Hfma Crcr Exam Questions And Correct Answers

HFMA CRCR EXAM QUESTIONS
AND CORRECT ANSWERS




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



What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -
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CORRECT ANSWER>>>~ Inform a Medicare beneficiary that Medicare may not pay for the or
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der or service JS JS




What type of account adjustment results from the patient's unwillingness to pay for a self-
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pay balance? - CORRECT ANSWER>>>~ Bad debt adjustment
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What is the initial hospice benefit? - CORRECT ANSWER>>>~ Two 90-
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day periods and an unlimited number of subsequent periods
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,When does a hospital add ambulance charges to the Medicare inpatient claim? -
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CORRECT ANSWER>>>~ If the patient requires ambulance transportation to a skilled nursing
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facility



How should a provider resolve a late-charge credit posted after an account is billed? -
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CORRECT ANSWER>>>~ Post a late-charge adjustment to the account
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an increase in the dollars aged greater than 90 days from date of service indicate what about
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accounts - CORRECT ANSWER>>>~ They are not being processed in a timely manner
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What is an advantage of a preregistration program? -
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CORRECT ANSWER>>>~ It reduces processing times at the time of service
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What are the two statutory exclusions from hospice coverage? -
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CORRECT ANSWER>>>~ Medically unnecessary services and custodial care
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What core financial activities are resolved within patient access? -
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CORRECT ANSWER>>>~ Scheduling, insurance verification, discharge processing, and payme
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nt of point-of-service receipts
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What statement applies to the scheduled outpatient? -
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CORRECT ANSWER>>>~ The services do not involve an overnight stay
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How is a mis-posted contractual allowance resolved? -
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CORRECT ANSWER>>>~ Comparing the contract reimbursement rates with the contract on t
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he admittance advice to identify the correct amount
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What type of patient status is used to evaluate the patient's need for inpatient care? -
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CORRECT ANSWER>>>~ Observation
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,Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the benef
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iciary has received what? -
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CORRECT ANSWER>>>~ Medically necessary inpatient hospital services for at least 3 consecu
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tive days before the skilled nursing care admission
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When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? -
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CORRECT ANSWER>>>~ When the patient is the insured
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What are non- JS JS



emergency patients who come for service without prior notification to the provider called? -
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CORRECT ANSWER>>>~ Unscheduled patients
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If the insurance verification response reports that a subscriber has a single policy, what is the
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status of the subscriber's spouse? -
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CORRECT ANSWER>>>~ Neither enrolled not entitled to benefits
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Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, e
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stablishes what? - JS JS



CORRECT ANSWER>>>~ Disclosure rules for consumer credit sales and consumer loans
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What is a principal diagnosis? -
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CORRECT ANSWER>>>~ Primary reason for the patient's admission
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Collecting patient liability dollars after service leads to what? -
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CORRECT ANSWER>>>~ Lower accounts receivable levels
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What is the daily out-of-pocket amount for each lifetime reserve day used? -
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CORRECT ANSWER>>>~ 50% of the current deductible amount
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, What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not billable as
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an RHC services? - CORRECT ANSWER>>>~ Inpatient care
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What code indicates the disposition of the patient at the conclusion of service? -
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CORRECT ANSWER>>>~ Patient discharge status code
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What are hospitals required to do for Medicare credit balance accounts? -
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CORRECT ANSWER>>>~ They result in lost reimbursement and additional cost to collect
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When an undue delay of payment results from a dispute between the patient and the third pa
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rty payer, who is responsible for payment? - CORRECT ANSWER>>>~ Patient
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Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the informati
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on provided on the order must include: - CORRECT ANSWER>>>~ A valid CPT or HCPCS code
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With advances in internet security and encryption, revenue-
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cycle processes are expanding to allow patients to do what? -
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CORRECT ANSWER>>>~ Access their information and perform functions on-line
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What date is required on all CMS 1500 claim forms? -
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CORRECT ANSWER>>>~ onset date of current illness
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What does scheduling allow provider staff to do -
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CORRECT ANSWER>>>~ Review appropriateness of the service request
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What code is used to report the provider's most common semiprivate room rate? -
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CORRECT ANSWER>>>~ Condition code
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Regulations and requirements for coding accountable care organizations, which allows provid
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ers to begin creating these organizations, were finalized in: - CORRECT ANSWER>>>~ 2012
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