HFMA - CERTIFIED REVENUE CYCLE
REPRESENTATIVE PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
According to best practices, when should you make a reasonable attempt to have a financial discussion
with a patient? - ansBefore a financial obligation is incurred (before care is provided).
Also, providers should:
A. have both elective and non-elective procedures clearly defined for the public
B. only elective procedures clearly defined, and non-elective are mandatory
C. only non-elective, as they are mandatory. - ansA.
Balance Resolution: how should you discuss prior balances for resolution? - ansI may discuss prior
balances that are currently being pursued for collection by the provider, a collection agency, or other
organizations. I may also write a list of the prior services delivered, dates of service, and the resulting
prior balance.
Compliance Framework 1/5: What is the Executive Level Metrics Reporting? - ansReports of
organizational performance evaluations should be developed, compiled into an overall compliance
report and presented to the organization's executive leadership team on an annual basis.
Compliance Framework 1/5: What is the Feedback and Response? - ansThis evaluation is designed to
ensure that processes are in place to regularly solicit input and receive key stakeholders'' feedback,
measure and respond to input and feedback, and ensure that patient complaints are resolved.
Compliance Framework 1/5: What is the Technology segment? - ansThe compliance framework ensures
that technology is in place to support verification of insurance eligibility for current services, verification
of existing prior balance for current services, and estimated cost of the current services and the patient
responsibility portion.
Compliance Framework 1/5: What's Process Observation? - ansAnnual observation, monitoring, and
tracking of results make up the process of compliance evaluation required to document compliance with
, HFMA - CERTIFIED REVENUE CYCLE
REPRESENTATIVE PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
the best practices. The evaluation should be comprehensive and should cover all scenarios addressed by
the practices that are relevant to a particular organization.
Compliance Framework 1/5: What's the Training Program? - ansHFMA's best practices call for annual
training on the organization's financial assistance policies for all staff who engage in patient financial
discussions, including patient access, financial counseling, and customer service representatives.
Compliance Framework: Training Program: What are the topics that must be covered? - ans- patient
financial communications best practices specific to staff role
-Financial Assistance Policies
-Available patient financing options
-Alternative solutions for the uninsured
-laws/regulations, such as EMTALA, the Fair Debt Collections Practice Act, and the Telephone Consumer
Protection Act - specific to the staff role.
For Complex Scenarios: for patients with non-routine or complex scenarios, such as uninsured or
underinsured patients, who should be involved in the financial discussions? - ansthe patient and financial
counselor or supervisor.
For Routine Scenarios: for patients with insurance coverage or a know ability to pay, who should be
involved in the financial discussions? - ansthe patient or guarantor and properly trained provider
representatives.
Healthcare Dollars & Sense is the name given to what 3 HFMA revenue cycle initiatives? - ans- Patient
financial communications best practices
- Best practices for price transparency
- Medical account resolution
REPRESENTATIVE PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
According to best practices, when should you make a reasonable attempt to have a financial discussion
with a patient? - ansBefore a financial obligation is incurred (before care is provided).
Also, providers should:
A. have both elective and non-elective procedures clearly defined for the public
B. only elective procedures clearly defined, and non-elective are mandatory
C. only non-elective, as they are mandatory. - ansA.
Balance Resolution: how should you discuss prior balances for resolution? - ansI may discuss prior
balances that are currently being pursued for collection by the provider, a collection agency, or other
organizations. I may also write a list of the prior services delivered, dates of service, and the resulting
prior balance.
Compliance Framework 1/5: What is the Executive Level Metrics Reporting? - ansReports of
organizational performance evaluations should be developed, compiled into an overall compliance
report and presented to the organization's executive leadership team on an annual basis.
Compliance Framework 1/5: What is the Feedback and Response? - ansThis evaluation is designed to
ensure that processes are in place to regularly solicit input and receive key stakeholders'' feedback,
measure and respond to input and feedback, and ensure that patient complaints are resolved.
Compliance Framework 1/5: What is the Technology segment? - ansThe compliance framework ensures
that technology is in place to support verification of insurance eligibility for current services, verification
of existing prior balance for current services, and estimated cost of the current services and the patient
responsibility portion.
Compliance Framework 1/5: What's Process Observation? - ansAnnual observation, monitoring, and
tracking of results make up the process of compliance evaluation required to document compliance with
, HFMA - CERTIFIED REVENUE CYCLE
REPRESENTATIVE PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
the best practices. The evaluation should be comprehensive and should cover all scenarios addressed by
the practices that are relevant to a particular organization.
Compliance Framework 1/5: What's the Training Program? - ansHFMA's best practices call for annual
training on the organization's financial assistance policies for all staff who engage in patient financial
discussions, including patient access, financial counseling, and customer service representatives.
Compliance Framework: Training Program: What are the topics that must be covered? - ans- patient
financial communications best practices specific to staff role
-Financial Assistance Policies
-Available patient financing options
-Alternative solutions for the uninsured
-laws/regulations, such as EMTALA, the Fair Debt Collections Practice Act, and the Telephone Consumer
Protection Act - specific to the staff role.
For Complex Scenarios: for patients with non-routine or complex scenarios, such as uninsured or
underinsured patients, who should be involved in the financial discussions? - ansthe patient and financial
counselor or supervisor.
For Routine Scenarios: for patients with insurance coverage or a know ability to pay, who should be
involved in the financial discussions? - ansthe patient or guarantor and properly trained provider
representatives.
Healthcare Dollars & Sense is the name given to what 3 HFMA revenue cycle initiatives? - ans- Patient
financial communications best practices
- Best practices for price transparency
- Medical account resolution
