CRCR EXAM MULTIPLE CHOICE,
CRCR Exam Prep, Certified Revenue
Cycle Representative - CRCR
Ninety. MSP (Medicare Secondary Payer) policies allow carriers to invoice Medicare for
liability claims after what occurs? - ANS-120 days passes, however the declare then be
withdrawn from the legal responsibility carrier
ninety. MSP (Medicare Secondary Payer) guidelines allow vendors to invoice Medicare for
legal responsibility claims after what takes place? - ANS-120 days passes, but the declare
then be withdrawn from the liability carrier
A sixty eight year old patient, a Medicare beneficiary, turned into in a automobile
coincidence. A medical insurance declare was filed with the car coverage carrier. Six months
later this claim stays unpaid. How can the company pursue payment from Medicare? -
ANS-The provider need to first invoice the auto insurer; however, after a length of one
hundred twenty days, if the declare stays unpaid, the provider may additionally cancel the
legal responsibility claim and bill Medicare.
A claim is denied for the subsequent reasons, EXCEPT:
a) The fitness plan cannot discover the subscriber
b) The frequency of provider changed into outside the insurance timeline
c) The submitted declare does now not have the physicians signature
d) The subscriber changed into not enrolled on the time of service - ANS-C
A complete "Compliance Program" is defined as
a) Annual prison audit and evaluate for adherence to rules
b) Educating personnel on guidelines
c) Systematic procedures to make sure that the provisions of
regulations imposed by means of a government employer are being met
d) The development of operational rules that correspond to
guidelines - ANS-C
A choice on whether a patient ought to be admitted as an inpatient or emerge as an
outpatient remark patient calls for scientific judgments based totally on all the following
EXCEPT
a) The patient's home care coverage
b) Current scientific wishes
c) The likelihood of an destructive event happening to the affected person
d) The affected person's clinical records - ANS-A
,A four digit variety code hooked up by means of the National Uniform Billing Committee
(NUBC)
that categorizes/classifies a line object inside the price grasp is known as
a) HCPCs codes
b) ICD-10 Procedural codes
c) CPT codes
d) Revenue codes - ANS-D
A huge range of credit score balances aren't the result of overpayments however of
a) Posting errors inside the pt accounting gadget
b) Incorrect declare submissions
c) Inadequate team of workers education
d) Banking transaction mistakes - ANS-A
A Medicare Part A benefit length begins:
a) With admission as an inpatient
b) The first day in which an individual has not been a clinic
inpatient not in a skilled nursing facility for the previous 60 days
c) Upon the day the insurance top class is paid
d) Immediately once authorization for remedy is supplied through the
fitness plan - ANS-A
A nightly room fee can be wrong if the patient's
a) Discharge for tomorrow has now not been charted
b) Condition has no longer been mentioned all through the shift change file
meeting
c) Pharmacy orders to the ICU have not been entered within the
pharmacy device
d) Transfer from ICU (in depth care unit) to the Medical/Surgical
floor is not reflected in the registration device - ANS-D
A part of the bills receivable stock which has NOT qualified for billing
includes
a) Charitable pledges
b) Accounts assigned to a pre-collection enterprise
c) Accounts coded but held in the suspense length
d) Accounts created during pre-registration however no longer activated - ANS-A
A portion of the bills receivable inventory which has NOT certified for billing
includes:
a) Charitable pledges
b) Accounts created at some point of pre-registration but not activated
c) Accounts coded but held within the suspense length
d) Accounts assigned to a pre-collection company - ANS-A
,A ordinary/series registration is characterised by way of
a) A advent of more than one registrations for multiple services
b) The introduction of one registration document for multiple days of provider
c) The advent of more than one patient sorts for one date of carrier
d) The creation of 1 registration document in line with diagnosis in line with go to - ANS-B
A habitual/series registration is characterized by way of
a) The introduction of one registration record for multiple days of carrier
b) The advent of multiple registrations for multiple offerings
c) The creation of one registration report according to prognosis in step with visits
d) The advent of multiple pt sorts for one date of service - ANS-A
A scheduled inpatient represents an possibility for the company to do which of the
following?
A) Refer the affected person to any other region with the fitness system
b) Comply with EMTALA (Emergency Medical Treatment and Labor Act)
necessities before carrier
c) Complete registration and coverage approval earlier than carrier
d) Register the affected person after she or he is located in a mattress on that service
unit. - ANS-C
ABC Hospital has skilled a sixteen% growth in new sufferers over the last 6 months. The
sanatorium is understaffed in its coverage claim and payment processing department and
can't handle this boom in paintings load. It is thinking about hiring an outsourcing seller to
help. What are the stairs that the sanatorium desires to take to establish and ensure a a
success seller dating? - ANS-**A. Distribute a RFP to solicit vendor abilties, examine seller's
expertise to provide outsourcing offerings, go to dealer locations, carry out seller reference
exams, speak with supplier customers, interview dealer personnel to assess enjoy stage.
