CRCS Exam Questions with Verified
Solutions
HHS - ANSWER-Health and Human Services
CMS - ANSWER-Centers for Medicare and Medicaid Services
HHS - ANSWER-U.S. Department of Health and Human Services
NIH - ANSWER-National Institutes of Health
FDA - ANSWER-Food and Drug Administration
ACL - ANSWER-Administration for Community Living; one of the HHS Operating
Divisions.
QIO - ANSWER-Quality Improvement Organization
OIG - ANSWER-Office of Inspector General
ACF - ANSWER-Administration for Children and Families
Title XVIII - ANSWER-Medicare
Title XIX - ANSWER-Medicaid
AHA - ANSWER-American Hospital Association
Patient's Bill of Rights - ANSWER-Patient Care Partnership
HIPAA - ANSWER-Health Insurance Portability and Accountability Act
PHI - ANSWER-Protected Health Information
TPO - ANSWER-Treatment, Payment & Operations
ERA - ANSWER-Electronic Remittance Advice
PSDA - ANSWER-Patient Self-Determination Act
DNR - ANSWER-do not resuscitate
,PPACA - ANSWER-Patient Protection and Affordable Care Act
CMP - ANSWER-Civil Monetary Penalty
TCPA - ANSWER-Telephone Consumer Protection Act
Regulation Z - ANSWER-Truth in Lending Act
EMTALA /Anti-Dumping Statute - ANSWER-Emergency Medical Treatment and Active
Labor Act
TJC - ANSWER-The Joint Commission
ABN - ANSWER-Advance Beneficiary Notice of Noncoverage
HINN - ANSWER-Hospital Issued Notice of Non coverage
ALOS - ANSWER-average length of stay
MOON - ANSWER-Medicare Outpatient Observation Notice
Patient Care Partnership - ANSWER-Replaces the Patient's Bill of Rights, was adopted
by the AHA, and is a plain-language brochure
PHI - ANSWER-Can be shared without explicit consent, cannot be shared for marketing
purposes w/o explicit consent, cannot be shared with law enforcement without consent
or notification to the patient, except under court order
Advance Directive - ANSWER-Living will, Healthcare Power of Attorney, DNR Order
Administrative Sanction for Inappropriate Behavior on the part of a provider - ANSWER-
Denial or revocation of the provider number application, suspension of provider
payments, application of CMP's
True of TJC - ANSWER-TJC will conduct an audit of a hospital every 39 months
PSDA - ANSWER-Deals with advance directives
ECOA - ANSWER-Prohibits credit discrimination, allowing creditors to request info but
not use it to grant credit or set terms
EMTALA - ANSWER-Prohibits questions about payment until an ED patient has been
medically screened
,PPACA - ANSWER-Has primary aim to decrease number of uninsured Americans and
reduce healthcare costs
Regulation Z - ANSWER-Requires clear identification of APR's and finance charges
HIPAA - ANSWER-Mandates patient right to examine/obtain a copy of their own health
records and request corrections
False Claims Act - ANSWER-Prohibits submitting false/fraudulent claims
Front Office - ANSWER-Acts as a liaison between the physician and the patient
Primary functions and responsibilities of Patient Access - ANSWER-1. Scheduling
2. Pre-admission and preregistration
3. Pre-certification and pre-authorization
4. Registration and admission
5. Insurance verification
6. Financial counseling
7. Collection
8. Compliance
Office productivity begins with... - ANSWER-efficient patient scheduling
Balance in scheduling - ANSWER-1. Patient satisfaction
2. Collection of financial information, demographic information, and insurance
information
3. Clinical services
Collection process gathers - ANSWER-1. Patient demographics
2. Financial information
3. Socioeconomic information
Pre-admission/service testing - ANSWER-Diagnostic medical testing of patients in
advance of surgical or invasive procedures to determine hospitalization/surgical
situability
Collection Points- Institutional Setting - ANSWER-1. Pre-admission
2. Admission
3. In-house
4. At discharge
5. After discharge
Collection Points- Professional Setting - ANSWER-1. Pre-service
2. Time of Service
3. In-house
4. At checkout
, 5. Post service
