Certified Revenue Cycle Representative
- CRCR (2021) (Answered) With
Complete Verified Solution 100%
Which of the following statements are true of HFMA's Financial Communications
Best Practices
The best practices were developed specifically to help patients understand the cost of
services, their individual insurance benefits, and their responsibility for balances after
insurance, if any.
The patient experience includes all of the following except:
The average number of positive mentions received by the health system or practice and
the public comments refuting unfriendly posts on social media sites.
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:
All of the above
Specific to Medicare fee-for-service patients, which of the following payers have
always been liable for payment?
Public health service programs, Federal grant programs, veteran affairs programs, black
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:
All of the above
Providers are now being reimbursed with a focus on the value of the services
provided, rather 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?
To eliminate duplicate services, prevent medical errors and ensure appropriateness of
care.
Historically, revenue cycle has delt with contractual adjustments, bad debt and
charity deductions from gross revenue. Although deductions continue to exist,
the definition of net revenue has been modified through the implementation of
ASC 606. Developed by the Financial Accounting Standards Board (FASB), this
change became effective in 2018.
What is the new terminology now employed in the calculation of net patient
services revenues?
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
submission of claims to third party payers and patients (self-pay)?
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.
True
**False
Patient service costs are calculated in the pre-service process for schedule
patients
**True
False
The patient is scheduled and registered for service is a time-of-service activity
True
**False
The patient account is monitored for payment is a time-of-service activity
True
**False
Case management and discharge planning services are a post-service activty
True
**False
Sending the bill electronically to the health plan is a time-of-service activity
True
**False
What happens during the post-service stage?
**A. Final coding of all services, preparation and submission of claims, payment
processing and balance billing and resolution.
B. Orders are entered, results are reported, charges are generated, and diagnostic and
procedural coding is initiated.
C. The encounter record is generated, and the patient and guarantor information is
obtained 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 Force. Check the box next to the True statements
**Educate Patients
**Coordinate to avoid duplicate patient contacts
Exercise moderate judgement when communicating with providers about scheduled
services
**Be consistent in key aspects of account resolution
Report to healthcare plans when the patient's account is transferred to collection agency
**Follow best practices for communication
- CRCR (2021) (Answered) With
Complete Verified Solution 100%
Which of the following statements are true of HFMA's Financial Communications
Best Practices
The best practices were developed specifically to help patients understand the cost of
services, their individual insurance benefits, and their responsibility for balances after
insurance, if any.
The patient experience includes all of the following except:
The average number of positive mentions received by the health system or practice and
the public comments refuting unfriendly posts on social media sites.
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:
All of the above
Specific to Medicare fee-for-service patients, which of the following payers have
always been liable for payment?
Public health service programs, Federal grant programs, veteran affairs programs, black
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:
All of the above
Providers are now being reimbursed with a focus on the value of the services
provided, rather 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?
To eliminate duplicate services, prevent medical errors and ensure appropriateness of
care.
Historically, revenue cycle has delt with contractual adjustments, bad debt and
charity deductions from gross revenue. Although deductions continue to exist,
the definition of net revenue has been modified through the implementation of
ASC 606. Developed by the Financial Accounting Standards Board (FASB), this
change became effective in 2018.
What is the new terminology now employed in the calculation of net patient
services revenues?
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
submission of claims to third party payers and patients (self-pay)?
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.
True
**False
Patient service costs are calculated in the pre-service process for schedule
patients
**True
False
The patient is scheduled and registered for service is a time-of-service activity
True
**False
The patient account is monitored for payment is a time-of-service activity
True
**False
Case management and discharge planning services are a post-service activty
True
**False
Sending the bill electronically to the health plan is a time-of-service activity
True
**False
What happens during the post-service stage?
**A. Final coding of all services, preparation and submission of claims, payment
processing and balance billing and resolution.
B. Orders are entered, results are reported, charges are generated, and diagnostic and
procedural coding is initiated.
C. The encounter record is generated, and the patient and guarantor information is
obtained 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 Force. Check the box next to the True statements
**Educate Patients
**Coordinate to avoid duplicate patient contacts
Exercise moderate judgement when communicating with providers about scheduled
services
**Be consistent in key aspects of account resolution
Report to healthcare plans when the patient's account is transferred to collection agency
**Follow best practices for communication
