Certified Revenue Cycle Representative

CRCR 2024 Through what document does a hospital establish compliance standards? -answer-code of conduct What is the purpose of OIG work plan -answer-Identify acceptable compliance programs in various provider settings If a Medicare patient is admitted on Friday, what service falls within the three day DRG window rule? -answer-Non-diagnostic services provided on Thursday through Friday What does a modifier allow a provider to do? -answer-Report a specific circumstances that affected a ...

CRCR Practice Questions 2024 The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of the following activities? A. Complete a community needs assessment and develop a discount program for patient balances after insurance payment. B. Pursue extraordinary collection activities with all patients eligible for financial assistance. C. Implement a financial assistance program for uninsured and underinsured patients. D. Discount all charges to self-pay patients to an amoun...

CR CR Exam Prep 2024What 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 cus...

CRCR Certification 2024 Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by – answer The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid - answerMeet Income and Assets Requirements In choosing a setting for patient financial discussions, organizations should first and foremost - answerRespect the patients privacy A nightly room charge will be ...

What are collection agency fees based on? -ANS-A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? -ANS-Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? -ANS-Case rates What customer service improvements might improve the patient accounts department? -ANS-Holding staff accountable for customer service during performance ...

Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by -ANS-The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid -ANS-Meet Income and Assets Requirements In choosing a setting for patient financial discussions, organizations should first and foremost -ANS-Respect the patients privacy A nightly room charge will be incorrect if the patient's -ANS-Tran...

Pre-Service (Step 1) - ANS-1. The patient is scheduled and pre-registered for service Pre-Service (Step 2) - ANS-2. The encounter record is generated, and the patient and guarantor information is obtained and/or updated as required. Pre-Service (Step 3) - ANS-3. The requested service is screened for medical necessity; health plan coverage and benefits are verified, and pre-authorizations are obtained. Pre-Service (Step 4) - ANS-4. The cost of the scheduled service is identified and the ...

Through what document does a hospital establish compliance standards? -ANS- Code of Conduct What is the purpose of the OIG work plan? -ANS- Communicate Issues that will be reviewed during the year for compliance with Medicare Regulations If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? -ANS- Diagnostic services and related charges provided on Wednesday, Thursday and Friday before admission. What does a modifier allow a provider to do?...

What are collection agency fees based on? -ANSA percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? -ANSBirthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? -ANSCase rates What customer service improvements might improve the patient accounts department? -ANSHolding staff accountable for customer service during performance revi...

Certified Revenue Cycle Representative (CRCR) Multiple Choice Answered Rationale 2023 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 D The Medicare fee-for service appeal process for both beneficiaries and providers inclu...