REPRESENTATIVE - CRCR (2021)
Which,of,the,following,statements,are,true,of,HFMA's,Financial,Communications,Best,Pra
ctices,-,ans-
✔✔The,best,practices,were,developed,specifically,to,help,patients,understand,the,cost,of,
services,,their,individual,insurance,benefits,,and,their,responsibility,for,balances,after,insur
ance,,if,any.
The,patient,experience,includes,all,of,the,following,except:,-,ans-
✔✔The,average,number,of,positive,mentions,received,by,the,health,system,or,practice,an
d,the,public,comments,refuting,unfriendly,posts,on,social,media,sites.
Corporate,compliance,programs,play,an,important,role,in,protecting,the,integrity,of,operati
ons,and,ensuring,compliance,with,federal,and,state,requirements.,The,code,of,conduct,is:,
-,ans-✔✔All,of,the,above
Specific,to,Medicare,fee-for-
service,patients,,which,of,the,following,payers,have,always,been,liable,for,payment?,-,ans-
✔✔Public,health,service,programs,,Federal,grant,programs,,veteran,affairs,programs,,bla
ck,lung,program,services,and,work-related,injuries,and,accidents,
(worker',compensation,claims)
Provider,policies,and,procedures,should,be,in,place,to,reduce,the,risk,of,ethics,violations.,
Examples,of,ethics,violations,include:,-,ans-✔✔All,of,the,above
Providers,are,now,being,reimbursed,with,a,focus,on,the,value,of,the,services,provided,,rat
her,than,volume,,which,requires,collaboration,among,providers.,
What,is,the,intended,outcome,of,collaborations,made,through,an,ACO,delivery,system,for,
a,population,of,patients?,-,ans-
✔✔To,eliminate,duplicate,services,,prevent,medical,errors,and,ensure,appropriateness,of,
care.
Historically,,revenue,cycle,has,delt,with,contractual,adjustments,,bad,debt,and,charity,ded
uctions,from,gross,revenue.,Although,deductions,continue,to,exist,,the,definition,of,net,rev
enue,has,been,modified,through,the,implementation,of,ASC,606.,Developed,by,the,Financ
ial,Accounting,Standards,Board,(FASB),,this,change,became,effective,in,2018.
, What,is,the,new,terminology,now,employed,in,the,calculation,of,net,patient,services,reven
ues?,-,ans-✔✔Explicit,prices,concessions,and,implicit,price,concessions
Key,performance,indicators,set,standards,for,A/
R,and,provide,a,method,for,measuring,the,control,and,collection,of,A/R.
What,are,the,two,KPIs,used,to,monitor,performance,related,to,the,production,and,submissi
on,of,claims,to,third,party,payers,and,patients,(self-pay)?,-,ans-
✔✔Elapsed,days,from,discharge,to,final,bill,and,elapsed,days,from,final,bill,to,claim/
bill,submission.
Consents,are,signed,as,part,of,the,post-services,process.,-,ans-✔✔True
**False
Patient,service,costs,are,calculated,in,the,pre-service,process,for,schedule,patients,-,ans-
✔✔**True
False
The,patient,is,scheduled,and,registered,for,service,is,a,time-of-service,activity,-,ans-
✔✔True
**False
The,patient,account,is,monitored,for,payment,is,a,time-of-service,activity,-,ans-✔✔True
**False
Case,management,and,discharge,planning,services,are,a,post-service,activty,-,ans-
✔✔True
**False
Sending,the,bill,electronically,to,the,health,plan,is,a,time-of-service,activity,-,ans-✔✔True
**False
What,happens,during,the,post-service,stage?,-,ans-
✔✔**A.,Final,coding,of,all,services,,preparation,and,submission,of,claims,,payment,proce
ssing,and,balance,billing,and,resolution.
B.,Orders,are,entered,,results,are,reported,,charges,are,generated,,and,diagnostic,and,pr
ocedural,coding,is,initiated.
C.,The,encounter,record,is,generated,,and,the,patient,and,guarantor,information,is,obtaine
d,and/or,updated,as,required.
D.,The,focus,is,on,the,patient,and,his/
her,financial,care,,in,addition,to,the,clinical,care,provided,for,the,patient.
The,following,statements,describe,best,practices,established,by,the,Medical,Debt,Task,Fo
rce.,Check,the,box,next,to,the,True,statements,-,ans-✔✔**Educate,Patients