B. Evaluate supplier's knowledge in offering outsourcing services, visit vendor locations,
interview supplier employees to evaluate knowledge level.
Access - ANS-An person's potential to reap medical offerings on a well timed and financially
perfect stage
Access - ANS-An character's capability to reap scientific services on a timely and financially
applicable stage
According to the Department of Health and Human Services tips, what's NOT considered
earnings? - ANS-Sale of property, residence, or car
According to the Department of Health and Human Services hints, what is NOT considered
income? - ANS-Sale of belongings, house, or automobile
, Accurate identity of the patient is the first step in the scheduling process. Identifiers utilized
in diverse aggregate to reap correct patient identification encompass? - ANS-Full criminal
name, date of beginning, intercourse and social safety number
Across all care settings, if a affected person concurs to a economic discussion for the
duration of a medical
come upon to expedite discharge, the HFMA first-rate exercise is to:
a) Make sure that the attending team of workers can solution questions and
assist in obtaining required affected person economic information
b) Have a affected person economic duties package equipped for the patient,
containing all the required registration forms and instructions
c) Support that preference, presenting that the dialogue does no longer
intrude with affected person care or disrupt affected person go with the flow
d) Decline such request as finance discussions can disrupt affected person
care and affected person drift - ANS-C
Across all care settings, if a pt concurs to a economic discussion all through a scientific
come across
to expedite discharge, the HFMA pleasant exercise is to
a) Have a pt economic obligations kit geared up for the pt containing all of the required
registration paperwork and instructions
b) Make positive that the attending team of workers can solution questions and help in
obtaining
required pt monetary data
c) Support that preference, providing that the dialogue does now not intrude with pt care or
disrupt pt waft
d) Decline such request as finance discussions can disrupt pt care and pt drift - ANS-C
Administrative Services Only (ASO) - ANS-Usually shriveled administrative services to a
self-insured health plan
Administrative Services Only (ASO) - ANS-Usually reduced in size administrative services to
a self-insured fitness plan
Agency expenses are: - ANS-A. Paid by means of sufferers.
**B. The price to the company for series company monies offset through the go back on
baddebt bills.
C. Only reported annually to the issuer.
D. Waived for debts elderly more than twelve months from date of service.
All of the following are situations that disqualify a procedure or service from being paid
for through Medicare EXCEPT
a) Medically useless
b) Not brought in a Medicare certified care placing
c) Offered in an outpatient placing
CRCR Exam Prep, Certified Revenue
Cycle Representative - CRCR
Ninety. MSP (Medicare Secondary Payer) policies allow carriers to invoice Medicare for
liability claims after what occurs? - ANS-120 days passes, however the declare then be
withdrawn from the legal responsibility carrier
ninety. MSP (Medicare Secondary Payer) guidelines allow vendors to invoice Medicare for
legal responsibility claims after what takes place? - ANS-120 days passes, but the declare
then be withdrawn from the liability carrier
A sixty eight year old patient, a Medicare beneficiary, turned into in a automobile
coincidence. A medical insurance declare was filed with the car coverage carrier. Six months
later this claim stays unpaid. How can the company pursue payment from Medicare? -
ANS-The provider need to first invoice the auto insurer; however, after a length of one
hundred twenty days, if the declare stays unpaid, the provider may additionally cancel the
legal responsibility claim and bill Medicare.
A claim is denied for the subsequent reasons, EXCEPT:
a) The fitness plan cannot discover the subscriber
b) The frequency of provider changed into outside the insurance timeline
c) The submitted declare does now not have the physicians signature
d) The subscriber changed into not enrolled on the time of service - ANS-C
A complete "Compliance Program" is defined as
a) Annual prison audit and evaluate for adherence to rules
b) Educating personnel on guidelines
c) Systematic procedures to make sure that the provisions of
regulations imposed by means of a government employer are being met
d) The development of operational rules that correspond to
guidelines - ANS-C
A choice on whether a patient ought to be admitted as an inpatient or emerge as an
outpatient remark patient calls for scientific judgments based totally on all the following
EXCEPT
a) The patient's home care coverage
b) Current scientific wishes
c) The likelihood of an destructive event happening to the affected person
d) The affected person's clinical records - ANS-A
,A four digit variety code hooked up by means of the National Uniform Billing Committee
(NUBC)
that categorizes/classifies a line object inside the price grasp is known as
a) HCPCs codes
b) ICD-10 Procedural codes
c) CPT codes
d) Revenue codes - ANS-D
A huge range of credit score balances aren't the result of overpayments however of
a) Posting errors inside the pt accounting gadget
b) Incorrect declare submissions
c) Inadequate team of workers education
d) Banking transaction mistakes - ANS-A
A Medicare Part A benefit length begins:
a) With admission as an inpatient
b) The first day in which an individual has not been a clinic
inpatient not in a skilled nursing facility for the previous 60 days
c) Upon the day the insurance top class is paid
