1
HFMA CRCR QUESTIONS AND
ANSWERS GRADED A+
COMPLETE GUIDE |UPDATED
VERSION |
Through what document does a hospital establish compliance standards? ✔✔code of conduct
What is the purpose OIG work plant? ✔✔Identify Acceptable compliance programs in various
provider setting
PR
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window
O
rule? ✔✔Non-diagnostic service provided on Tuesday through Friday
FD
What does a modifier allow a provider to do? ✔✔Report a specific circumstance that affected a
procedure or service without changing the code or its definition
O
C
IF outpatient diagnostic services are provided within three days of the admission of a Medicare
beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to
these charges ✔✔They must be billed separately to the part B Carrier
what is a recurring or series registration? ✔✔One registration record is created for multiple days
of service
, 2
What are nonemergency patients who come for service without prior notification to the provider
called? ✔✔Unscheduled patients
Which of the following statement apply to the observation patient type? ✔✔It is used to evaluate
the need for an inpatient admission
PR
which services are hospice programs required to provide around the clock patient ✔✔Physician,
Nursing, Pharmacy
O
FD
Scheduler instructions are used to prompt the scheduler to do what? ✔✔Complete the scheduling
process correctly based on service requeste
O
C
The Time needed to prepare the patient before service is the difference between the patients
arrival time and which of the following? ✔✔Procedure time
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
provided on the order must include: ✔✔Documentation of the medical necessity for the test
, 3
What is the advantage of a pre-registration program ✔✔It reduces processing times at the time of
service
What date are required to establish a new MPI(Master patient Index) entry ✔✔The responsible
party's full legal name, date of birth, and social security number
PR
Which of the following statements is true about third-party payments? ✔✔The payments are
received by the provider from the payer responsible for reimbursing the provider for the patient's
covered services.
O
FD
Which provision protects the patient from medical expenses that exceed the pre-set level ✔✔stop
loss
O
what documentation must a primary care physician send to HMO patient to authorize a visit to a
C
specialist for additional testing or care? ✔✔Referral
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may
not ask about a patient's insurance information if it would delay what? ✔✔Medical screening and
stabilizing treatment
HFMA CRCR QUESTIONS AND
ANSWERS GRADED A+
COMPLETE GUIDE |UPDATED
VERSION |
Through what document does a hospital establish compliance standards? ✔✔code of conduct
What is the purpose OIG work plant? ✔✔Identify Acceptable compliance programs in various
provider setting
PR
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window
O
rule? ✔✔Non-diagnostic service provided on Tuesday through Friday
FD
What does a modifier allow a provider to do? ✔✔Report a specific circumstance that affected a
procedure or service without changing the code or its definition
O
C
IF outpatient diagnostic services are provided within three days of the admission of a Medicare
beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to
these charges ✔✔They must be billed separately to the part B Carrier
what is a recurring or series registration? ✔✔One registration record is created for multiple days
of service
, 2
What are nonemergency patients who come for service without prior notification to the provider
called? ✔✔Unscheduled patients
Which of the following statement apply to the observation patient type? ✔✔It is used to evaluate
the need for an inpatient admission
PR
which services are hospice programs required to provide around the clock patient ✔✔Physician,
Nursing, Pharmacy
O
FD
Scheduler instructions are used to prompt the scheduler to do what? ✔✔Complete the scheduling
process correctly based on service requeste
O
C
The Time needed to prepare the patient before service is the difference between the patients
arrival time and which of the following? ✔✔Procedure time
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
provided on the order must include: ✔✔Documentation of the medical necessity for the test
, 3
What is the advantage of a pre-registration program ✔✔It reduces processing times at the time of
service
What date are required to establish a new MPI(Master patient Index) entry ✔✔The responsible
party's full legal name, date of birth, and social security number
PR
Which of the following statements is true about third-party payments? ✔✔The payments are
received by the provider from the payer responsible for reimbursing the provider for the patient's
covered services.
O
FD
Which provision protects the patient from medical expenses that exceed the pre-set level ✔✔stop
loss
O
what documentation must a primary care physician send to HMO patient to authorize a visit to a
C
specialist for additional testing or care? ✔✔Referral
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may
not ask about a patient's insurance information if it would delay what? ✔✔Medical screening and
stabilizing treatment
