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CRCR Certification Study Guide | HFMA Exam Prep

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This certification prep document covers Medicare, Medicaid, ACA, EMTALA, HIPAA, KPIs, compliance programs, chargemaster management, claims processing, and bankruptcy rules. It provides detailed Q&A for mastering HFMA’s CRCR exam requirements.

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CRCR



1. Which of the following statements are true of HFMA's Patient Financial Com-
munications Best Practices?: The 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.
2. The patient experience includes all of the following except:: Recognition that revenue
cycle processes must be patient-centric and eflcient. This is especially true in the areas of scheduling, registration,
admitting, financial counseling and account resolution conversation with patients.
3. Corporate compliance programs play an important role in protecting the
integrity of operations and ensuring compliance with federal and state re-
quirements. The code of conduct is:: A critical tool to ensure compliance, essential and integral
component, fosters an environment, (all of the above)
4. Specific to Medicare free-for-service patients, which of the following payers
have always been liable for payment?: Black lung service programs, veteran attairs program,
working aged programs, ESRD, and disability
5. Provider policies and procedures should be in place to reduce the risk of
ethics violations. Examples include:: financial misconduct, theft of property, applying policies in
inconsistent manner (all of the above)
6. What is the intended outcome of collaborations made through an ACO
delivery system for a population of patients?: To eliminate duplicate services, prevent medical
errors and ensure appropriateness of care
7. What is the new terminology now employed in the calculation of net patient
service revenues?: explicit price concessions and implicit price concessions
8. What are the two KPIs used to monitor performance related to the produc-

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, tion and submission of claims to third party payers and patients (self-pay)?: -
Elapsed days from discharge to final bill and elapsed days from final bill to claim/bill submission
9. What happens during the post-service stage?: Final coding of all services, preparation and
submission of claims, payment processing and balance billing and resolution.
10. The following statements describe best practices established by the Medic-
aid Debt Task Force. Select true statements.: educate patients, coordinate to avoid duplicate
patient contacts, be consistent in key aspects of account resolution, follow best practices for communication
11. Which option is NOT a main HFMA Healthcare Dollars & Sense revenue cycle
initiative?: Process Compliance




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Written in
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