CRCR 2 - Pre-Service Financial Care -30 Quiz with Answers,100% CORRECT

CRCR 2 - Pre-Service Financial Care -30 Quiz with Answers While the highest level of differentiation among patients is scheduled patient vs unscheduled patient, a variety of patient types are routinely identified in both the acute and non-acute settings. Which patient types are typically considered acute care patients? (Pre-Test2) - CORRECT ANSWERSObservation, newborn, emergency (ED) Accurate identification of the patient is the first step in the scheduling process. Identifiers used in various combination to achieve accurate patient identification include? (Pre-Test2) - CORRECT ANSWERSFull legal name, date of birth, sex and social security number Pre-registration is defined as: (Pre-Test2) - CORRECT ANSWERSThe collection of demographic information, insurance data, financial information, providing reminders, prep information, and identifying the potential need for financial assistance for scheduled patients. Medicare has unique features not found in other health plan programs. It is government sponsored and financed through taxes and general revenue funds. Which of the following statements accurately describe the various Medicare benefit programs: (Pre-Test2) - CORRECT ANSWERSMedicare Part A provides benefits for inpatient hospital services, skilled nursing care and home health care; Medicare Part B covers outpatient and professional services; Medicare Part C or Medicare Advantage plans are managed care plans combining Part A and Part B coverages; and Medicare part D is the prescription drug coverage benefit. Which of the following statements about Medicaid eligibility is NOT true? (Pre-Test2) - CORRECT ANSWERSMedicaid categories are restricted to children, pregnant women and elderly in nursing homes. Examples of managed care plans include: (Pre-Test2) - CORRECT ANSWERSAll of the above Patient Financial Communications best practices include all of the following activities except: (Pre-Test2) - CORRECT ANSWERSCollecting payment or initiating the process to immediately remove the patient from the service schedule. Which statement includes the required components of an accurate pricing determination? (Pre-Test2) - CORRECT ANSWERSInsurance coverage and benefits, service or test involved, diagnosis and procedure codes, total estimated charges, adjudication calculations based on the patient's benefit package. The value of a robust scheduling and pre-registration process includes all of the following except: (Pre-Test2) - CORRECT ANSWERSIdentification of patients who are likely to be "no shows". Which patients are considered scheduled? (KC2.1) - CORRECT ANSWERSRecurring/Series Patients Name the guideline that Medicare established to determine which diagnoses, signs, or symptoms are payable. (KC2.2) - CORRECT ANSWERSLocal Coverage Determinations (LCD) What is the purpose of insurance verification? (KC2.3) - CORRECT ANSWERSTo ensure accuracy of the health plan information. The attempt to reduce costs through contractual agreements with providers is best described as: (KC2.4) - CORRECT ANSWERSManaged Care Plans The nation's oldest and largest family of private health benefits companies: (KC2.4) - CORRECT ANSWERSBlue Cross/Blue Shield Health plans that cover almost all services without authorization requirements are: (KC2.4) - CORRECT ANSWERSCommercial Indemnity Plans Plans where the costs of medical care are borne by the employer on a pay-as-you-go basis are called: (KC2.4) - CORRECT ANSWERSSelf-Insured Plans Plans responsible for providing Federal health services to Native Americans: (KC2.4) - CORRECT ANSWERSIndian Health Service (IHS) Which option is a federally-aided, state-operated program to provide health and long-term care coverage? (KC2.5) - CORRECT ANSWERSMedicaid Which most appropriately describes an HMO plan? (KC2.5) - CORRECT ANSWERSA health plan that provides comprehensive healthcare services, within a designated population, on a pre-payment basis. Which most appropriately describes a CDHP plan? (KC2.5) - CORRECT ANSWERSSubscriber agrees to a high initial deductible, in return for lower premiums. Which most appropriately describes a POS plan? (KC2.5) - CORRECT ANSWERSMembers can refer themselves outside the plan and still get some coverage. Which most appropriately describes a PPO plan? (KC2.5) - CORRECT ANSWERSA group of medical providers is identified to furnish services at lower than usual fees. What is the first step in determining a surgical case price estimate for an uninsured patient? (KC2.6) - CORRECT ANSWERSVerify the patient is not eligible for Medicaid. After verifying the patient is not eligible for Medicaid, what is the next step in determining a surgical case price estimate for an uninsured patient? (KC2.6) - CORRECT ANSWERSObtain total charges for hospital portion of case and identify network status of additional providers. In determining a surgical case price estimate for an uninsured patient, would it be appropriate to apply the organization's self-pay discount BEFORE or AFTER obtaining total charges for hospital portion of case and identifying network status of additional providers? (KC2.6) - CORRECT ANSWERSAFTER What is the first component of a pricing determination? (KC2.6) - CORRECT ANSWERSVerification of the patient's insurance eligibility and benefits. After greeting the patient and introducing yourself, what is the next step in financial counseling for an uninsured patient's surgery case? (KC2.7) - CORRECT ANSWERSExplain organization's financial care approach and patient's financial responsibility There are six steps in in financial counseling for an uninsured patient's surgery case. The first two steps are listed below. What is the third step? 1. Greet patient and give your name 2. Explain organization's financial care approach and patient's financial responsibility (KC2.7) - CORRECT ANSWERSReview patient's heath plan benefits and status Select the response that lists the steps in financial counseling for an uninsured patient's surgery case in the correct order. (KC2.7) - CORRECT ANSWERS1. Greet patient and give your name 2. Explain organization's financial care approach and patient's financial responsibility 3. Review patient's heath plan benefits and status 4. Review anticipated charges and patients anticipated liability 5. Ask patient to resolve liability by reviewing payment options 6. For uninsured, explain financial assistance options What is the purpose of financial counseling? - CORRECT ANSWERSTo educate the patient on his/her health plan coverage and financial responsibility for healthcare services