CRCR Unit 1 Review 24 Questions and Answers 2023,100% CORRECT

CRCR Unit 1 Review 24 Questions and Answers 2023 The 3 patient-centric revenue cycle processing steps - CORRECT ANSWERSPre-service, time-of-service, post-service Pre-service steps - CORRECT ANSWERSPatient scheduled and pre-registered, encounter record generated, patient and guarantor information is obtained, medical necesity-health plan coverage verified-pre-auth, cost of service determined, additional processing for not medically necessary procedures, explanation of patients financial responsibility Time of service steps - CORRECT ANSWERSPatient arrives and pre-registered information is pulled up. Consents signed and amounts collected. Positive ID completed and armband given. Post service steps - CORRECT ANSWERSAfter the patient is discharged until the account reaches a zero balance such as final coding, prep and submission of claims, payment processing and balance billing What happens during the post-service stage? - CORRECT ANSWERSFinal coding of all services, preparation and submission of claims, payment processing and balance billing and resolution. What happens during the pre-service segment? - CORRECT ANSWERSScheduling and pre-access processing is completed. The patient is scheduled, pre-registered for service and the required data is collected. What happens during time-of-service segment? - CORRECT ANSWERSFinal account review is completed for a scheduled patient prior to arrival. Upon arrival, patient is positively identified, pre-registration record activated, consents are signed, copays collected. What is done at time-of-service for unscheduled patients? - CORRECT ANSWERSComprehensive registration and financial processing is completed which mirrors the work that was completed for scheduled patients. 3 components to Healthcare Dollars and Sense Revenue Cycle initiative? - CORRECT ANSWERSMedical Account Resolution, Pricing Transparency, Patient Financial Communications When is it appropriate to discuss financial items for a ED patient? - CORRECT ANSWERSAfter the patient has been stabilized or during the discharge process. As long as it does not interfere with the patients care. What is the objective of the HCAHPS initiative? - CORRECT ANSWERSTo provide a standardized method for evaluating patients' perspective on hospital care. Examples of a continuum of care provider? - CORRECT ANSWERSSkilled Nursing Facility, Physician, Hospice What are types of OIG compliance issues published? - CORRECT ANSWERSMedical devices, provider based status, reconciliation of outlier payments 3 goals of HIPAA - CORRECT ANSWERSExpand health coverage by improving portability, give patients access to health files and the right to request amendments or make corrections, facilitate the electronic exchange of medical information. CMS developed in order to promote the use of correct coding methods on a national basis. - CORRECT ANSWERSCorrect Coding Initiative (CCI) Three-Day DRG Window Rule - CORRECT ANSWERSRequires certain outpatient services that are provided within three days of the admit date to be billed as part of an inpatient stay. Purpose of the ABN - CORRECT ANSWERSTo inform Medicare beneficiary what Medicare will not pay for. 4 situations where Medicare acts as secondary payer - CORRECT ANSWERSWorking Aged, Accident or other liability, disability, End stage renal disease (ESRD) What is the intended outcome of collaborations made through an ACO delivery system? - CORRECT ANSWERSTo ensure appropriateness of care, elimination of duplicate services, and prevention of medical errors for a population of patients. 3 types of reserve amounts on a providers financial statement - CORRECT ANSWERSBad Debt, contractual allowance accounts, charity care 4 reasons why ACA was passed and signed into law - CORRECT ANSWERSImprove the quality of care, reform the healthcare delivery system, encourage pricing transparency and modernized financing systems, address the issue of waste, fraud, and abuse. Quality of care improvements include: - CORRECT ANSWERSReducing hospital re-admissions, reducing hospital acquired conditions, comprehensive joint replacement and cardiac services, improving physician quality reporting. MSSP Medicare Shared Savings Program - CORRECT ANSWERSIs designed to improve beneficiary outcomes and increase the value of care by promoting accountability for Medicare Fee-for-service beneficiaries, requiring coordinated care for all services, encouraging investment in infrastructure and redesigned care models and processes. BPCI Bundled Payments for Care Improvement - CORRECT ANSWERS4 models of care. 1-episode of care inpatient stay, acute. 2-retrospective bundled, total expenditures for a beneficiary's episode is later reconciled for the target price of the bundled payment amount. 3-retrospective bundled payment where actual expenditures are reconciled against a target price for an episode of care. 4-single prospectively determined bundled payment for all services furnished.