d) Immediately once authorization for remedy is supplied through the
fitness plan - ANS-A
A nightly room fee can be wrong if the patient's
a) Discharge for tomorrow has now not been charted
b) Condition has no longer been mentioned all through the shift change file
meeting
c) Pharmacy orders to the ICU have not been entered within the
pharmacy device
d) Transfer from ICU (in depth care unit) to the Medical/Surgical
floor is not reflected in the registration device - ANS-D
A part of the bills receivable stock which has NOT qualified for billing
includes
a) Charitable pledges
b) Accounts assigned to a pre-collection enterprise
c) Accounts coded but held in the suspense length
d) Accounts created during pre-registration however no longer activated - ANS-A
A portion of the bills receivable inventory which has NOT certified for billing
includes:
a) Charitable pledges
b) Accounts created at some point of pre-registration but not activated
c) Accounts coded but held within the suspense length
d) Accounts assigned to a pre-collection company - ANS-A
,A ordinary/series registration is characterised by way of
a) A advent of more than one registrations for multiple services
b) The introduction of one registration document for multiple days of provider
c) The advent of more than one patient sorts for one date of carrier
d) The creation of 1 registration document in line with diagnosis in line with go to - ANS-B
A habitual/series registration is characterized by way of
a) The introduction of one registration record for multiple days of carrier
b) The advent of multiple registrations for multiple offerings
c) The creation of one registration report according to prognosis in step with visits
d) The advent of multiple pt sorts for one date of service - ANS-A
A scheduled inpatient represents an possibility for the company to do which of the
following?
A) Refer the affected person to any other region with the fitness system
b) Comply with EMTALA (Emergency Medical Treatment and Labor Act)
necessities before carrier
c) Complete registration and coverage approval earlier than carrier
d) Register the affected person after she or he is located in a mattress on that service
unit. - ANS-C
ABC Hospital has skilled a sixteen% growth in new sufferers over the last 6 months. The
sanatorium is understaffed in its coverage claim and payment processing department and
can't handle this boom in paintings load. It is thinking about hiring an outsourcing seller to
help. What are the stairs that the sanatorium desires to take to establish and ensure a a
success seller dating? - ANS-**A. Distribute a RFP to solicit vendor abilties, examine seller's
expertise to provide outsourcing offerings, go to dealer locations, carry out seller reference
exams, speak with supplier customers, interview dealer personnel to assess enjoy stage.
B. Evaluate supplier's knowledge in offering outsourcing services, visit vendor locations,
interview supplier employees to evaluate knowledge level.
Access - ANS-An person's potential to reap medical offerings on a well timed and financially
perfect stage
Access - ANS-An character's capability to reap scientific services on a timely and financially
applicable stage
According to the Department of Health and Human Services tips, what's NOT considered
earnings? - ANS-Sale of property, residence, or car
According to the Department of Health and Human Services hints, what is NOT considered
income? - ANS-Sale of belongings, house, or automobile
, Accurate identity of the patient is the first step in the scheduling process. Identifiers utilized
in diverse aggregate to reap correct patient identification encompass? - ANS-Full criminal
name, date of beginning, intercourse and social safety number
Across all care settings, if a affected person concurs to a economic discussion for the
duration of a medical
come upon to expedite discharge, the HFMA first-rate exercise is to:
a) Make sure that the attending team of workers can solution questions and
assist in obtaining required affected person economic information
b) Have a affected person economic duties package equipped for the patient,
containing all the required registration forms and instructions
c) Support that preference, presenting that the dialogue does no longer
intrude with affected person care or disrupt affected person go with the flow
d) Decline such request as finance discussions can disrupt affected person
care and affected person drift - ANS-C
Across all care settings, if a pt concurs to a economic discussion all through a scientific
come across
to expedite discharge, the HFMA pleasant exercise is to
a) Have a pt economic obligations kit geared up for the pt containing all of the required
registration paperwork and instructions
b) Make positive that the attending team of workers can solution questions and help in
obtaining
required pt monetary data
c) Support that preference, providing that the dialogue does now not intrude with pt care or
disrupt pt waft
d) Decline such request as finance discussions can disrupt pt care and pt drift - ANS-C
Administrative Services Only (ASO) - ANS-Usually shriveled administrative services to a
self-insured health plan
Administrative Services Only (ASO) - ANS-Usually reduced in size administrative services to
a self-insured fitness plan
Agency expenses are: - ANS-A. Paid by means of sufferers.
**B. The price to the company for series company monies offset through the go back on
baddebt bills.
C. Only reported annually to the issuer.
D. Waived for debts elderly more than twelve months from date of service.
All of the following are situations that disqualify a procedure or service from being paid
for through Medicare EXCEPT
a) Medically useless
b) Not brought in a Medicare certified care placing
c) Offered in an outpatient placing
