CRCR Certification 2024
Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by –
answer The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid - answerMeet Income and Assets
Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost -
answerRespect the patients privacy
A nightly room charge will be incorrect if the patient's - answerTransfer from ICU (intensive care unit) to
the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals
and small businesses can - answerPurchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes: -
answerCharitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare?
- answerRevenue codes
This directive was developed to promote and ensure healthcare quality and value and also to protect
consumers and workers in the healthcare system. This directive is called - answerPatient bill of rights
The activity which results in the accurate recording of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time basis is known as - answerCase management
,Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? -
answerRegistration staff may routinely contact managed are plans for prior authorizations before the
patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to
identify the employer of an individual described in a transaction EIN's are
assigned by - answerThe Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all examples of -
answerControl points for cash posting
What are some core elements if a board-approved financial assistance policy? - answerEligibility,
application process, and nonpayment collection activities
A recurring/series registration is characterized by - answerThe creation of one registration record for
multiple days of service
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of
Medicaid in some states, it is more important than ever for hospitals to - answerAssist patients in
understanding their insurance coverage and their financial obligation
The purpose of a financial report is to: - answerPresent financial information to decision makers
Patient financial communications best practices produce communications that are - answerConsistent,
clear and transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD) and National
Coverage Determinations (NCD) that establish - answerWhat services or healthcare items are covered
under Medicare
Any provider that has filed a timely cost report may appeal an adverse final decision received from the
Medicare Administrative Contractor (MAC). This appeal may be filed with - answerThe Provider
Reimbursement Review Board
, Concurrent review and discharge planning - answerOccurs during service
Duplicate payments occur: - answerWhen providers re-bill claims based on nonpayment from the initial
bill submission
An individual enrolled in Medicare who is dissatisfied with the government's claim determination is
entitled to reconsideration of the decision. This type of appeal is known as - answerA beneficiary appeal
Insurance verification results in which of the following - answerThe accurate identification of the
patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the
following levels EXCEPT: - answerJudicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask
about a patient's insurance information if it would delay what? - answerMedical screening and
stabilizing treatment
Ambulance services are billed directly to the health plan for - answerServices provided before a patient
is admitted and for ambulance rides arranged to pick up the patient from the hospital after discharge to
take him/her home or to another facility
Key performance indicators (KPIs) set standards for accounts receivables (A/R) and - answerProvide a
method of measuring the collection and control of A/R
he patient discharge process begins when - answerThe physician writes the discharge orders
The nightly room charge will be incorrect if the patient's - answerTransfer from ICU to the
Medical/Surgical floor is not reflected in the registration system.
The soft cost of a dissatisfied customer is - answerThe customer passing on info about their negative
experience to potential pts or through social media channels
Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by –
answer The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid - answerMeet Income and Assets
Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost -
answerRespect the patients privacy
A nightly room charge will be incorrect if the patient's - answerTransfer from ICU (intensive care unit) to
the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals
and small businesses can - answerPurchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes: -
answerCharitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare?
- answerRevenue codes
This directive was developed to promote and ensure healthcare quality and value and also to protect
consumers and workers in the healthcare system. This directive is called - answerPatient bill of rights
The activity which results in the accurate recording of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time basis is known as - answerCase management
,Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? -
answerRegistration staff may routinely contact managed are plans for prior authorizations before the
patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to
identify the employer of an individual described in a transaction EIN's are
assigned by - answerThe Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all examples of -
answerControl points for cash posting
What are some core elements if a board-approved financial assistance policy? - answerEligibility,
application process, and nonpayment collection activities
A recurring/series registration is characterized by - answerThe creation of one registration record for
multiple days of service
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of
Medicaid in some states, it is more important than ever for hospitals to - answerAssist patients in
understanding their insurance coverage and their financial obligation
The purpose of a financial report is to: - answerPresent financial information to decision makers
Patient financial communications best practices produce communications that are - answerConsistent,
clear and transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD) and National
Coverage Determinations (NCD) that establish - answerWhat services or healthcare items are covered
under Medicare
Any provider that has filed a timely cost report may appeal an adverse final decision received from the
Medicare Administrative Contractor (MAC). This appeal may be filed with - answerThe Provider
Reimbursement Review Board
, Concurrent review and discharge planning - answerOccurs during service
Duplicate payments occur: - answerWhen providers re-bill claims based on nonpayment from the initial
bill submission
An individual enrolled in Medicare who is dissatisfied with the government's claim determination is
entitled to reconsideration of the decision. This type of appeal is known as - answerA beneficiary appeal
Insurance verification results in which of the following - answerThe accurate identification of the
patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the
following levels EXCEPT: - answerJudicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask
about a patient's insurance information if it would delay what? - answerMedical screening and
stabilizing treatment
Ambulance services are billed directly to the health plan for - answerServices provided before a patient
is admitted and for ambulance rides arranged to pick up the patient from the hospital after discharge to
take him/her home or to another facility
Key performance indicators (KPIs) set standards for accounts receivables (A/R) and - answerProvide a
method of measuring the collection and control of A/R
he patient discharge process begins when - answerThe physician writes the discharge orders
The nightly room charge will be incorrect if the patient's - answerTransfer from ICU to the
Medical/Surgical floor is not reflected in the registration system.
The soft cost of a dissatisfied customer is - answerThe customer passing on info about their negative
experience to potential pts or through social media channels
