HFMA CRCR Final Exam
HFMA CRCR FINAL EXAM NEWEST ACTUAL EXAM
COMPLETE 350 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
The important message from Medicare provides beneficiaries with information
concerning what? - Correct Answer-Right to appeal a discharge decision if the
patient disagrees with the services
Why do managed care plans have agreements with hospitals, physicians, and
other healthcare providers to offer a range of services to plan members? - Correct
Answer-To improve access to quality healthcare
If a patient remains an inpatient of an SNF (skilled nursing facility for more than 30
days, what is the SNF permitted to do? - Correct Answer-Submit interim bills to
the Medicare program.
90. MSP (Medicare Secondary Payer) rules allow providers to bill Medicare for
liability claims after what happens? - Correct Answer-120 days passes, but the
claim then be withdrawn from the liability carrier
What data are required to establish a new MPI entry? - Correct Answer-The
patient's full legal name, date of birth, and sex
1|Page
, HFMA CRCR Final Exam
What should the provider do if both of the patient's insurance plans pay as
primary? - Correct Answer-Determine the correct payer and notify the incorrect
payer of the processing error
What do EMTALA regulations require on-call physicians to do? - Correct Answer-
Personally appear in the emergency department and attend to the patient within
a reasonable time
At the end of each shift, what must happen to cash, checks, and credit card
transaction documents? - Correct Answer-They must be balanced
What will cause a CMS 1500 claim to be rejected? - Correct Answer-The provider
is billing with a future date of service
Under Medicare regulations, which of the following is not included on a valid
physician's order for services? - Correct Answer-The cost of the test
how are HCPCS codes and the appropriate modifiers used? - Correct Answer-To
report the level 1, 2, or 3 code that correctly describes the service provided
If a Medicare patient is admitted on Friday, what services fall within the three-day
DRG window rule? - Correct Answer-Diagnostic and clinically-related non-
diagnostic charges provided on the Tuesday, Wednesday, Thursday, and Friday
before admission
What is a benefit of pre-registering patient's for service? - Correct Answer-Patient
arrival processing is expedited, reducing wait times and delays
2|Page
, HFMA CRCR Final Exam
What is a characteristic of a managed contracting methodology? - Correct Answer-
Prospectively set rates for inpatient and outpatient services
What do the MSP disability rules require? - Correct Answer-That the patient's
spouse's employer must have less than 20 employees in the group health plan
what organization originated the concept of insuring prepaid health care services?
- Correct Answer-Blue Cross and blue Shield
What is true about screening a beneficiary for possible MSP situations? - Correct
Answer-It is acceptable to complete the screening form after the patient has
completed the registration process and been sent to the service department
If the patient cannot agree to payment arrangements, what is the next option? -
Correct Answer-Warn the patient that unpaid accounts are placed with collection
agencies for further processing
In services lines such as cardiology or orthopedics, what does the case-rate
payment methodology allow providers to do? - Correct Answer-Receive a fixed for
specific procedures
What will comprehensive patient access processing accomplish? - Correct Answer-
Minimize the need for follow-up on insurance accounts
3|Page
, HFMA CRCR Final Exam
Through what document does a hospital establish compliance standards? -
Correct Answer-Code of conduct
How does utilization review staff use correct insurance information? - Correct
Answer-To obtain approval for inpatient days and coordinate services
When is it not appropriate to use observation status? - Correct Answer-As a
substitute for an inpatient admission
What is a serious consequence of misidentifying a patient in the MPI? - Correct
Answer-The services will be documented in the wrong record
When a patient reports directly to a clinical department for service, what will the
clinical department staff do? - Correct Answer-Redirect the patient to the patient
access department for registration
What process can be used to shorten claim turnaround time? - Correct Answer-
Send high-dollar hard-copy claims with required attachments by overnight mail or
registered mail
How are patient reminder calls used? - Correct Answer-To make sure the patient
follows the prep instructions and arrives at the scheduled time for service
If a patient declares a straight bankruptcy, what must the provider do? - Correct
Answer-Write off the account to the contractual adjustment account
4|Page
HFMA CRCR FINAL EXAM NEWEST ACTUAL EXAM
COMPLETE 350 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
The important message from Medicare provides beneficiaries with information
concerning what? - Correct Answer-Right to appeal a discharge decision if the
patient disagrees with the services
Why do managed care plans have agreements with hospitals, physicians, and
other healthcare providers to offer a range of services to plan members? - Correct
Answer-To improve access to quality healthcare
If a patient remains an inpatient of an SNF (skilled nursing facility for more than 30
days, what is the SNF permitted to do? - Correct Answer-Submit interim bills to
the Medicare program.
