(CRCR)Exam Actual Questions with Revised
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Terms in this set (68)
Pricing transparency is defined as Identify, compare, and choose providers that offer
readily available information on the the desired level of value.
price of healthcare services, that
together with other information, help
define the value of those services
and enable consumers to
Because case managers document A good resource when developing written appeals
the clinical reasons for treatment, and denials.
they are
All of the following information The claim editing process slowed down the receipt
describe claim edits EXCEPT of payments, increases account receivable
outstanding, and decreases cash flow.
What types of services are classified Hospice Care, Clinic Services & Skilled Nursing
as non-acute?
The unscheduled "direct" admission Is admitted from a physician's office on an urgent
represents a patient who: basis.
, The process of creating the pre- That access staff will have complete and valid
registration record ensures information needed to finalize any remaining pre-
access activities.
An advantage of a pre-registration The opportunity to reduce processing times at the
program is time of service.
Claim edits are Rules developed to verify the accuracy of claims
based on each health plan's policies.
Examples of ethic violations that Seeking payment options for patient self-pay
impact the revenue cycle include all
of the following EXCEPT
EMTALA and HFMA best practices No patient financial discussions should occur
specify that, in an Emergency before a patient is screened and stabilized.
Department setting
Which of the following is usually Release of information
covered on a Conditions of
Admission form
The nuanced data resulting from Obtain higher compensation for physicians
detailed ICD-10 coding allows senior
leadership to work with physicians to
do all of the following EXCEPT
Selecting the wrong insurance plan Estimating the wrong reimbursement
code can lead to the following
problems or denials, except