CRCR Section 1 - Revenue Cycle Introduction Exam Questions and Answers 100% Pass

CRCR Section 1 - Revenue Cycle Introduction Exam Questions and Answers 100% Pass The Revenue Cycle - ANSWER -Includes all of the major processing steps required to process a patient account from the request for service through closing the account with a zero balance and purging it from the system. 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 6 of my notes) * Scheduling and pre-registering * Encounter generated * Guarantor information is obtained/updated * Medical Necessity screening * Health plan coverage and benefits are verified * Pre-Authorizations are obtained * The cost of the scheduled service is identified and calculated * Calculation of copay, coinsurance, and deductibles - ANSWER -Pre-Service processes 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 6 of my notes) * Scheduled Patients: * A final account review is completed prior to the patient's arrival. 2 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. * Pre-registration record is activated * Consents are signed * Co-payments and/or other agreed upon amounts are collected. * Positive patient identification is completed, and the patient is given an armband * Unscheduled Patients (Walk-ins) * Comprehensive registration and financial processing is completed * This process mirrors the work completed for the scheduled patients prior to service. * Case Management and discharge planning - ANSWER -Time-of-service processes 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 6 - 7 of my notes) * Final coding of all services provided * Preparation and submission of claims * Payment processing * Balance billing and resolution * Account reaches a zero balance - ANSWER -Post-Service processes 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 7 of my notes) 3 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. False - ANSWER -Consents are signed as part of the post-service process (T or F) 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 6 of my notes) True - ANSWER -Patient service costs are calculated in the pre-service process for scheduled patients (T or F) 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 6 -7 of my notes) False - ANSWER -The patient is scheduled and registered for service is a time-of-service activity (T or F) 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 6 -7 of my notes) False - ANSWER -The patient account is monitored for payment is a time-of-service activity (T or F) 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 6 -7 of my notes) False - ANSWER -Case management and discharge planning services are a post-service activity (T or F) 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 6 -7 of my notes) False - ANSWER -Sending the bill electronically to the health plan is a time-of-service activity (T or F) 4 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. 1.1 Best Practice (Patient Centric) Revenue Cycle Overview (p. 6 -7 of my notes) to improve the way we communicate about healthcare prices. Out of these efforts have come recommendations for all stakeholders. - ANSWER -HFMA convened stakeholders from across the healthcare industry to do what? 1.2 Healthcare Dollars & Sense (p. 10 of my notes) 1 ) Patient Financial Communications Best Practices 2) Best Practices for Price Transparency 3) Medical Account Resolution - ANSWER -What are the 3 HFMA Revenue Cycle Initiatives? 1.2 Healthcare Dollars & Sense (p. 10 - 18 of my notes) These common-sense best practices bring: consistency, clarity, and transparency to patient financial communications by outlining steps to help patients understand the cost of services they receive, their insurance coverage, and their individual responsibility - ANSWER -Patient Financial Communications Best Practices... 1.2 Healthcare Dollars & Sense (p. 10 of my notes) During the discharge process - ANSWER -In an emergency medical condition, when should the financial discussion take place? 1.2 Healthcare Dollars & Sense (p. 10 of my notes) 5 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. As early as possible, before a financial obligation is incurred (i.e., before care is provided) - ANSWER -Excluding emergency medical conditions, best practices stipulate that reasonable attempts should be made to have the financial discussion when? 1.2 Healthcare Dollars & Sense (p. 10 of my notes) Annually - ANSWER -According to HFMA's best practices, how often should training on the organization's financial assistance policies for all staff who engage in patient financial discussions happen? 1.2 Healthcare Dollars & Sense (p. 14 of my notes) Health Insurance Marketplace, also known as Health Insurance Exchange - ANSWER -Where individuals and small businesses can compare and purchase qualified health benefit plans. 1.2 Healthcare Dollars & Sense (p. 15 of my notes) 1. The type of hospital service based on CPT or MS-DRG code. 2. The patient's health plan 3. The patient's benefit plan - ANSWER -In order to provide a patient with information that is meaningful to them, what factors must be included? 1.2 Healthcare Dollars & Sense (p. 15 of my notes) 6 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. Taking the charge for service based on the CPT/HCPCS or MS-DRG code and applying a hospital's health plan contract terms and the patient's benefit plan to the charges to determine an accurate patient liability. - ANSWER -What is price transparency? 1.2 Healthcare Dollars & Sense (p. 15 of my notes) Association of Credit and Collections Professionals International - ANSWER -HFMA partnered with ACA and brought together provider organizations, our business partners in the collection agencies, and patient advocates to form the Medical Debt Task Force. What is the ACA? 1.2 Healthcare Dollars & Sense (p. 17 of my notes) To improve both the efficiency of the revenue cycle and the patient experience. - ANSWER -What is the goal of the Medical Debt Task Force? 1.2 Healthcare Dollars & Sense (p. 17 of my notes) * Educate patients * Follow best practices for communication * Make ALL billing and other communications clear, concise, correct, and patient-friendly. * Establish policies and make sure they are followed 7 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. * Be consistent in key aspects of account resolution * Coordinate to avoid duplicate patient contacts * Exercise good judgement about the best ways to communicate with patients about bills. * Start account resolution clock when first statement is sent to the patient. * Report to credit bureaus when account is resolved * Track all complaints - ANSWER -The following statements describe best practices established by the Medical Debt Task Force. Select the True statements. 1.2 Healthcare Dollars & Sense (p. 16 of my notes) False - ANSWER -Process compliance is a main HFMA Healthcare Dollars & Sense revenue cycle initiative. (True or False) 1.2 Healthcare Dollars & Sense (p. 9 - 18 of my notes) Hosptial Consumer Assessment of Healthcare Providers & Systems - ANSWER -HCAHPS 1.3 Patient Experience and Satisfaction (p. 20 of my notes) HCAHPS initiative - ANSWER -The Center for Medicare and Medicaid Services (CMS) implementation of the value‐based purchasing program has increasingl