CRCR Topics | HFMA CRCR (2023) Exam Unit 1 | Approved Answers

CRCR Topics | HFMA CRCR (2023) Exam Unit 1 | Approved Answers CRCR Topics | HFMA CRCR (2023) Exam Unit 1 | Approved Answers CRCR Topics | HFMA CRCR (2023) Exam Unit 1 | Approved Answers Net Days in AR - Answer - Measures how fast receivables are collected. It is a trending indicator of overall A/R performance & revenue cycle efficiency. A/R Aging - Answer - Reports divide the AR into 30, 60, 90, and 120 day categories, based on discharge. Credit Balances - Days Outstanding - Answer - The dollars in credit balance at the account level divided by the three month daily average of total net patient service revenue. Credit balances should be resolved timely and should be benchmarked at 1% of the days outstanding in the AR. 3 Critical Elements of the Healthcare Revenue Cycle - Answer - Pre-Service, Time of Service, Post Service Provision of Care - Answer - Describing elective vs. non-elective services to the patient, and discussing prior balances the patient has (if applicable). Emergency Medical Treatment and Active Labor Act (EMTALA) - Answer - Says that no patient financial discussions should occur before a patient is screened and stabilized. HFMA's Adopter Program - Answer - Providers who implement and support the best practices of Patient Financial Communication are eligible and encouraged to apply for recommendation by HFMA as an Adopter of Patient Financial Communication Best Practices. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Initiative - Answer - Implemented by CMS to provide a standardized method for evaluating patient's perspective on hospital care. 27 total questions on the survey. Key Question is "Would you recommend this hospital to your friends and family?" Continuum of Care - Answer - Involves healthcare providers in multiple settings and multiple levels coming together with the overall goal of coordinating patients' healthcare Transfer Agreements - Answer - To participate in the Medicare program, a SNF must have written transfer agreement with one or more participating hospitals providing for the transfer of patients between the hospital and the SNF, and for the interchange of medical and other information. Office of the Inspector General (OIG) - Answer - Developed the Model Compliance Plan for clinical Laboratories in 1997, and the Compliance Program Guidance for Hospitals in 1998, followed by almost a dozen other guidance documents. Oversees medical billing compliance. Essential Elements in a Corporate Compliance Program - Answer - Have a Plan Follow the Plan Review the Code of Conduct to verify you follow the plan Fraud Enforcement and Recovery Act (FERA) - Answer - Signed into law in 2009, which amended the False Claims Act (FCA) in several important respects, including the closure of loopholes and enhancement of the ability of government whistleblowers, and reporting individuals to identify and successfully pursue entities and individuals who improperly receive government funds. The Healthcare Insurance and Portability Act (HIPPA) - Answer - Passed in 1996, includes requirements that specifically address compliance include the following: Coordinating a fraud and abuse control program Establishing a fraud and abuse control account Increasing the civil money penalties Permitting the exclusion of individuals with ownership or control interest in a sanctioned entity. Also created National Provider Identifiers (NPI) were created to eliminate the myriad of other provider IDs previously used. The Health Information Technology for Electronic and Clinical Health (HITECH) - Answer - Passed in 2009 to promote the adoption of meaningful use of health IT. Addressed the privacy and security concerns associated with the electronic transmission of health information. The rule became effective on March 26th and compliance was required as of 9.23.13.