HFMA CRCR EXAM | QUESTIONS &
ANSWERS (VERIFIED) | LATEST
UPDATE | GRADED A+
Through what document does a hospital establish compliance standards?
PR
Correct Answer: code of conduct
What is the purpose OIG work plant?
O
Correct Answer: Identify Acceptable compliance programs in various provider setting
FD
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG
window rule?
O
Correct Answer: Non-diagnostic service provided on Tuesday through Friday
C
What does a modifier allow a provider to do?
Correct Answer: Report a specific circumstance that affected a procedure or service
without changing the code or its definition
IF outpatient diagnostic services are provided within three days of the admission of a
Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what
must happen to these charges
1
,Correct Answer: They must be billed separately to the part B Carrier
what is a recurring or series registration?
Correct Answer: One registration record is created for multiple days of service
What are nonemergency patients who come for service without prior notification to the
provider called?
Correct Answer: Unscheduled patients
PR
Which of the following statement apply to the observation patient type?
Correct Answer: It is used to evaluate the need for an inpatient admission
O
FD
which services are hospice programs required to provide around the clock patient
Correct Answer: Physician, Nursing, Pharmacy
O
Scheduler instructions are used to prompt the scheduler to do what?
Correct Answer: Complete the scheduling process correctly based on service
C
requeste
The Time needed to prepare the patient before service is the difference between the
patients arrival time and which of the following?
Correct Answer: Procedure time
2
, Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the
information provided on the order must include:
Correct Answer: Documentation of the medical necessity for the test
What is the advantage of a pre-registration program
Correct Answer: It reduces processing times at the time of service
What date are required to establish a new MPI(Master patient Index) entry
PR
Correct Answer: The responsible party's full legal name, date of birth, and social
security number
O
Which of the following statements is true about third-party payments?
FD
Correct Answer: The payments are received by the provider from the payer
responsible for reimbursing the provider for the patient's covered services.
O
Which provision protects the patient from medical expenses that exceed the pre-set
level
C
Correct Answer: stop loss
what documentation must a primary care physician send to HMO patient to authorize a
visit to a specialist for additional testing or care?
Correct Answer: Referral
3
ANSWERS (VERIFIED) | LATEST
UPDATE | GRADED A+
Through what document does a hospital establish compliance standards?
PR
Correct Answer: code of conduct
What is the purpose OIG work plant?
O
Correct Answer: Identify Acceptable compliance programs in various provider setting
FD
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG
window rule?
O
Correct Answer: Non-diagnostic service provided on Tuesday through Friday
C
What does a modifier allow a provider to do?
Correct Answer: Report a specific circumstance that affected a procedure or service
without changing the code or its definition
IF outpatient diagnostic services are provided within three days of the admission of a
Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what
must happen to these charges
1
,Correct Answer: They must be billed separately to the part B Carrier
what is a recurring or series registration?
Correct Answer: One registration record is created for multiple days of service
What are nonemergency patients who come for service without prior notification to the
provider called?
Correct Answer: Unscheduled patients
PR
Which of the following statement apply to the observation patient type?
Correct Answer: It is used to evaluate the need for an inpatient admission
O
FD
which services are hospice programs required to provide around the clock patient
Correct Answer: Physician, Nursing, Pharmacy
O
Scheduler instructions are used to prompt the scheduler to do what?
Correct Answer: Complete the scheduling process correctly based on service
C
requeste
The Time needed to prepare the patient before service is the difference between the
patients arrival time and which of the following?
Correct Answer: Procedure time
2
, Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the
information provided on the order must include:
Correct Answer: Documentation of the medical necessity for the test
What is the advantage of a pre-registration program
Correct Answer: It reduces processing times at the time of service
What date are required to establish a new MPI(Master patient Index) entry
PR
Correct Answer: The responsible party's full legal name, date of birth, and social
security number
O
Which of the following statements is true about third-party payments?
FD
Correct Answer: The payments are received by the provider from the payer
responsible for reimbursing the provider for the patient's covered services.
O
Which provision protects the patient from medical expenses that exceed the pre-set
level
C
Correct Answer: stop loss
what documentation must a primary care physician send to HMO patient to authorize a
visit to a specialist for additional testing or care?
Correct Answer: Referral
3