Advantages of a deposit collection program - ANSWER-Increased Hospital Cash
Collections
Reduced Amount Due at Discharge
Reduced Overall Accounts Receivable
Reduced Financial Risk and Bad Debt
NOTICE - ANSWER-Notice of Observation Treatment and Implication for Care Eligibility
Act requires that hospitals must inform patients who are hospitalized for more than 24
hours if they are in observation status
MOON - ANSWER-Standardized notice developed to inform beneficiaries when they
are an outpatient receiving observation services and are not inpatient of hospital or
critical access hospital
Refusal to Sign - ANSWER-If the beneficiary refuses to sign the MOON and there is no
rep to sign on behalf of the beneficiary, the notice must be signed by the staff member
of the hospital or CAH (Critical Access Hospital) who presented the written notification
When a service does not meet or is not expected to meet medical necessity... -
ANSWER-The beneficiary is given an ABN before services are furnished that states that
the provider believes that Medicare will not or probably will not cover the specified item
ABN - ANSWER-Contains a brief description of the service, the estimated cost, and the
reason the service is not expected to be covered
If a valid and signed ABN is not obtained prior to the services being rendered... -
ANSWER-the provider cannot bill the beneficiary for those services and will be held
financially liable if payment if not received by Medicare
ABN - ANSWER-Notice of Non-coverage- Medicare's rule that a beneficiary is not
protected from financial liability of a non-covered service if that person has knowledge
or should have had knowledge of the non-coverage **should not be given unless there
is genuine doubt of a Medicare payment**must be retained for 5 years from discharge
or completion of care
Don't Require an ABN or HINN - ANSWER-Screening mammogram
Prostate Screening Antigen
Routine Physical
Routine Foot Care
Cosmetic Surgery
Dental Care and Dentures
Solutions
HHS - ANSWER-Health and Human Services
CMS - ANSWER-Centers for Medicare and Medicaid Services
HHS - ANSWER-U.S. Department of Health and Human Services
NIH - ANSWER-National Institutes of Health
FDA - ANSWER-Food and Drug Administration
ACL - ANSWER-Administration for Community Living; one of the HHS Operating
Divisions.
QIO - ANSWER-Quality Improvement Organization
OIG - ANSWER-Office of Inspector General
ACF - ANSWER-Administration for Children and Families
Title XVIII - ANSWER-Medicare
Title XIX - ANSWER-Medicaid
AHA - ANSWER-American Hospital Association
Patient's Bill of Rights - ANSWER-Patient Care Partnership
HIPAA - ANSWER-Health Insurance Portability and Accountability Act
PHI - ANSWER-Protected Health Information
TPO - ANSWER-Treatment, Payment & Operations
ERA - ANSWER-Electronic Remittance Advice
PSDA - ANSWER-Patient Self-Determination Act
DNR - ANSWER-do not resuscitate
,PPACA - ANSWER-Patient Protection and Affordable Care Act
CMP - ANSWER-Civil Monetary Penalty
TCPA - ANSWER-Telephone Consumer Protection Act
Regulation Z - ANSWER-Truth in Lending Act
EMTALA /Anti-Dumping Statute - ANSWER-Emergency Medical Treatment and Active
Labor Act
TJC - ANSWER-The Joint Commission
ABN - ANSWER-Advance Beneficiary Notice of Noncoverage
HINN - ANSWER-Hospital Issued Notice of Non coverage
ALOS - ANSWER-average length of stay
MOON - ANSWER-Medicare Outpatient Observation Notice
Patient Care Partnership - ANSWER-Replaces the Patient's Bill of Rights, was adopted
by the AHA, and is a plain-language brochure
PHI - ANSWER-Can be shared without explicit consent, cannot be shared for marketing
purposes w/o explicit consent, cannot be shared with law enforcement without consent
or notification to the patient, except under court order
Advance Directive - ANSWER-Living will, Healthcare Power of Attorney, DNR Order
Administrative Sanction for Inappropriate Behavior on the part of a provider - ANSWER-
