CRCR Exam Prep With all Correct & 100% Verified
Answers| Actual Complete Exam| Already Graded A+
What are collection agency fees based on? ✔Correct Answers--A percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule? ✔Correct Answers--Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the
payer and some or all providers? ✔Correct Answers--Case rates
What customer service improvements might improve the patient accounts department? ✔Correct
Answers--Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? ✔Correct Answers--
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? ✔Correct Answers--Bad debt adjustment
What is the initial hospice benefit? ✔Correct Answers--Two 90-day periods and an unlimited
number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? ✔Correct
Answers--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? ✔Correct
Answers--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 ✔Correct Answers--They are not being processed in a timely manner
What is an advantage of a preregistration program? ✔Correct Answers--It reduces processing
times at the time of service
What are the two statutory exclusions from hospice coverage? ✔Correct Answers--Medically
unnecessary services and custodial care
What core financial activities are resolved within patient access? ✔Correct Answers--Scheduling,
insurance verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? ✔Correct Answers--The services do not
involve an overnight stay
How is a mis-posted contractual allowance resolved? ✔Correct Answers--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? ✔Correct
Answers--Observation
, Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary
has received what? ✔Correct Answers--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$? ✔Correct Answers--
When the patient is the insured
What are non-emergency patients who come for service without prior notification to the provider
called? ✔Correct Answers--Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the status
of the subscriber's spouse? ✔Correct Answers--Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act,
establishes what? ✔Correct Answers--Disclosure rules for consumer credit sales and consumer
loans
What is a principal diagnosis? ✔Correct Answers--Primary reason for the patient's admission
Collecting patient liability dollars after service leads to what? ✔Correct Answers--Lower accounts
receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? ✔Correct Answers--
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? ✔Correct Answers--Inpatient care
What code indicates the disposition of the patient at the conclusion of service? ✔Correct
Answers--Patient discharge status code
What are hospitals required to do for Medicare credit balance accounts? ✔Correct Answers--They
result in lost reimbursement and additional cost to collect
When an undue delay of payment results from a dispute between the patient and the third party
payer, who is responsible for payment? ✔Correct Answers--Patient
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
provided on the order must include: ✔Correct Answers--A valid CPT or HCPCS code
With advances in internet security and encryption, revenue-cycle processes are expanding to allow
patients to do what? ✔Correct Answers--Access their information and perform functions on-line
What date is required on all CMS 1500 claim forms? ✔Correct Answers--onset date of current
illness
What does scheduling allow provider staff to do ✔Correct Answers--Review appropriateness of the
service request
Answers| Actual Complete Exam| Already Graded A+
What are collection agency fees based on? ✔Correct Answers--A percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule? ✔Correct Answers--Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the
payer and some or all providers? ✔Correct Answers--Case rates
What customer service improvements might improve the patient accounts department? ✔Correct
Answers--Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? ✔Correct Answers--
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? ✔Correct Answers--Bad debt adjustment
What is the initial hospice benefit? ✔Correct Answers--Two 90-day periods and an unlimited
number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? ✔Correct
Answers--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? ✔Correct
Answers--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 ✔Correct Answers--They are not being processed in a timely manner
What is an advantage of a preregistration program? ✔Correct Answers--It reduces processing
times at the time of service
What are the two statutory exclusions from hospice coverage? ✔Correct Answers--Medically
unnecessary services and custodial care
What core financial activities are resolved within patient access? ✔Correct Answers--Scheduling,
insurance verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? ✔Correct Answers--The services do not
involve an overnight stay
How is a mis-posted contractual allowance resolved? ✔Correct Answers--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? ✔Correct
Answers--Observation
, Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary
has received what? ✔Correct Answers--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$? ✔Correct Answers--
When the patient is the insured
What are non-emergency patients who come for service without prior notification to the provider
called? ✔Correct Answers--Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the status
of the subscriber's spouse? ✔Correct Answers--Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act,
establishes what? ✔Correct Answers--Disclosure rules for consumer credit sales and consumer
loans
What is a principal diagnosis? ✔Correct Answers--Primary reason for the patient's admission
Collecting patient liability dollars after service leads to what? ✔Correct Answers--Lower accounts
receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? ✔Correct Answers--
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? ✔Correct Answers--Inpatient care
What code indicates the disposition of the patient at the conclusion of service? ✔Correct
Answers--Patient discharge status code
What are hospitals required to do for Medicare credit balance accounts? ✔Correct Answers--They
result in lost reimbursement and additional cost to collect
When an undue delay of payment results from a dispute between the patient and the third party
payer, who is responsible for payment? ✔Correct Answers--Patient
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
provided on the order must include: ✔Correct Answers--A valid CPT or HCPCS code
With advances in internet security and encryption, revenue-cycle processes are expanding to allow
patients to do what? ✔Correct Answers--Access their information and perform functions on-line
What date is required on all CMS 1500 claim forms? ✔Correct Answers--onset date of current
illness
What does scheduling allow provider staff to do ✔Correct Answers--Review appropriateness of the
service request
