Crcr part 4 - Study guides, Class notes & Summaries

Through what document does a hospital establish compliance standards? code of conduct What is the purpose OIG work plant? Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? Non-diagnostic service provided on Tuesday through Friday What does a modifier allow a provider to do? Report a specific circumstance that affected a procedure or service without changing the code or it...

2024 CRCR Certification Exam Review Complete Questions & Answers (Solved) 100% Correct 1. Consents are signed as part of the post-service process.T or F Answer: False 2. Patient service costs are calculated in the pre-service process for sched-uled patients.T or F Answer: True 3. What happens during the post-service stage? Answer: Final coding of all services, preparation and submission of claims, payment processing and balance billing andresolution. 4. The patient is scheduled and r...

2024 CRCR Study Guide 1 A+ Rated Guide | Questions and Answers (Solved) 1. Health Maintenance Organization (HMO): Answer: Ensures comprehensive healthmaintenance and treatment services for an enrolled group of persons based ona monthly fee. The plan will provide the beneficiary with a list of physicians fromwhich they may choose as their Primary Care Physician (PCP).The beneficiary must contact their PCP to coordinate their care.The PCP will provide the beneficiarywith a referral to ...

2024 CRCR Test Review Complete Questions & Answers (Solved) 100% Correct 1. Important revenue cycle activities in the pre-service stage include Answer: Obtaining or updating patient and guarantor information 2. In the pre-service stage, the cost of the scheduled service is identified andthe patient's health plan and benefits are used to calculate; Answer: The amount the patient may be expected to pay after insurance. 3. Demographic and health plan edit failures are identified and reso...

HFMA CRCR EXAM LATEST EXAM 170+ QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS) Pre-Service activities 1. Requested service is screened for med necessity, health coverage/benefits verified, preauthorization obtained and estimate to patient oop costs generated within guidelines of NSA and state regulations. 2. Patient notified of financial responsibility including copayment and health plan deductibles, eligibility of financial assistance assessed. 3. Patient is scheduled 4. Encounte...

HFMA CRCR EXAM QUESTIONS WITH CORRECT ANSWERS Pre-Service activities - ANSWER- 1. Requested service is screened for med necessity, health coverage/benefits verified, preauthorization obtained and estimate to patient oop costs generated within guidelines of NSA and state regulations. 2. Patient notified of financial responsibility including copayment and health plan deductibles, eligibility of financial assistance assessed. 3. Patient is scheduled 4. Encounter record is generated and pati...

CRCR EXAM MULTIPLE CHOICE, CRCR Exam Prep, Certified Revenue Cycle Representative Revenue Cycle - ANS All of the major processing steps required to process a patient account from the request for service through closing the account with a zero balance and purging it from the system. Pre-Service - ANS 1. Patient is scheduled and registered for service 2. Patient Service cost is calculated Time-of-Servce - ANS 1. Case Management and Discharge Plans are provided 2. Consent forms are s...

CRCR 4 -FINANCIAL CARE EXAM 2023- 2024 Credit balances may be created by any of the following activities except: (Pre-Test 4) - CORRECT ANSWER-Credits to pharmacy charges posted before the claim final bills. Which of the following statements represent common reasons for inpatient claim denials? (Pre-Test 4) - CORRECT ANSWER-Failure to obtain a required pre-authorization; failure to complete a continued stay authorization and services provided which were not medically necessary. A 6...

CRCR Certification Exam 2023 - Questions and Answers 2023 Graded A+. What are some core elements if a board-approved financial assistance policy? Eligibility, application process, and nonpayment collection activities 4 / 15 14. A recurring/series registration is characterized by The creation of one registration record for multiple days of service 15. With the advent of the Affordable Care Act Health Insurance Marketplaces and the expion of Medicaid in some states, it is more important ...