CRCR 2022 EXAM QUESTIONS WITH ANSWERS
GUARANTEED SUCCESS
What core financial activities are resolved within patient access? -
Correct answer- Scheduling, insurance verification, discharge
processing, and payment of point-of- service receipts
What statement applies to the scheduled outpatient? - Correct answer-The
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? - Correct answer-
Comparing the contract reimbursement rates with the contract on the
admittance advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for
inpatient care? - Correct answer-Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? - Correct answer-Medically
necessary inpatient hospital services for at least 3 consecutive days before
the skilled nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
- Correct answer-When the patient is the insured
What are non-emergency patients who come for service without prior
notification to the provider called? - Correct answer-Unscheduled patients
If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? - Correct answer-
Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth
in Lending Act, establishes what? - Correct answer-Disclosure rules for
consumer credit sales and consumer loans
What is a principal diagnosis? - Correct answer-Primary reason for the
patient's admission
Collecting patient liability dollars after service leads to what? - Correct
answer-Lower accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day
used? - Correct answer-50% of the current deductible amount
What service provided to a Medicare beneficiary in a rural health clinic
(RHC) is not billable as an RHC services? - Correct answer-Inpatient care
,CRCR 2022 EXAM QUESTIONS WITH ANSWERS
GUARANTEED SUCCESS
What code indicates the disposition of the patient at the conclusion of
service? - Correct answer-Patient discharge status code
What are hospitals required to do for Medicare credit balance
accounts? - Correct answer-They result in lost reimbursement and
additional cost to collect
When an undue delay of payment results from a dispute between the
patient and the third party payer, who is responsible for payment? - Correct
answer-Patient
Medicare guidelines require that when a test is ordered for a LCD or NCD
exists, the information provided on the order must include: - Correct
answer-A valid CPT or HCPCS code
With advances in internet security and encryption, revenue-cycle processes
are expanding to allow patients to do what? - Correct answer-Access their
information and perform functions on-line
What date is required on all CMS 1500 claim forms? - Correct answer-
onset date of current illness
What does scheduling allow provider staff to do - Correct
answer-Review appropriateness of the service request
What code is used to report the provider's most common semiprivate
room rate? - Correct answer-Condition code
Regulations and requirements for coding accountable care organizations,
which allows providers to begin creating these organizations, were finalized
in: - Correct answer-2012
What is a primary responsibility of the Recover Audit Contractor? - Correct
answer-To correctly identify proper payments for Medicare Part A & B
claims
How must providers handle credit balances? - Correct answer-Comply
with state statutes concerning reporting credit balance
Insurance verification results in what? - Correct answer-The accurate
identification of the patient's eligibility and benefits
What form is used to bill Medicare for rural health clinics? - Correct answer-
CMS 1500
What activities are completed when a scheduled pre-registered patient
arrives for service? - Correct answer-Registering the patient and directing
,CRCR 2022 EXAM QUESTIONS WITH ANSWERS
GUARANTEED SUCCESS
the patient to the service area
, CRCR 2022 EXAM QUESTIONS WITH ANSWERS
GUARANTEED SUCCESS
In addition to being supported by information found in the patient's chart, a
CMS 1500 claim must be coded using what? - Correct answer-HCPCS
(Healthcare Common Procedure Coding system)
What results from a denied claim? - Correct answer-The provider incurs
rework and appeal costs
Why does the financial counselor need pricing for services? - Correct
answer-To calculate the patient's financial responsibility
What type of provider bills third-party payers using CMS 1500 form -
Correct answer- Hospital-based mammography centers
How are disputes with nongovernmental payers resolved? - Correct
answer-Appeal conditions specified in the individual payer's contract
The important message from Medicare provides beneficiaries with
information concerning what? - Correct answer-Right to appeal a discharge
decision if the patient disagrees with the services
Why do managed care plans have agreements with hospitals, physicians,
and other healthcare providers to offer a range of services to plan
members? - Correct answer-To improve access to quality healthcare
If a patient remains an inpatient of an SNF (skilled nursing facility for
more than 30 days, what is the SNF permitted to do? - Correct answer-
Submit interim bills to the Medicare program.
