CRCR Updated Study Questions and Answers 2023-
Graded A+
CRCR study
QUESTION ANSWER
ERA Electronic Remittance Advice
Level 1 of ERA Receipt of Data/the information is printed
Electronic remittance is received, entered into
Level 2 of ERA
computer, and viewed at terminal
Electronic remittance is received, entered into
computer - remittance data are electronically posted
Level 3 of ERA
by the patient accounting software, updating the
patients account.
Total automation receipt, data entry, payment
Level 4 of ERA
posting, adjustment processing
is the electronic transfer of funds from payer to
EFT payee thru the banking system (fasted way to move
money)
Room and board, PT, OT, ST, Respiratory Carem
SNF Services Covered (6)
Drugs, Blood transfusions, supplies and equipment
EDI Electronic Data interchange
translating, standardizing and sending transactions
EDI used for?
electronically (claims) 837. 270/271, etc...
835 Remittance
Violation of the DRG Window (3 delay in billing, rejection of claim, additionaly
day) causes sanctions, fines, revocation of medicare status
, UBO4 is used for institutional
hospitals, hospice, rural health clinic, snf
providers(List 4)
must be IP atleast 3 days before discharging to SNF,
SNF IP rules
must be admitted with in30 days of IP stay.
DRG used for Inpatient billing
APC used for outpatient billing
100 Days during a benefit period/ Benefit period
Benefit SNF Period? ends during which the patient is not a IP or SNF for
60 days.
Program consists of Edits implemented w/claim
CCI Edits are?
processing to catch errors before sending out
payment system in which a lump sum or bundled
Package Pricing is? payment is negotiated between payor and some or
all providers.
health plans developed care plans for common
Site of service limitation? disease and procedures and must happen in
approved setting
Title 804 governs actions of skip tracing
Title 805 Collector communication ceasing communication
Title 806 proibits harassment abuse from the collector
Title 807 deceptive or false representations
gives permision to see credit reports by court, by
Title 604 (FCRA) consumer, and a reporting agency who has
legitimate business to view
Hospice Benefits with Medicare 2 90 day periods and unlimited subsequent periods-
include 60 days each
Graded A+
CRCR study
QUESTION ANSWER
ERA Electronic Remittance Advice
Level 1 of ERA Receipt of Data/the information is printed
Electronic remittance is received, entered into
Level 2 of ERA
computer, and viewed at terminal
Electronic remittance is received, entered into
computer - remittance data are electronically posted
Level 3 of ERA
by the patient accounting software, updating the
patients account.
Total automation receipt, data entry, payment
Level 4 of ERA
posting, adjustment processing
is the electronic transfer of funds from payer to
EFT payee thru the banking system (fasted way to move
money)
Room and board, PT, OT, ST, Respiratory Carem
SNF Services Covered (6)
Drugs, Blood transfusions, supplies and equipment
EDI Electronic Data interchange
translating, standardizing and sending transactions
EDI used for?
electronically (claims) 837. 270/271, etc...
835 Remittance
Violation of the DRG Window (3 delay in billing, rejection of claim, additionaly
day) causes sanctions, fines, revocation of medicare status
, UBO4 is used for institutional
hospitals, hospice, rural health clinic, snf
providers(List 4)
must be IP atleast 3 days before discharging to SNF,
SNF IP rules
must be admitted with in30 days of IP stay.
DRG used for Inpatient billing
APC used for outpatient billing
100 Days during a benefit period/ Benefit period
Benefit SNF Period? ends during which the patient is not a IP or SNF for
60 days.
Program consists of Edits implemented w/claim
CCI Edits are?
processing to catch errors before sending out
payment system in which a lump sum or bundled
Package Pricing is? payment is negotiated between payor and some or
all providers.
health plans developed care plans for common
Site of service limitation? disease and procedures and must happen in
approved setting
Title 804 governs actions of skip tracing
Title 805 Collector communication ceasing communication
Title 806 proibits harassment abuse from the collector
Title 807 deceptive or false representations
gives permision to see credit reports by court, by
Title 604 (FCRA) consumer, and a reporting agency who has
legitimate business to view
Hospice Benefits with Medicare 2 90 day periods and unlimited subsequent periods-
include 60 days each
