CRCR Exam Prep Questions And
Answers
/. What are collection agency fees based on? - Answer-✅A percentage of dollars
collected
/.Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule? - Answer-✅Birthday
/.In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers? - Answer-✅Case rates
/.What customer service improvements might improve the patient accounts department?
- Answer-✅Holding staff accountable for customer service during performance reviews
/.What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -
Answer-✅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? - Answer-✅Bad debt adjustment
/.What is the initial hospice benefit? - Answer-✅Two 90-day periods and an unlimited
number of subsequent periods
/.When does a hospital add ambulance charges to the Medicare inpatient claim? -
Answer-✅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? -
Answer-✅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 - Answer-✅They are not being processed in a timely manner
/.What is an advantage of a preregistration program? - Answer-✅It reduces processing
times at the time of service
/.What are the two statutory exclusions from hospice coverage? - Answer-✅Medically
unnecessary services and custodial care
, /.What core financial activities are resolved within patient access? - Answer-
✅Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
/.What statement applies to the scheduled outpatient? - Answer-✅The services do not
involve an overnight stay
/.How is a mis-posted contractual allowance resolved? - Answer-✅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? -
Answer-✅Observation
/.Coverage rules for Medicare beneficiaries receiving skilled nursing care require that
the beneficiary has received what? - Answer-✅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$? - Answer-
✅When the patient is the insured
/.What are non-emergency patients who come for service without prior notification to the
provider called? - Answer-✅Unscheduled patients
/.If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse? - Answer-✅Neither enrolled not entitled
to benefits
/.Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what? - Answer-✅Disclosure rules for consumer credit sales
and consumer loans
/.What is a principal diagnosis? - Answer-✅Primary reason for the patient's admission
/.Collecting patient liability dollars after service leads to what? - Answer-✅Lower
accounts receivable levels
/.What is the daily out-of-pocket amount for each lifetime reserve day used? - Answer-
✅50% of the current deductible amount
/.What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not
billable as an RHC services? - Answer-✅Inpatient care
Answers
/. What are collection agency fees based on? - Answer-✅A percentage of dollars
collected
/.Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule? - Answer-✅Birthday
/.In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers? - Answer-✅Case rates
/.What customer service improvements might improve the patient accounts department?
- Answer-✅Holding staff accountable for customer service during performance reviews
/.What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -
Answer-✅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? - Answer-✅Bad debt adjustment
/.What is the initial hospice benefit? - Answer-✅Two 90-day periods and an unlimited
number of subsequent periods
/.When does a hospital add ambulance charges to the Medicare inpatient claim? -
Answer-✅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? -
Answer-✅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 - Answer-✅They are not being processed in a timely manner
/.What is an advantage of a preregistration program? - Answer-✅It reduces processing
times at the time of service
/.What are the two statutory exclusions from hospice coverage? - Answer-✅Medically
unnecessary services and custodial care
, /.What core financial activities are resolved within patient access? - Answer-
✅Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
/.What statement applies to the scheduled outpatient? - Answer-✅The services do not
involve an overnight stay
/.How is a mis-posted contractual allowance resolved? - Answer-✅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? -
Answer-✅Observation
/.Coverage rules for Medicare beneficiaries receiving skilled nursing care require that
the beneficiary has received what? - Answer-✅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$? - Answer-
✅When the patient is the insured
/.What are non-emergency patients who come for service without prior notification to the
provider called? - Answer-✅Unscheduled patients
/.If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse? - Answer-✅Neither enrolled not entitled
to benefits
/.Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what? - Answer-✅Disclosure rules for consumer credit sales
and consumer loans
/.What is a principal diagnosis? - Answer-✅Primary reason for the patient's admission
/.Collecting patient liability dollars after service leads to what? - Answer-✅Lower
accounts receivable levels
/.What is the daily out-of-pocket amount for each lifetime reserve day used? - Answer-
✅50% of the current deductible amount
/.What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not
billable as an RHC services? - Answer-✅Inpatient care
