CRCR Exam Prep Updated 2023 Correct Answers
What are collection agency fees based on? - correct answersA percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule? - correct answersBirthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the
payer and some or all providers? - correct answersCase rates
What customer service improvements might improve the patient accounts department? - correct
answersHolding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - correct
answersInform a Medicare beneficiary that Medicare may not pay for the order or service
What type of account adjustment results from the patient's unwillingness to pay for a self-pay
balance? - correct answersBad debt adjustment
What is the initial hospice benefit? - correct answersTwo 90-day periods and an unlimited
number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? - correct
answersIf the patient requires ambulance transportation to a skilled nursing facility
How should a provider resolve a late-charge credit posted after an account is billed? - correct
answersPost a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service indicate what about
accounts - correct answersThey are not being processed in a timely manner
What is an advantage of a preregistration program? - correct answersIt reduces processing times
at the time of service
What are the two statutory exclusions from hospice coverage? - correct answersMedically
unnecessary services and custodial care
What core financial activities are resolved within patient access? - correct answersScheduling,
insurance verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? - correct answersThe services do not involve
an overnight stay
How is a mis-posted contractual allowance resolved? - correct answersComparing 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
answersObservation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what? - correct answersMedically 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
answersWhen the patient is the insured
What are non-emergency patients who come for service without prior notification to the provider
called? - correct answersUnscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the
status of the subscriber's spouse? - correct answersNeither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act,
establishes what? - correct answersDisclosure rules for consumer credit sales and consumer loans
What is a principal diagnosis? - correct answersPrimary reason for the patient's admission
Collecting patient liability dollars after service leads to what? - correct answersLower accounts
receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? - correct answers50%
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 answersInpatient care
What code indicates the disposition of the patient at the conclusion of service? - correct
answersPatient discharge status code
What are hospitals required to do for Medicare credit balance accounts? - correct answersThey
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 answersPatient
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
provided on the order must include: - correct answersA valid CPT or HCPCS code
With advances in internet security and encryption, revenue-cycle processes are expanding to
allow patients to do what? - correct answersAccess their information and perform functions on-
line
What are collection agency fees based on? - correct answersA percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule? - correct answersBirthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the
payer and some or all providers? - correct answersCase rates
What customer service improvements might improve the patient accounts department? - correct
answersHolding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - correct
answersInform a Medicare beneficiary that Medicare may not pay for the order or service
What type of account adjustment results from the patient's unwillingness to pay for a self-pay
balance? - correct answersBad debt adjustment
What is the initial hospice benefit? - correct answersTwo 90-day periods and an unlimited
number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? - correct
answersIf the patient requires ambulance transportation to a skilled nursing facility
How should a provider resolve a late-charge credit posted after an account is billed? - correct
answersPost a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service indicate what about
accounts - correct answersThey are not being processed in a timely manner
What is an advantage of a preregistration program? - correct answersIt reduces processing times
at the time of service
What are the two statutory exclusions from hospice coverage? - correct answersMedically
unnecessary services and custodial care
What core financial activities are resolved within patient access? - correct answersScheduling,
insurance verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? - correct answersThe services do not involve
an overnight stay
How is a mis-posted contractual allowance resolved? - correct answersComparing 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
answersObservation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what? - correct answersMedically 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
answersWhen the patient is the insured
What are non-emergency patients who come for service without prior notification to the provider
called? - correct answersUnscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the
status of the subscriber's spouse? - correct answersNeither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act,
establishes what? - correct answersDisclosure rules for consumer credit sales and consumer loans
What is a principal diagnosis? - correct answersPrimary reason for the patient's admission
Collecting patient liability dollars after service leads to what? - correct answersLower accounts
receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? - correct answers50%
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 answersInpatient care
What code indicates the disposition of the patient at the conclusion of service? - correct
answersPatient discharge status code
What are hospitals required to do for Medicare credit balance accounts? - correct answersThey
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 answersPatient
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
provided on the order must include: - correct answersA valid CPT or HCPCS code
With advances in internet security and encryption, revenue-cycle processes are expanding to
allow patients to do what? - correct answersAccess their information and perform functions on-
line
