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CRCR Practice 141 Questions with Answers 2023 The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of the following activities? A. Complete a community needs assessment and develop a discount program for patient balances after insurance payment. B. Pursue extraordinar...

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  • 8 april 2023
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CRCR Practice 141 Questions with Answers 2023
The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of
the following activities?
A. Complete a community needs assessment and develop a discount program for
patient balances after insurance payment.
B. Pursue extraordinary collection activities with all patients eligible for financial
assistance.
C. Implement a financial assistance program for uninsured and underinsured
patients.
D. Discount all charges to self-pay patients to an amount generally billed to all
other patients. - CORRECT ANSWERSA. Complete a community needs assessment
and develop a discount program for patient balances after insurance payment

The accurate capture of charges remains critically important because:
A. Of the potential of fraud and abuse charges from erroneous billing.
B. Charges remain one of the few consistent indicators available to monitor
resource use.
C. Charges are means of measuring physician productivity.
D. Charges provide the data used in activity based costing. - CORRECT ANSWERSB.
Charges remain one of the few consistent indicators available to monitor resource
use

The ACO investment model will test the use of pre-paid shared savings to:
A. Invest in treatment protocols that reduce costs to Medicare
B. Attract physicians to participate in the ACO payment system.
C. Raise quality ratings in designated hospitals.
D. Encourage new ACOs to form in rural and underserved areas. - CORRECT
ANSWERSD. Encourage new ACOs to form in rural and underserved areas

Across all care settings, if a patient consents to a financial discussion during a
medical encounter to expedite discharge, the HFMA best practice is to:
A. Have a patient financial responsibilities kit ready for the patient, containing all
of the required registration forms and instructions.
B. Make sure that the attending staff can answer questions and assist in obtaining
required patient financial data.

,C. Support that choice, providing that the discussion does not interfere with
patient care or disrupt patient flow.
D. Decline such request as finance discussions can disrupt patient care and patient
flow. - CORRECT ANSWERSC. Support that choice, providing that the discussion
does not interfere with patient care or disrupt patient flow

Activities completed when the scheduled, pre-registered patient arrives for
service includes:
A. Verifying insurance, activating the record and directing the patient to the
service area.
B. Scanning the driver's license or other phot identification and directing the
patient to the financial counselor.
C. Activating the record, obtaining signatures and finalizing financial issues.
D. Registering the patient and directing the patient to the service area. - CORRECT
ANSWERSC. Activating the record, obtaining signatures and

The activity which results in the accurate recording of patient bed and level of
care assessment, patient transfer and patient discharge status on a real-time basis
is known as:
A. Utilization review
B. Case Management
C. Census Management
D. Patient through-put - CORRECT ANSWERSA. Utilization review
or
B. Case Management

An advantage of a pre-registration program is:
A. The markets value of such a program
B. The ability to eliminate no-show appointments.
C. The opportunity to reduce processing times at the time of service.
D. The opportunity to reduce corporate compliance failures within the
registration process. - CORRECT ANSWERSC. The opportunity to reduce processing
times at the time of service.

The Affordable Care Act legislated the development of Health Insurance
Exchanges, where individuals and small businesses can:
A. Obtain price estimates for medical services

,B. Negotiate the price of medical services with providers
C. Purchase qualified health benefit plans regardless of insured's health status
D. Meet federal mandates for insurance coverage and obtain the corresponding
tax deduction - CORRECT ANSWERSC. Purchase qualified health benefit plans
regardless of insured's health status.

All of the following are conditions that disqualify a procedure or service from
being paid for by Medicare EXCEPT:
A. Offered in an outpatient setting
B. Medically unnecessary
C. Not delivered in a Medicare licensed care setting.
D. Services and procedures that are custodial in nature - CORRECT ANSWERSC.
Not delivered in a Medicare licensed care setting

All of the following are reference resources used to help guide in the application
for business ethics EXCEPT:
A. Consumer satisfaction reports
B. Mission & Value Statements
C. Code of Ethics / Code of Conduct
D. Compliance Office & Policies - CORRECT ANSWERSA. Consumer satisfaction
reports

All of the following are steps in safeguarding collections EXCEPT:
A. Placing collections in a lock-box for posting review the next business day.
B. Posting the payment to the patient's account
C. Completing balancing activities
D. Issuing receipts - CORRECT ANSWERSA. Placing collections in a lock-box for
posting review the next business day

All of the following are steps in verifying insurance EXCEPT:
A. Sequencing plans involved in a coordination of benefits (COB) situation.
B. The patient signing the statement of financial responsibility.
C. Identifying and documenting the patient's health plan benefits
D. Confirming the patient's eligibility for benefits - CORRECT ANSWERSB. The
patient signing the statement of financial responsibility

All of the following information is used to identify a patient EXCEPT:

, A. Date of Birth
B. Gender
C. Social Security Number
D. Address - CORRECT ANSWERSD. Address

All of the following information should be reviewed as part of schedule
finalization EXCEPT:
A. The estimated patient financial obligations
B. The service to be provided
C. The arrival time and procedure time
D. The patient's preparation instructions - CORRECT ANSWERSA. The estimated
patient financial obligations

Ambulance services are billed directly to the health plan for :
A. All pre-admission emergency transports
B. Transport deemed medically necessary by the attending paramedic-ambulance
crew
C. Services provided before a patient is admitted and for ambulance rides
arranged to pick up the patient from the hospital after discharge to take him/her
home or to another facility
D. The portion of the bill outside of the patient's self-pay - CORRECT ANSWERSC.
Services provided before a patient is admitted and for ambulance rides arranged
to pick up the patient from the hospital after discharge to take him/her home or
the another facility

Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons on a
monthly fee is known as a:
A. HMO
B. PPO
C. MSO
D. GPO - CORRECT ANSWERSA. HMO

Any provider that has filed a timely cost report may appeal an adverse final
decision received from the Medicare Administrative Contractor (MAC). This
appeal may be filed with:
A. The Provider Reimbursement Review Board

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