CRCR Certification Actual Exams
Study Guide with Coplete Study
Questions and Answers Already
Graded A+
1. What are some core elements if a board-approved financial assistance
policy? - ANSWER Eligibility, application process, and nonpayment
collection activities A portion of the accounts receivable inventory which
has NOT qualified for billing includes: - ANSWER Charitable pledges
2. What is required for the UB-04/837-I, used by Rural Health Clinics to
generate payment from Medicare? - ANSWER Revenue codes
3. This directive was developed to promote and ensure healthcare quality and
value and also to protect consumers and workers in the healthcare system.
This directive is called - ANSWER Patient bill of rights
4. A recurring/series registration is characterized by - ANSWER The creation
of one registration record for multiple days of service
5. With the advent of the Affordable Care Act Health Insurance Marketplaces
and the expansion of Medicaid in some states, it is more important than ever
for hospitals to - ANSWER Assist patients in understanding their insurance
coverage and their financial obligation
6. The purpose of a financial report is to: - ANSWER Present financial
information to decision makers
,7. Patient financial communications best practices produce communications
that are - ANSWER Consistent, clear and transparent
8. Medicare has established guidelines called the Local Coverage
Determinations (LCD) and National Coverage Determinations (NCD) that
establish - ANSWER What services or healthcare items are covered under
Medicare
9. 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 - ANSWER The Provider Reimbursement
Review Board
10.Concurrent review and discharge planning - ANSWER Occurs during
service
11.Duplicate payments occur: - ANSWER When providers re-bill claims based
on nonpayment from the initial bill submission
12.An individual enrolled in Medicare who is dissatisfied with the government's
claim determination is entitled to reconsideration of the decision. This type
of appeal is known as - ANSWER A beneficiary appeal
13.Insurance verification results in which of the following - ANSWER The
accurate identification of the patient's eligibility and benefits
14.The Medicare fee-for service appeal process for both beneficiaries and
providers includes all of the following levels EXCEPT: - ANSWER Judicial
review by a federal district court
,15.Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the providermay not ask about a patient's insurance information
if it would delay what? - ANSWER Medical screening and stabilizing
treatment
16.Ambulance services are billed directly to the health plan for - ANSWER
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
17.Key performance indicators (KPIs) set standards for accounts receivables
(A/R) and - ANSWER Provide a method of measuring the collection and
control of A/R
18.he patient discharge process begins when - ANSWER The physician writes
the discharge orders
19.The nightly room charge will be incorrect if the patient's - ANSWER
Transfer from ICU to the Medical/Surgical floor is not reflected in the
registration system.
20.The soft cost of a dissatisfied customer is - ANSWER The customer passing
on info about their negative experience to potential pts or through social
media channels
21.An advantage of a pre-registration program is - ANSWER The opportunity
to reduce the corporate compliance failures within the registration process
, 22.It is important to have high registration quality standards because -
ANSWER Inaccurate or incomplete patient data will delay payment or cause
denials
23.Telemed seeks to improve a patient's health by - ANSWER Permitting 2-
way real time interactive communication between the patient and the clinical
professional
24.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 - ANSWER HMO
25.Identifying the patient, in the MPI, creating the registration record,
completing medical necessity screening, determining insurance eligibility
and benefits resolving managed care, requirements and completing financial
education/resolution are all - ANSWER The data collection steps for
scheduling and pre-registering a patient
26.Medicare Part B has an annual deductible, and the beneficiary is responsible
for - ANSWER A co-insurance payment for all Part B covered services
27.The standard claim form used for billing by hospitals, nursing facilities, and
other inpatient - ANSWER UB-04
28.Charges are the basis for - ANSWER Separation of fiscal responsibilities
between the patient and the health plan
29.All of the following are forms of hospital payment contracting EXCEPT -
ANSWER Contracted Rebating
Study Guide with Coplete Study
Questions and Answers Already
Graded A+
1. What are some core elements if a board-approved financial assistance
policy? - ANSWER Eligibility, application process, and nonpayment
collection activities A portion of the accounts receivable inventory which
has NOT qualified for billing includes: - ANSWER Charitable pledges
2. What is required for the UB-04/837-I, used by Rural Health Clinics to
generate payment from Medicare? - ANSWER Revenue codes
3. This directive was developed to promote and ensure healthcare quality and
value and also to protect consumers and workers in the healthcare system.
This directive is called - ANSWER Patient bill of rights
4. A recurring/series registration is characterized by - ANSWER The creation
of one registration record for multiple days of service
5. With the advent of the Affordable Care Act Health Insurance Marketplaces
and the expansion of Medicaid in some states, it is more important than ever
for hospitals to - ANSWER Assist patients in understanding their insurance
coverage and their financial obligation
6. The purpose of a financial report is to: - ANSWER Present financial
information to decision makers
,7. Patient financial communications best practices produce communications
that are - ANSWER Consistent, clear and transparent
8. Medicare has established guidelines called the Local Coverage
Determinations (LCD) and National Coverage Determinations (NCD) that
establish - ANSWER What services or healthcare items are covered under
Medicare
9. 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 - ANSWER The Provider Reimbursement
Review Board
10.Concurrent review and discharge planning - ANSWER Occurs during
service
11.Duplicate payments occur: - ANSWER When providers re-bill claims based
on nonpayment from the initial bill submission
12.An individual enrolled in Medicare who is dissatisfied with the government's
claim determination is entitled to reconsideration of the decision. This type
of appeal is known as - ANSWER A beneficiary appeal
13.Insurance verification results in which of the following - ANSWER The
accurate identification of the patient's eligibility and benefits
14.The Medicare fee-for service appeal process for both beneficiaries and
providers includes all of the following levels EXCEPT: - ANSWER Judicial
review by a federal district court
,15.Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the providermay not ask about a patient's insurance information
if it would delay what? - ANSWER Medical screening and stabilizing
treatment
16.Ambulance services are billed directly to the health plan for - ANSWER
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
17.Key performance indicators (KPIs) set standards for accounts receivables
(A/R) and - ANSWER Provide a method of measuring the collection and
control of A/R
18.he patient discharge process begins when - ANSWER The physician writes
the discharge orders
19.The nightly room charge will be incorrect if the patient's - ANSWER
Transfer from ICU to the Medical/Surgical floor is not reflected in the
registration system.
20.The soft cost of a dissatisfied customer is - ANSWER The customer passing
on info about their negative experience to potential pts or through social
media channels
21.An advantage of a pre-registration program is - ANSWER The opportunity
to reduce the corporate compliance failures within the registration process
, 22.It is important to have high registration quality standards because -
ANSWER Inaccurate or incomplete patient data will delay payment or cause
denials
23.Telemed seeks to improve a patient's health by - ANSWER Permitting 2-
way real time interactive communication between the patient and the clinical
professional
24.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 - ANSWER HMO
25.Identifying the patient, in the MPI, creating the registration record,
completing medical necessity screening, determining insurance eligibility
and benefits resolving managed care, requirements and completing financial
education/resolution are all - ANSWER The data collection steps for
scheduling and pre-registering a patient
26.Medicare Part B has an annual deductible, and the beneficiary is responsible
for - ANSWER A co-insurance payment for all Part B covered services
27.The standard claim form used for billing by hospitals, nursing facilities, and
other inpatient - ANSWER UB-04
28.Charges are the basis for - ANSWER Separation of fiscal responsibilities
between the patient and the health plan
29.All of the following are forms of hospital payment contracting EXCEPT -
ANSWER Contracted Rebating