90. MSP (Medicare Secondary Payer) rules allow providers to bill Medicare
for liability claims after what happens? - Correct answer-120 days passes,
but the claim then be withdrawn from the liability carrier
What data are required to establish a new MPI entry? - Correct answer-The
patient's full legal name, date of birth, and sex
What should the provider do if both of the patient's insurance plans pay as
primary? - Correct answer-Determine the correct payer and notify the
incorrect payer of the processing error
What do EMTALA regulations require on-call physicians to do? - Correct
answer- Personally appear in the emergency department and attend to
the patient within a reasonable time
At the end of each shift, what must happen to cash, checks, and credit card
transaction documents? - Correct answer-They must be balanced
GUARANTEED SUCCESS
What core financial activities are resolved within patient access? -
Correct answer- Scheduling, insurance verification, discharge
processing, and payment of point-of- service receipts
What statement applies to the scheduled outpatient? - Correct answer-The
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? - Correct answer-
Comparing the contract reimbursement rates with the contract on the
admittance advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for
inpatient care? - Correct answer-Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? - Correct answer-Medically
necessary inpatient hospital services for at least 3 consecutive days before
the skilled nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
- Correct answer-When the patient is the insured
What are non-emergency patients who come for service without prior
notification to the provider called? - Correct answer-Unscheduled patients
If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? - Correct answer-
Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth
in Lending Act, establishes what? - Correct answer-Disclosure rules for
consumer credit sales and consumer loans
What is a principal diagnosis? - Correct answer-Primary reason for the
patient's admission
Collecting patient liability dollars after service leads to what? - Correct
answer-Lower accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day
used? - Correct answer-50% of the current deductible amount
What service provided to a Medicare beneficiary in a rural health clinic
(RHC) is not billable as an RHC services? - Correct answer-Inpatient care
,CRCR 2022 EXAM QUESTIONS WITH ANSWERS
GUARANTEED SUCCESS
What code indicates the disposition of the patient at the conclusion of
service? - Correct answer-Patient discharge status code
What are hospitals required to do for Medicare credit balance
accounts? - Correct answer-They result in lost reimbursement and
additional cost to collect
When an undue delay of payment results from a dispute between the
patient and the third party payer, who is responsible for payment? - Correct
answer-Patient
Medicare guidelines require that when a test is ordered for a LCD or NCD
exists, the information provided on the order must include: - Correct
answer-A valid CPT or HCPCS code
With advances in internet security and encryption, revenue-cycle processes
are expanding to allow patients to do what? - Correct answer-Access their
information and perform functions on-line
What date is required on all CMS 1500 claim forms? - Correct answer-
onset date of current illness
What does scheduling allow provider staff to do - Correct
answer-Review appropriateness of the service request
What code is used to report the provider's most common semiprivate
room rate? - Correct answer-Condition code
Regulations and requirements for coding accountable care organizations,
which allows providers to begin creating these organizations, were finalized
in: - Correct answer-2012
What is a primary responsibility of the Recover Audit Contractor? - Correct
answer-To correctly identify proper payments for Medicare Part A & B
claims
How must providers handle credit balances? - Correct answer-Comply
with state statutes concerning reporting credit balance
Insurance verification results in what? - Correct answer-The accurate
identification of the patient's eligibility and benefits
What form is used to bill Medicare for rural health clinics? - Correct answer-
CMS 1500
What activities are completed when a scheduled pre-registered patient
arrives for service? - Correct answer-Registering the patient and directing
,CRCR 2022 EXAM QUESTIONS WITH ANSWERS
GUARANTEED SUCCESS
the patient to the service area
, CRCR 2022 EXAM QUESTIONS WITH ANSWERS
GUARANTEED SUCCESS
In addition to being supported by information found in the patient's chart, a
CMS 1500 claim must be coded using what? - Correct answer-HCPCS
(Healthcare Common Procedure Coding system)
What results from a denied claim? - Correct answer-The provider incurs
rework and appeal costs
Why does the financial counselor need pricing for services? - Correct
answer-To calculate the patient's financial responsibility
What type of provider bills third-party payers using CMS 1500 form -
Correct answer- Hospital-based mammography centers
How are disputes with nongovernmental payers resolved? - Correct
answer-Appeal conditions specified in the individual payer's contract
The important message from Medicare provides beneficiaries with
information concerning what? - Correct answer-Right to appeal a discharge
decision if the patient disagrees with the services
Why do managed care plans have agreements with hospitals, physicians,
and other healthcare providers to offer a range of services to plan
members? - Correct answer-To improve access to quality healthcare
If a patient remains an inpatient of an SNF (skilled nursing facility for
more than 30 days, what is the SNF permitted to do? - Correct answer-
Submit interim bills to the Medicare program.
90. MSP (Medicare Secondary Payer) rules allow providers to bill Medicare
for liability claims after what happens? - Correct answer-120 days passes,
but the claim then be withdrawn from the liability carrier
What data are required to establish a new MPI entry? - Correct answer-The
patient's full legal name, date of birth, and sex
What should the provider do if both of the patient's insurance plans pay as
primary? - Correct answer-Determine the correct payer and notify the
incorrect payer of the processing error
What do EMTALA regulations require on-call physicians to do? - Correct
answer- Personally appear in the emergency department and attend to
the patient within a reasonable time
At the end of each shift, what must happen to cash, checks, and credit card
transaction documents? - Correct answer-They must be balanced
