CRCR Exam Prep: NEWEST 2023-2024 ACTUAL TEST 140
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A
What are collection agency fees based on? - Correct answer-A percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? -
Correct answer Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the payer
and some or all providers? - Correct answer Case rates
What customer service improvements might improve the patient accounts department?
- Correct answer-Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - Correct answer Inform 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 answer Bad debt adjustment
What is the initial hospice benefit? - Correct answer Two 90-day periods and an unlimited number of
subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? - Correct answer-If 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 answer-Post a
late-charge adjustment to the account
[Date] 1
,an increase in the dollars aged greater than 90 days from date of service indicate what about accounts -
Correct answer They are not being processed in a timely manner
What is an advantage of a preregistration program? - Correct answer It reduces processing times at the time
of service
What are the two statutory exclusions from hospice coverage? - Correct answer- Medically unnecessary
services and custodial care
[Date] 2
,What core financial activities are resolved within patient access? - Correct answer- Scheduling, insurance
verification, discharge processing, and payment of point-of- service receipts
What statement applies to the scheduled outpatient? - Correct answer-The services do not involve an
overnight stay
How is a mis-posted contractual allowance resolved? - Correct answer Comparing 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 answer
Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has
received what? - Correct answer Medically 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 answer-When the
patient is the insured
What are non-emergency patients who come for service without prior notification to the provider called? -
Correct answer Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the status of the
subscriber's spouse? - Correct answer-Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes
what? - Correct answer Disclosure rules for consumer credit sales and consumer loans
What is a principal diagnosis? - Correct answer Primary reason for the patient's admission
[Date] 3
, Collecting patient liability dollars after service leads to what? - Correct answer Lower accounts receivable
levels
What is the daily out-of-pocket amount for each lifetime reserve day used? - Correct answer-50% 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 answer Inpatient care
[Date] 4
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A
What are collection agency fees based on? - Correct answer-A percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? -
Correct answer Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the payer
and some or all providers? - Correct answer Case rates
What customer service improvements might improve the patient accounts department?
- Correct answer-Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - Correct answer Inform 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 answer Bad debt adjustment
What is the initial hospice benefit? - Correct answer Two 90-day periods and an unlimited number of
subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? - Correct answer-If 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 answer-Post a
late-charge adjustment to the account
[Date] 1
,an increase in the dollars aged greater than 90 days from date of service indicate what about accounts -
Correct answer They are not being processed in a timely manner
What is an advantage of a preregistration program? - Correct answer It reduces processing times at the time
of service
What are the two statutory exclusions from hospice coverage? - Correct answer- Medically unnecessary
services and custodial care
[Date] 2
,What core financial activities are resolved within patient access? - Correct answer- Scheduling, insurance
verification, discharge processing, and payment of point-of- service receipts
What statement applies to the scheduled outpatient? - Correct answer-The services do not involve an
overnight stay
How is a mis-posted contractual allowance resolved? - Correct answer Comparing 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 answer
Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has
received what? - Correct answer Medically 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 answer-When the
patient is the insured
What are non-emergency patients who come for service without prior notification to the provider called? -
Correct answer Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the status of the
subscriber's spouse? - Correct answer-Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes
what? - Correct answer Disclosure rules for consumer credit sales and consumer loans
What is a principal diagnosis? - Correct answer Primary reason for the patient's admission
[Date] 3
, Collecting patient liability dollars after service leads to what? - Correct answer Lower accounts receivable
levels
What is the daily out-of-pocket amount for each lifetime reserve day used? - Correct answer-50% 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 answer Inpatient care
[Date] 4
