CRCR Exam Questions and Answers 2023 (80 Verified Questions & Answers)

CRCR Exam 2023 1. Which of the following statements are true of HFMA's Patient Financial Communications Best Practices? ANS The best practices were developed specifi- cally 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 ANS Recognition that revenue cycle processes must be patient-centric and efficient. This is espe- cially 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 requirements. The code of conduct is ANS 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 pay- ers have always been liable for payment? ANS Black lung service programs, veteran affairs 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 ANS 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? ANS 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? ANS explicit price concessions and implicit price concessions 8. What are the two KPIs used to monitor performance related to the produc- tion and submission 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 9. What happens during the post-service stage? ANS 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 Med- icaid Debt Task Force. Select true statements. ANS 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? ANS Process Compliance 12. What is the objective of the HCAHPS initiative? ANS To provide a standardized method for evaluating patient's perspective on hospital care 13. Which option is NOT a department that supports and collaborates with the revenue cycle? ANS Assisted Living Services 14. Which option is NOT a continuum of care provider? ANS Health Plan Contract- ing 15. Which of the following are essential elements of an effective compliance program? ANS established compliance standards and procedures, oversight of per- sonnel by high-level personnel, reasonable methods to achieve compliance with standards, including monitoring systems and hotlines 16. Annually, the OIG publishes a work plan of compliance issues and objects that will be focused on the throughout the following year. Identify which option is NOT a work plan task mentioned in this course. ANS Standard Unique Employer Identifier 17. In order to promote the use of correct coding methods on a national basis and prevent payment errors due to improper coding, CMS developed what? ANS The Correct Coding Initiative(CCI) 18. What do business/organizational ethics represent? ANS Principles and stan- dards by which organizations operate 19. What is the intended outcome of collaborations made through an ACO delivery system? ANS To ensure appropriateness of care, elimination of duplicate services, and prevention of medical errors for a population of patients 20. Which of these statements describes the new methodology for the de- terminations of net patient service revenue? ANS Net patient service revenue is defined a the total incurred charges, less the explicit price concession, less any applicable implicit price concession(s) as applied to the specific portfolio of accounts. 21. What are KPIs? ANS Key Performance Indicators, which set standards for ac- counts receivable (A/R) and provide a method of measuring the collection and control of A/R 22. Which patient types are typically considered acute care patient types? ANS - Observation, newborn, Emergency(ED) 23. Accurate identification of the patient is the first step in the scheduling process. Identifiers used in various combination to achieve accurate patient identification include ANS Full legal name, date of birth, sex and social security number 24. Pre-registration is defined as ANS The collection of demographic information, insurance data, financial information, providing reminders, prep information, and identifying the potential need for financial assistance for scheduled patients.