
years Correct Answer a) Monitor compliance
For routine scenarios, such as patients with insurance coverage
or a known ability to pay, financial discussions:
a) Are optional
b) Should take place between the patient or guarantor and
properly
trained provider representatives
c) May take place between the patient and discharge planning
d) Are focused on verifying required third-party payer information
Correct Answer b) Should take place between the patient or
guarantor and properly trained provider representatives
The purpose of a financial report is to:
a) Provide a public record, if requested
b) Present financial information to decision makers
c) Prepare tax documents
d) Monitor expenses Correct Answer b) Present financial
information to decision makers
Which statement is an EMTALA (Emergency Medical Treatment
and Active Labor Act) violation?
a) Registration staff may routinely contact managed are plans for
prior authorizations before the patient is seen by the on-duty
physician
b) Initial registration activities may occur so long as these
activities
do not delay treatment or suggest that treatment with not be
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