CRCR Exam New Full Exam Questions and
Answers ( Included ) 100% Correct
Accountable Care Organization - ANSWER>>>Assumes responsibility for the care
of a clearly defined population of Medicare beneficiaries attributed to it on the
basis of their pattern of use of primary care; Groups of doctors, hospitals, and
other health care providers, who come together voluntarily to give coordinated
high quality care to their Medicare patients
Accounts Receivable - ANSWER>>>money owed by third-party payers and
patients to the provider for health care services
Advanced Beneficiary Notice - ANSWER>>>"waiver of liability"; medical
providers are required to give a patient notice when they offer services or items
that they know or have reason to believe Medicare will determine to be
medically unnecessary, and therefore will not pay for
Aged Trial Balance - ANSWER>>>report that shows accounts receivable totals by
financial class and aging
Ambulatory Payment Classificaiton - ANSWER>>>government's method of
paying for facility outpatient services for Medicare when a patient is discharged
or transferred to another facility not affiliated with the initial treatment facility
Average Daily Gross Revenue - ANSWER>>>Monthly Gross Patient Service
Revenue divided by Days in the month
Bad Debt Agency - ANSWER>>>third-party that focuses on working self-pay
claims including patient balances remaining after insurance has paid
,Bundled Payment - ANSWER>>>the reimbursement of health care providers on
the basis of expected costs for clinically-defined episodes of care
Care Management - ANSWER>>>method of managing the provision of
healthcare with the goal of improving continuity and quality of care while
lowering cost
Case Mix Index - ANSWER>>>average DRG weight for all of a hospital's
Medicare volume
Centers for Medicare and Medicaid Services - ANSWER>>>US federal agency
that administers Medicare rules and payment
Charge Description Master - ANSWER>>>file that contains a list of chargeable
services and the respective charge for the procedures
Clearinghouse - ANSWER>>>third party agency that settles accounts, clears
claims and acts as an intermediary between healthcare providers and insurance
to process or facilitate the processing of information
Clinical Documentation Integrity - ANSWER>>>using electronic tools to perform
inpatient record review for the purpose of recognizing opportunities for
documentation improvement
Commercial Payer - ANSWER>>>third-party, non-government payer
Contractual Allowance - ANSWER>>>the agreed amount that an insurance
company will pay for specified services provided to one of its members
Current Procedural Terminology Codes - ANSWER>>>codes assigned to every
task and service a medical practitioner may provide to a patient used to
determine the amount of reimbursement that a practitioner will receive by an
insurer
, Denial - ANSWER>>>a claim that has been initially denied payment from a
commercial or government payer
Diagnosis Related Group - ANSWER>>>system used to classify hospital cases
into groups to determine how much government and commercial payers pay
the hospital for each "product"
Early Out - ANSWER>>>service that focuses on on working self-pay claims
including self-pay after insurance
Electronic Data Interchange - ANSWER>>>structured transmission of data
between organizations by electronic means
Government Payers - ANSWER>>>Medicare, Medicaid, Tricare, and SCHIP
Healthcare Common Procedure Coding System - ANSWER>>>coding system used
to identify products, supplies, and services not included in the CPT-4 codes
Healthcare Financial Management Association - ANSWER>>>leading
membership organization for health care financial management executives and
leaders
Hospital-Acquired Condition - ANSWER>>>"Never Events"; CMS will withhold
payments to hospitals for specific conditions that a patient acquires while an
inpatient that could be "reasonably prevented" by following established
evidence-based guidelines
Hospital Consumer Assessment of Healthcare Providers and Systems -
ANSWER>>>intended to provide a standardized survey instrument and data
collection methodology for measuring patients' perspectives on hospital care
Answers ( Included ) 100% Correct
Accountable Care Organization - ANSWER>>>Assumes responsibility for the care
of a clearly defined population of Medicare beneficiaries attributed to it on the
basis of their pattern of use of primary care; Groups of doctors, hospitals, and
other health care providers, who come together voluntarily to give coordinated
high quality care to their Medicare patients
Accounts Receivable - ANSWER>>>money owed by third-party payers and
patients to the provider for health care services
Advanced Beneficiary Notice - ANSWER>>>"waiver of liability"; medical
providers are required to give a patient notice when they offer services or items
that they know or have reason to believe Medicare will determine to be
medically unnecessary, and therefore will not pay for
Aged Trial Balance - ANSWER>>>report that shows accounts receivable totals by
financial class and aging
Ambulatory Payment Classificaiton - ANSWER>>>government's method of
paying for facility outpatient services for Medicare when a patient is discharged
or transferred to another facility not affiliated with the initial treatment facility
Average Daily Gross Revenue - ANSWER>>>Monthly Gross Patient Service
Revenue divided by Days in the month
Bad Debt Agency - ANSWER>>>third-party that focuses on working self-pay
claims including patient balances remaining after insurance has paid
,Bundled Payment - ANSWER>>>the reimbursement of health care providers on
the basis of expected costs for clinically-defined episodes of care
Care Management - ANSWER>>>method of managing the provision of
healthcare with the goal of improving continuity and quality of care while
lowering cost
Case Mix Index - ANSWER>>>average DRG weight for all of a hospital's
Medicare volume
Centers for Medicare and Medicaid Services - ANSWER>>>US federal agency
that administers Medicare rules and payment
Charge Description Master - ANSWER>>>file that contains a list of chargeable
services and the respective charge for the procedures
Clearinghouse - ANSWER>>>third party agency that settles accounts, clears
claims and acts as an intermediary between healthcare providers and insurance
to process or facilitate the processing of information
Clinical Documentation Integrity - ANSWER>>>using electronic tools to perform
inpatient record review for the purpose of recognizing opportunities for
documentation improvement
Commercial Payer - ANSWER>>>third-party, non-government payer
Contractual Allowance - ANSWER>>>the agreed amount that an insurance
company will pay for specified services provided to one of its members
Current Procedural Terminology Codes - ANSWER>>>codes assigned to every
task and service a medical practitioner may provide to a patient used to
determine the amount of reimbursement that a practitioner will receive by an
insurer
, Denial - ANSWER>>>a claim that has been initially denied payment from a
commercial or government payer
Diagnosis Related Group - ANSWER>>>system used to classify hospital cases
into groups to determine how much government and commercial payers pay
the hospital for each "product"
Early Out - ANSWER>>>service that focuses on on working self-pay claims
including self-pay after insurance
Electronic Data Interchange - ANSWER>>>structured transmission of data
between organizations by electronic means
Government Payers - ANSWER>>>Medicare, Medicaid, Tricare, and SCHIP
Healthcare Common Procedure Coding System - ANSWER>>>coding system used
to identify products, supplies, and services not included in the CPT-4 codes
Healthcare Financial Management Association - ANSWER>>>leading
membership organization for health care financial management executives and
leaders
Hospital-Acquired Condition - ANSWER>>>"Never Events"; CMS will withhold
payments to hospitals for specific conditions that a patient acquires while an
inpatient that could be "reasonably prevented" by following established
evidence-based guidelines
Hospital Consumer Assessment of Healthcare Providers and Systems -
ANSWER>>>intended to provide a standardized survey instrument and data
collection methodology for measuring patients' perspectives on hospital care
