CRCR Multiple Choice (questions with most accurate answers)

CRCR
Multiple
Choice
(questions
with
most
accurate
answers)
2023\2024
The
disadvantages
of
outsourcing
include
all
of
the
following
EXCEPT:
a)
The
impact
of
customer
service
or
patient
relations
b)
The
impact
of
loss
of
direct
control
of
accounts
receivable
services
c)
Increased
costs
due
to
vendor
ineffectiveness
d)
Reduced
internal
staffing
costs
and
a
reliance
on
outsourced
staff
-
ANS
D
The
Medicare
fee-for
service
appeal
process
for
both
beneficiaries
and
providers
includes
all
of
the
following
levels
EXCEPT:
a)
Medical
necessity
review
by
an
independent
physician's
panel
b)
Judicial
review
by
a
federal
district
court
c)
Redetermination
by
the
company
that
handles
claims
for
Medicare
d)
Review
by
the
Medicare
Appeals
Council
(Appeals
Council)
-
ANS
B
Business
ethics,
or
organizational
ethics
represent:
a)
The
principles
and
standards
by
which
organizations
operate
b)
Regulations
that
must
be
followed
by
law
c)
Definitions
of
appropriate
customer
service
d)
The
code
of
acceptable
conduct
-
ANS
A
A
portion
of
the
accounts
receivable
inventory
which
has
NOT
qualified
for
billing
includes:
a)
Charitable
pledges
b)
Accounts
created
during
pre-registration
but
not
activated
c)
Accounts
coded
but
held
within
the
suspense
period
d)
Accounts
assigned
to
a
pre-collection
agency
-
ANS
A
Local
Coverage
Determinations
(LCD)
and
National
Coverage
Determinations
(NCD)
are
Medicare
established
guideline(s)
used
to
determine:
a)
Medicare
and
Medicaid
provider
eligibility
b)
Medicare
outpatient
reimbursement
rates
c)
Which
diagnoses,
signs,
or
symptoms
are
reimbursable
d)
What
Medicare
reimburses
and
what
should
be
referred
to
Medicaid
-
ANS
C
Days
in
A/R
is
calculated
based
on
the
value
of: a)
The
total
accounts
receivable
on
a
specific
date
b)
Total
anticipated
revenue
minus
expenses
c)
The
time
it
takes
to
collect
anticipated
revenue
d)
Total
cash
received
to
date
-
ANS
C
Patients
are
contacting
hospitals
to
proactively
inquire
about
costs
and
fees
prior
to
agreeing
to
service.
The
problem
for
hospitals
in
providing
such
information
is:
a)
That
hospitals
don't
want
to
establish
a
price
without
knowing
if
the
patient
has
insurance
and
how
much
reimbursement
can
be
expected
b)
The
fact
that
charge
master
lists
the
total
charge,
not
net
charges
that
reflect
charges
after
a
payer's
contractual
adjustment
c)
That
hospitals
don't
want
to
be
put
in
the
position
of
"guaranteeing"
price
without
having
room
for
additional
charges
that
may
arise
in
the
course
of
treatment
d)
Their
reluctance
to
share
proprietary
information
-
ANS
B
Across
all
care
settings,
if
a
patient
consents
to
a
financial
discussion
during
a
medical
encounter
to
expedite
discharge,
the
HFMA
best
practice
is
to:
a)
Make
sure
that
the
attending
staff
can
answer
questions
and
assist
in
obtaining
required
patient
financial
data
b)
Have
a
patient
financial
responsibilities
kit
ready
for
the
patient,
containing
all
of
the
required
registration
forms
and
instructions
c)
Support
that
choice,
providing
that
the
discussion
does
not
interfere
with
patient
care
or
disrupt
patient
flow
d)
Decline
such
request
as
finance
discussions
can
disrupt
patient
care
and
patient
flow
-
ANS
C
A
comprehensive
"Compliance
Program"
is
defined
as
a)
Annual
legal
audit
and
review
for
adherence
to
regulations
b)
Educating
staff
on
regulations
c)
Systematic
procedures
to
ensure
that
the
provisions
of
regulations
imposed
by
a
government
agency
are
being
met
d)
The
development
of
operational
policies
that
correspond
to
regulations
-
ANS
C
Case
Management
requires
that
a
case
manager
be
assigned
a)
To
patients
of
any
physician
requesting
case
management
b)
To
a
select
patient
group c)
To
every
patient
d)
To
specific
cases
designated
by
third
party
contractual
agreement
-
ANS
B
Pricing
transparency
is
defined
as
readily
available
information
on
the
price
of
healthcare
services,
that
together
with
other
information,
help
define
the
value
of
those
services
and
enable
consumers
to
a)
Identify,
compare,
and
choose
providers
that
offer
the
desired
level
of
value
b)
Customize
health
care
with
a
personally
chosen
mix
of
providers
c)
Negotiate
the
cost
of
health
plan
premiums
d)
Verify
the
cost
of
individual
clinicians
-
ANS
A
Any
healthcare
insurance
plan
that
provides
or
ensures
comprehensive
health
maintenance
and
treatment
services
for
an
enrolled
group
of
persons
based
on
a
monthly
fee
is
known
as
a
a)
MSO
b)
HMO
c)
PPO
d)
GPO
-
ANS
B
In
a
Chapter
7
Straight
Bankruptcy
filing
a)
The
court
liquidates
the
debtor's
nonexempt
property,
pays
creditors,
and
discharges
the
debtor
from
the
debt
b)
The
court
liquidates
the
debtor's
nonexempt
property,
pays
creditors,
and
begins
to
pay
off
the
largest
claims
first.
All
claims
are
paid
some
portion
of
the
amount
owed
c)
The
court
vacates
all
claims
against
a
debtor
with
the
understanding
that
the
debtor
may
not
apply
for
credit
without
court
supervision
d)
The
court
establishes
a
creditor
payment
schedule
with
the
longest
outstanding
claims
paid
first
-
ANS
A
The
core
financial
activities
resolved
within
patient
access
include:
a)
Scheduling,
pre-registration,
insurance
verification
and
managed
care
processing
b)
Scheduling,
insurance
verification,
clinical
discharge
processing
and
payment
posting
of
point
of
service
receipts
c)
Scheduling,
registration,
charge
entry
and
managed
care
processing
d)
Scheduling,
pre-registration,
registration,
medical
necessity