Certified Revenue Cycle
Representative - CRCR
Which of the following statements are true of HFMA's Financial Communications Best Practices -
Answer-The best practices were developed specifically to help patients understand the cost of services,
their individual insurance benefits, and their responsibility for balances after insurance, if any.
The patient experience includes all of the following except: - Answer-The average number of positive
mentions received by the health system or practice and the public comments refuting unfriendly posts
on social media sites.
Corporate compliance programs play an important role in protecting the integrity of operations and
ensuring compliance with federal and state requirements. The code of conduct is: - Answer-All of the
above
Specific to Medicare fee-for-service patients, which of the following payers have always been liable for
payment? - Answer-Public health service programs, Federal grant programs, veteran affairs programs,
black lung program services and work-related injuries and accidents (worker' compensation claims)
Provider policies and procedures should be in place to reduce the risk of ethics violations. Examples of
ethics violations include: - Answer-All of the above
Providers are now being reimbursed with a focus on the value of the services provided, rather than
volume, which requires collaboration among providers.
,What is the intended outcome of collaborations made through an ACO delivery system for a population
of patients? - Answer-To eliminate duplicate services, prevent medical errors and ensure
appropriateness of care.
Historically, revenue cycle has delt with contractual adjustments, bad debt and charity deductions from
gross revenue. Although deductions continue to exist, the definition of net revenue has been modified
through the implementation of ASC 606. Developed by the Financial Accounting Standards Board (FASB),
this change became effective in 2018.
What is the new terminology now employed in the calculation of net patient services revenues? -
Answer-Explicit prices concessions and implicit price concessions
Key performance indicators set standards for A/R and provide a method for measuring the control and
collection of A/R.
What are the two KPIs used to monitor performance related to the production and submission of claims
to third party payers and patients (self-pay)? - Answer-Elapsed days from discharge to final bill and
elapsed days from final bill to claim/bill submission.
Consents are signed as part of the post-services process. - Answer-True
**False
Patient service costs are calculated in the pre-service process for schedule patients - Answer-**True
False
The patient is scheduled and registered for service is a time-of-service activity - Answer-True
**False
The patient account is monitored for payment is a time-of-service activity - Answer-True
, **False
Case management and discharge planning services are a post-service activty - Answer-True
**False
Sending the bill electronically to the health plan is a time-of-service activity - Answer-True
**False
What happens during the post-service stage? - Answer-**A. Final coding of all services, preparation and
submission of claims, payment processing and balance billing and resolution.
B. Orders are entered, results are reported, charges are generated, and diagnostic and procedural
coding is initiated.
C. The encounter record is generated, and the patient and guarantor information is obtained and/or
updated as required.
D. The focus is on the patient and his/her financial care, in addition to the clinical care provided for the
patient.
The following statements describe best practices established by the Medical Debt Task Force. Check the
box next to the True statements - Answer-**Educate Patients
**Coordinate to avoid duplicate patient contacts
Exercise moderate judgement when communicating with providers about scheduled services
**Be consistent in key aspects of account resolution
Report to healthcare plans when the patient's account is transferred to collection agency
Representative - CRCR
Which of the following statements are true of HFMA's Financial Communications Best Practices -
Answer-The best practices were developed specifically to help patients understand the cost of services,
their individual insurance benefits, and their responsibility for balances after insurance, if any.
The patient experience includes all of the following except: - Answer-The average number of positive
mentions received by the health system or practice and the public comments refuting unfriendly posts
on social media sites.
Corporate compliance programs play an important role in protecting the integrity of operations and
ensuring compliance with federal and state requirements. The code of conduct is: - Answer-All of the
above
Specific to Medicare fee-for-service patients, which of the following payers have always been liable for
payment? - Answer-Public health service programs, Federal grant programs, veteran affairs programs,
black lung program services and work-related injuries and accidents (worker' compensation claims)
Provider policies and procedures should be in place to reduce the risk of ethics violations. Examples of
ethics violations include: - Answer-All of the above
Providers are now being reimbursed with a focus on the value of the services provided, rather than
volume, which requires collaboration among providers.
,What is the intended outcome of collaborations made through an ACO delivery system for a population
of patients? - Answer-To eliminate duplicate services, prevent medical errors and ensure
appropriateness of care.
Historically, revenue cycle has delt with contractual adjustments, bad debt and charity deductions from
gross revenue. Although deductions continue to exist, the definition of net revenue has been modified
through the implementation of ASC 606. Developed by the Financial Accounting Standards Board (FASB),
this change became effective in 2018.
What is the new terminology now employed in the calculation of net patient services revenues? -
Answer-Explicit prices concessions and implicit price concessions
Key performance indicators set standards for A/R and provide a method for measuring the control and
collection of A/R.
What are the two KPIs used to monitor performance related to the production and submission of claims
to third party payers and patients (self-pay)? - Answer-Elapsed days from discharge to final bill and
elapsed days from final bill to claim/bill submission.
Consents are signed as part of the post-services process. - Answer-True
**False
Patient service costs are calculated in the pre-service process for schedule patients - Answer-**True
False
The patient is scheduled and registered for service is a time-of-service activity - Answer-True
**False
The patient account is monitored for payment is a time-of-service activity - Answer-True
, **False
Case management and discharge planning services are a post-service activty - Answer-True
**False
Sending the bill electronically to the health plan is a time-of-service activity - Answer-True
**False
What happens during the post-service stage? - Answer-**A. Final coding of all services, preparation and
submission of claims, payment processing and balance billing and resolution.
B. Orders are entered, results are reported, charges are generated, and diagnostic and procedural
coding is initiated.
C. The encounter record is generated, and the patient and guarantor information is obtained and/or
updated as required.
D. The focus is on the patient and his/her financial care, in addition to the clinical care provided for the
patient.
The following statements describe best practices established by the Medical Debt Task Force. Check the
box next to the True statements - Answer-**Educate Patients
**Coordinate to avoid duplicate patient contacts
Exercise moderate judgement when communicating with providers about scheduled services
**Be consistent in key aspects of account resolution
Report to healthcare plans when the patient's account is transferred to collection agency