Denial or revocation of the provider number application, suspension of provider
payments, application of CMP's
True of TJC - ANSWER-TJC will conduct an audit of a hospital every 39 months
PSDA - ANSWER-Deals with advance directives
ECOA - ANSWER-Prohibits credit discrimination, allowing creditors to request info but
not use it to grant credit or set terms
EMTALA - ANSWER-Prohibits questions about payment until an ED patient has been
medically screened
,PPACA - ANSWER-Has primary aim to decrease number of uninsured Americans and
reduce healthcare costs
Regulation Z - ANSWER-Requires clear identification of APR's and finance charges
HIPAA - ANSWER-Mandates patient right to examine/obtain a copy of their own health
records and request corrections
False Claims Act - ANSWER-Prohibits submitting false/fraudulent claims
Front Office - ANSWER-Acts as a liaison between the physician and the patient
Primary functions and responsibilities of Patient Access - ANSWER-1. Scheduling
2. Pre-admission and preregistration
3. Pre-certification and pre-authorization
4. Registration and admission
5. Insurance verification
6. Financial counseling
7. Collection
8. Compliance
Office productivity begins with... - ANSWER-efficient patient scheduling
Balance in scheduling - ANSWER-1. Patient satisfaction
2. Collection of financial information, demographic information, and insurance
information
3. Clinical services
Collection process gathers - ANSWER-1. Patient demographics
2. Financial information
3. Socioeconomic information
Pre-admission/service testing - ANSWER-Diagnostic medical testing of patients in
advance of surgical or invasive procedures to determine hospitalization/surgical
situability
Collection Points- Institutional Setting - ANSWER-1. Pre-admission
2. Admission
3. In-house
4. At discharge
5. After discharge
Collection Points- Professional Setting - ANSWER-1. Pre-service
2. Time of Service
3. In-house
4. At checkout
, 5. Post service
Advantages of a deposit collection program - ANSWER-Increased Hospital Cash
Collections
Reduced Amount Due at Discharge
Reduced Overall Accounts Receivable
Reduced Financial Risk and Bad Debt
NOTICE - ANSWER-Notice of Observation Treatment and Implication for Care Eligibility
Act requires that hospitals must inform patients who are hospitalized for more than 24
hours if they are in observation status
MOON - ANSWER-Standardized notice developed to inform beneficiaries when they
are an outpatient receiving observation services and are not inpatient of hospital or
critical access hospital
Refusal to Sign - ANSWER-If the beneficiary refuses to sign the MOON and there is no
rep to sign on behalf of the beneficiary, the notice must be signed by the staff member
of the hospital or CAH (Critical Access Hospital) who presented the written notification
When a service does not meet or is not expected to meet medical necessity... -
ANSWER-The beneficiary is given an ABN before services are furnished that states that
the provider believes that Medicare will not or probably will not cover the specified item
ABN - ANSWER-Contains a brief description of the service, the estimated cost, and the
reason the service is not expected to be covered
If a valid and signed ABN is not obtained prior to the services being rendered... -
ANSWER-the provider cannot bill the beneficiary for those services and will be held
financially liable if payment if not received by Medicare
ABN - ANSWER-Notice of Non-coverage- Medicare's rule that a beneficiary is not
protected from financial liability of a non-covered service if that person has knowledge
or should have had knowledge of the non-coverage **should not be given unless there
is genuine doubt of a Medicare payment**must be retained for 5 years from discharge
or completion of care
Don't Require an ABN or HINN - ANSWER-Screening mammogram
Prostate Screening Antigen
Routine Physical
Routine Foot Care
Cosmetic Surgery
Dental Care and Dentures
