CRCR Exam Questions and Answers 2023-2024 Solved By
An Expert
What are collection agency fees based on? -ANS-A percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? -
ANS-Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the payer
and some or all providers? -ANS-Case rates
What customer service improvements might improve the patient accounts department? -ANS-Holding
staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -ANS-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? -
ANS-Bad debt adjustment
What is the initial hospice benefit? -ANS-Two 90-day periods and an unlimited number of subsequent
periods
When does a hospital add ambulance charges to the Medicare inpatient claim? -ANS-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? -ANS-Post 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 -
ANS-They are not being processed in a timely manner
, What is an advantage of a preregistration program? -ANS-It reduces processing times at the time of
service
What are the two statutory exclusions from hospice coverage? -ANS-Medically unnecessary services and
custodial care
What core financial activities are resolved within patient access? -ANS-Scheduling, insurance
verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? -ANS-The services do not involve an overnight
stay
How is a mis-posted contractual allowance resolved? -ANS-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? -ANS-Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has
received what? -ANS-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$? -ANS-When the patient is
the insured
What are non-emergency patients who come for service without prior notification to the provider
called? -ANS-Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the status of
the subscriber's spouse? -ANS-Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes
what? -ANS-Disclosure rules for consumer credit sales and consumer loans
An Expert
What are collection agency fees based on? -ANS-A percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? -
ANS-Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the payer
and some or all providers? -ANS-Case rates
What customer service improvements might improve the patient accounts department? -ANS-Holding
staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -ANS-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? -
ANS-Bad debt adjustment
What is the initial hospice benefit? -ANS-Two 90-day periods and an unlimited number of subsequent
periods
When does a hospital add ambulance charges to the Medicare inpatient claim? -ANS-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? -ANS-Post 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 -
ANS-They are not being processed in a timely manner
, What is an advantage of a preregistration program? -ANS-It reduces processing times at the time of
service
What are the two statutory exclusions from hospice coverage? -ANS-Medically unnecessary services and
custodial care
What core financial activities are resolved within patient access? -ANS-Scheduling, insurance
verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? -ANS-The services do not involve an overnight
stay
How is a mis-posted contractual allowance resolved? -ANS-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? -ANS-Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has
received what? -ANS-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$? -ANS-When the patient is
the insured
What are non-emergency patients who come for service without prior notification to the provider
called? -ANS-Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the status of
the subscriber's spouse? -ANS-Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes
what? -ANS-Disclosure rules for consumer credit sales and consumer loans
