Healthcare Financial Management Association, Certified Revenue Cycle Representative (HFMA CRCR), Final Exam Questions with Answers

Healthcare Financial Management Association, Certified Revenue Cycle Representative (HFMA CRCR), Final Exam Questions with Answers-What are collection agency fees based on? - A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - Case rates What customer service improvements might improve the patient accounts department? - Holding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - Inform a Medicare beneficiary that Medicare may not pay for the order or service What type of account adjustment results from the patient's unwillingness to pay for a self-pay balance? - Bad debt adjustment What is the initial hospice benefit? - Two 90-day periods and an unlimited number of subsequent periods When does a hospital add ambulance charges to the Medicare inpatient claim? - If the patient requires ambulance transportation to a skilled nursing facility How should a provider resolve a late-charge credit posted after an account is billed? - Post a late-charge adjustment to the account an increase in the dollars aged greater than 90 days from date of service indicate what about accounts - They are not being processed in a timely manner What is an advantage of a preregistration program? - It reduces processing times at the time of service What are the two statutory exclusions from hospice coverage? - Medically unnecessary services and custodial care What core financial activities are resolved within patient access? - Scheduling, insurance verification, discharge processing, and payment of point-of-service receipts What statement applies to the scheduled outpatient? - The services do not involve an overnight stay How is a mis-posted contractual allowance resolved? - Comparing the contract reimbursement rates with the contract on the admittance advice to identify the correct amount What type of patient status is used to evaluate the patient's need for inpatient care? - Observation Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has received what? - Medically necessary inpatient hospital services for at least 3 consecutive days before the skilled nursing care admission When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? - When the patient is the insured What are non-emergency patients who come for service without prior notification to the provider called? - Unscheduled patients If the insurance verification response reports that a subscriber has a single policy, what is the status of the subscriber's spouse? - Neither enrolled not entitled to benefits