90. MSP (Medicare Secondary Payer) rules allow providers to bill Medicare for
liability claims after what happens? - Correct Answer-120 days passes, but the
claim then be withdrawn from the liability carrier
What data are required to establish a new MPI entry? - Correct Answer-The
patient's full legal name, date of birth, and sex
1|Page
, HFMA CRCR Final Exam
What should the provider do if both of the patient's insurance plans pay as
primary? - Correct Answer-Determine the correct payer and notify the incorrect
payer of the processing error
What do EMTALA regulations require on-call physicians to do? - Correct Answer-
Personally appear in the emergency department and attend to the patient within
a reasonable time
At the end of each shift, what must happen to cash, checks, and credit card
transaction documents? - Correct Answer-They must be balanced
What will cause a CMS 1500 claim to be rejected? - Correct Answer-The provider
is billing with a future date of service
Under Medicare regulations, which of the following is not included on a valid
physician's order for services? - Correct Answer-The cost of the test
how are HCPCS codes and the appropriate modifiers used? - Correct Answer-To
report the level 1, 2, or 3 code that correctly describes the service provided
If a Medicare patient is admitted on Friday, what services fall within the three-day
DRG window rule? - Correct Answer-Diagnostic and clinically-related non-
diagnostic charges provided on the Tuesday, Wednesday, Thursday, and Friday
before admission
What is a benefit of pre-registering patient's for service? - Correct Answer-Patient
arrival processing is expedited, reducing wait times and delays
2|Page
, HFMA CRCR Final Exam
What is a characteristic of a managed contracting methodology? - Correct Answer-
Prospectively set rates for inpatient and outpatient services
What do the MSP disability rules require? - Correct Answer-That the patient's
spouse's employer must have less than 20 employees in the group health plan
what organization originated the concept of insuring prepaid health care services?
- Correct Answer-Blue Cross and blue Shield
What is true about screening a beneficiary for possible MSP situations? - Correct
Answer-It is acceptable to complete the screening form after the patient has
completed the registration process and been sent to the service department
If the patient cannot agree to payment arrangements, what is the next option? -
Correct Answer-Warn the patient that unpaid accounts are placed with collection
agencies for further processing
In services lines such as cardiology or orthopedics, what does the case-rate
payment methodology allow providers to do? - Correct Answer-Receive a fixed for
specific procedures
What will comprehensive patient access processing accomplish? - Correct Answer-
Minimize the need for follow-up on insurance accounts
3|Page
, HFMA CRCR Final Exam
Through what document does a hospital establish compliance standards? -
Correct Answer-Code of conduct
How does utilization review staff use correct insurance information? - Correct
Answer-To obtain approval for inpatient days and coordinate services
When is it not appropriate to use observation status? - Correct Answer-As a
substitute for an inpatient admission
What is a serious consequence of misidentifying a patient in the MPI? - Correct
Answer-The services will be documented in the wrong record
When a patient reports directly to a clinical department for service, what will the
clinical department staff do? - Correct Answer-Redirect the patient to the patient
access department for registration
What process can be used to shorten claim turnaround time? - Correct Answer-
Send high-dollar hard-copy claims with required attachments by overnight mail or
registered mail
How are patient reminder calls used? - Correct Answer-To make sure the patient
follows the prep instructions and arrives at the scheduled time for service
If a patient declares a straight bankruptcy, what must the provider do? - Correct
Answer-Write off the account to the contractual adjustment account
4|Page
