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Exam (elaborations)

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 Certification

1. Overall aggregate payments made to a hospice are subject to a computed
"cap amount" calculated by: The Medicare Administrative Contractor (MAC) at the end of the hospice
cap period
2. Which of the following is required for participation in Medicaid: Meet Income and
Assets Requirements
3. In choosing a setting for patient financial discussions, organizations should
first and foremost: Respect the patients privacy
4. A nightly room charge will be incorrect if the patient's: Transfer from ICU (intensive care
unit) to the Medical/Surgical
floor is not reflected in the registration system
5. The Affordable Care Act legislated the development of Health Insurance
Exchanges, where individuals and small businesses can: Purchase qualified health
benefit plans regardless of insured's
health status
6. A portion of the accounts receivable inventory which has NOT qualified for
billing includes:: Charitable pledges
7. What is required for the UB-04/837-I, used by Rural Health Clinics to gener-
ate payment from Medicare?: Revenue codes
8. 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: Patient bill of rights
9. 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: Case management
10. Which statement is an EMTALA (Emergency Medical Treatment and Active
Labor Act) violation?: Registration statt may routinely contact managed are plans for prior authorizations
before the patient is seen by the on-duty physician
11. HIPAA had adopted Employer Identification Numbers (EIN) to be used in
standard transactions to identify the employer of an individual described in a
transaction EIN's are


,assigned by: The Internal Revenue Service






, 12. Checks received through mail, cash received through mail, and lock box are
all examples of: Control points for cash posting
13. What are some core elements if a board-approved financial assistance
policy?: Eligibility, application process, and nonpayment collection activities
14. A recurring/series registration is characterized by: The creation of one registration
record for multiple days of service
15. 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: Assist patients in understanding their insurance coverage and their financial obligation
16. The purpose of a financial report is to:: Present financial information to decision makers
17. Patient financial communications best practices produce communications
that are: Consistent, clear and transparent
18. Medicare has established guidelines called the Local Coverage Determina-
tions (LCD) and National Coverage Determinations (NCD) that establish: What
services or healthcare items are covered under Medicare
19. 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: The Provider Reimbursement Review Board
20. Concurrent review and discharge planning: Occurs during service
21. Duplicate payments occur:: When providers re-bill claims based on nonpayment from the initial bill
submission
22. 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: A beneficiary appeal
23. Insurance verification results in which of the following: The accurate identification of
the patient's eligibility and benefits
24. The Medicare fee-for service appeal process for both beneficiaries and
providers includes all of the following levels EXCEPT:: Judicial review by a federal district
court
25. Under EMTALA (Emergency Medical Treatment and Labor Act) regulations,
the providermay not ask about a patient's insurance information if it would
delay what?: Medical screening and stabilizing treatment

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Uploaded on
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Number of pages
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Written in
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