CRCR -Certified Revenue Cycle Representative (2021)
Which of the following statements are true of HFMA's Financial Communications Best Practices - CORRECT ANSWERSThe best practices were developed specifically to help patients understand the cost of services, their individual insurance benefits...
Which of the following statements are true of HFMA's Financial Communications
Best Practices - CORRECT ANSWERSThe best practices were developed specifically
to help patients understand the cost of services, their individual insurance
benefits, and their responsibility for balances after insurance, if any.
The patient experience includes all of the following except: - CORRECT
ANSWERSThe average number of positive mentions received by the health system
or practice and the public comments refuting unfriendly posts on social media
sites.
Corporate compliance programs play an important role in protecting the integrity
of operations and ensuring compliance with federal and state requirements. The
code of conduct is: - CORRECT ANSWERSAll of the above
Specific to Medicare fee-for-service patients, which of the following payers have
always been liable for payment? - CORRECT ANSWERSPublic health service
programs, Federal grant programs, veteran affairs programs, black lung program
services and work-related injuries and accidents (worker' compensation claims)
Provider policies and procedures should be in place to reduce the risk of ethics
violations. Examples of ethics violations include: - CORRECT ANSWERSAll of the
above
Providers are now being reimbursed with a focus on the value of the services
provided, rather than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery
system for a population of patients? - CORRECT ANSWERSTo eliminate duplicate
services, prevent medical errors and ensure appropriateness of care.
Historically, revenue cycle has delt with contractual adjustments, bad debt and
charity deductions from gross revenue. Although deductions continue to exist, the
definition of net revenue has been modified through the implementation of ASC
,606. Developed by the Financial Accounting Standards Board (FASB), this change
became effective in 2018.
What is the new terminology now employed in the calculation of net patient
services revenues? - CORRECT ANSWERSExplicit prices concessions and implicit
price concessions
Key performance indicators set standards for A/R and provide a method for
measuring the control and collection of A/R.
What are the two KPIs used to monitor performance related to the production
and submission of claims to third party payers and patients (self-pay)? - CORRECT
ANSWERSElapsed days from discharge to final bill and elapsed days from final bill
to claim/bill submission.
Consents are signed as part of the post-services process. - CORRECT
ANSWERSTrue
**False
Patient service costs are calculated in the pre-service process for schedule
patients - CORRECT ANSWERS**True
False
The patient is scheduled and registered for service is a time-of-service activity -
CORRECT ANSWERSTrue
**False
The patient account is monitored for payment is a time-of-service activity -
CORRECT ANSWERSTrue
**False
Case management and discharge planning services are a post-service activty -
CORRECT ANSWERSTrue
**False
Sending the bill electronically to the health plan is a time-of-service activity -
CORRECT ANSWERSTrue
, **False
What happens during the post-service stage? - CORRECT ANSWERS**A. Final
coding of all services, preparation and submission of claims, payment processing
and balance billing and resolution.
B. Orders are entered, results are reported, charges are generated, and diagnostic
and procedural coding is initiated.
C. The encounter record is generated, and the patient and guarantor information
is obtained and/or updated as required.
D. The focus is on the patient and his/her financial care, in addition to the clinical
care provided for the patient.
The following statements describe best practices established by the Medical Debt
Task Force. Check the box next to the True statements - CORRECT
ANSWERS**Educate Patients
**Coordinate to avoid duplicate patient contacts
Exercise moderate judgement when communicating with providers about
scheduled services
**Be consistent in key aspects of account resolution
Report to healthcare plans when the patient's account is transferred to collection
agency
**Follow best practices for communication
Which option is NOT a main HFMA Healthcare Dollars & Sense® revenue cycle
initiative? - CORRECT ANSWERSA. Patient Financial Communications
B. Price Transparency
C. Medical Account Resolution
**D. Process Compliance
What is the objective of the HCAHPS initiative? - CORRECT ANSWERS**A. To
provide a standardized method for evaluating patients' perspective on hospital
care.
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