NEW CRCR CERTIFICATION ACTUAL EXAM
TESTED AND APPROVED GRADED A+!!!
Local Coverage Determinations (LCD) and National Coverage Determinations
(NCD) are Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred to
Medicaid -- ANSWER--C
Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date -- ANSWER--C
A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
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,b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of regulations
imposed by a government agency are being met
d) The development of operational policies that correspond to regulations --
ANSWER--C
Case Management requires that a case manager be assigned
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual agreement --
ANSWER--B
Pricing transparency is defined as readily available information on the price of
healthcare services, that together with other information, help define the value
of those services and enable consumers to
a) Identify, compare, and choose providers that offer the desired level of
value
b) Customize health care with a personally chosen mix of providers
c) Negotiate the cost of health plan premiums
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,d) Verify the cost of individual clinicians -- ANSWER--A
The Medicare fee-for service appeal process for both beneficiaries and
providers includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for
Medicare
d) Review by the Medicare Appeals Council (Appeals Council) --
ANSWER--B
The disadvantages of outsourcing include all of the following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff --
ANSWER--D
Patients are contacting hospitals to proactively inquire about costs and fees prior
to agreeing to service. The problem for hospitals in providing such information
is:
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, a) That hospitals don't want to establish a price without knowing if the
patient has insurance and how much reimbursement can be expected
b) The fact that charge master lists the total charge, not net charges that
reflect charges after a payer's contractual adjustment
c) That hospitals don't want to be put in the position of "guaranteeing" price
without having room for additional charges that may arise in the course of
treatment
d) Their reluctance to share proprietary information -- ANSWER--B
Across all care settings, if a patient consents to a financial discussion during a
medical encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer questions and assist in
obtaining required patient financial data
b) Have a patient financial responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not interfere with
patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt patient care and
patient flow -- ANSWER--C
Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
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TESTED AND APPROVED GRADED A+!!!
Local Coverage Determinations (LCD) and National Coverage Determinations
(NCD) are Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred to
Medicaid -- ANSWER--C
Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date -- ANSWER--C
A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
Page 1 of 99
,b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of regulations
imposed by a government agency are being met
d) The development of operational policies that correspond to regulations --
ANSWER--C
Case Management requires that a case manager be assigned
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual agreement --
ANSWER--B
Pricing transparency is defined as readily available information on the price of
healthcare services, that together with other information, help define the value
of those services and enable consumers to
a) Identify, compare, and choose providers that offer the desired level of
value
b) Customize health care with a personally chosen mix of providers
c) Negotiate the cost of health plan premiums
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,d) Verify the cost of individual clinicians -- ANSWER--A
The Medicare fee-for service appeal process for both beneficiaries and
providers includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for
Medicare
d) Review by the Medicare Appeals Council (Appeals Council) --
ANSWER--B
The disadvantages of outsourcing include all of the following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff --
ANSWER--D
Patients are contacting hospitals to proactively inquire about costs and fees prior
to agreeing to service. The problem for hospitals in providing such information
is:
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, a) That hospitals don't want to establish a price without knowing if the
patient has insurance and how much reimbursement can be expected
b) The fact that charge master lists the total charge, not net charges that
reflect charges after a payer's contractual adjustment
c) That hospitals don't want to be put in the position of "guaranteeing" price
without having room for additional charges that may arise in the course of
treatment
d) Their reluctance to share proprietary information -- ANSWER--B
Across all care settings, if a patient consents to a financial discussion during a
medical encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer questions and assist in
obtaining required patient financial data
b) Have a patient financial responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not interfere with
patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt patient care and
patient flow -- ANSWER--C
Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
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