CRCR Certification- Complete Exam Study
Guide 2026/2027 with Verified Answers |
Newest Version. A+
Overall aggregate payments made to a hospice are subject to a computed "cap amount"
calculated by
The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid
Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost
Respect the patients privacy
A nightly room charge will be incorrect if the patient's
Transfer from ICU (intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance Exchanges, where
individuals and small businesses can
Purchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes:
Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from
Medicare?
Revenue codes
This directive was developed to promote and ensure healthcare quality and value and also to
protect consumers and workers in the healthcare system. This directive is called
Patient bill of rights
,The activity which results in the accurate recording of patient bed and level of care
assessment, patient transfer and patient discharge status on a real-time basis is known as
Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act)
violation?
Registration staff may routinely contact managed are plans for prior authorizations before the
patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard
transactions to identify the employer of an individual described in a transaction EIN's are
assigned by
The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all examples of
Control points for cash posting
What are some core elements if a board-approved financial assistance policy?
Eligibility, application process, and nonpayment collection activities
A recurring/series registration is characterized by
The creation of one registration record for multiple days of service
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion
of Medicaid in some states, it is more important than ever for hospitals to
Assist patients in understanding their insurance coverage and their financial obligation
The purpose of a financial report is to:
Present financial information to decision makers
Patient financial communications best practices produce communications that are
Consistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD) and
National Coverage Determinations (NCD) that establish
What services or healthcare items are covered under Medicare
, Any provider that has filed a timely cost report may appeal an adverse final decision received
from the Medicare Administrative Contractor (MAC). This appeal may be filed with
The Provider Reimbursement Review Board
Concurrent review and discharge planning
Occurs during service
Duplicate payments occur:
When providers re-bill claims based on nonpayment from the initial bill submission
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is known as
A beneficiary appeal
Insurance verification results in which of the following
The accurate identification of the patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers includes all
of the following levels EXCEPT:
Judicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay
not ask about a patient's insurance information if it would delay what?
Medical screening and stabilizing treatment
Ambulance services are billed directly to the health plan for
Services provided before a patient is admitted and for ambulance rides arranged to pick up the
patient from the hospital after discharge to take him/her home or to another facility
Key performance indicators (KPIs) set standards for accounts receivables (A/R) and
Provide a method of measuring the collection and control of A/R
he patient discharge process begins when
The physician writes the discharge orders
The nightly room charge will be incorrect if the patient's
Transfer from ICU to the Medical/Surgical floor is not reflected in the registration system.
Guide 2026/2027 with Verified Answers |
Newest Version. A+
Overall aggregate payments made to a hospice are subject to a computed "cap amount"
calculated by
The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid
Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost
Respect the patients privacy
A nightly room charge will be incorrect if the patient's
Transfer from ICU (intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance Exchanges, where
individuals and small businesses can
Purchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes:
Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from
Medicare?
Revenue codes
This directive was developed to promote and ensure healthcare quality and value and also to
protect consumers and workers in the healthcare system. This directive is called
Patient bill of rights
,The activity which results in the accurate recording of patient bed and level of care
assessment, patient transfer and patient discharge status on a real-time basis is known as
Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act)
violation?
Registration staff may routinely contact managed are plans for prior authorizations before the
patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard
transactions to identify the employer of an individual described in a transaction EIN's are
assigned by
The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all examples of
Control points for cash posting
What are some core elements if a board-approved financial assistance policy?
Eligibility, application process, and nonpayment collection activities
A recurring/series registration is characterized by
The creation of one registration record for multiple days of service
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion
of Medicaid in some states, it is more important than ever for hospitals to
Assist patients in understanding their insurance coverage and their financial obligation
The purpose of a financial report is to:
Present financial information to decision makers
Patient financial communications best practices produce communications that are
Consistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD) and
National Coverage Determinations (NCD) that establish
What services or healthcare items are covered under Medicare
, Any provider that has filed a timely cost report may appeal an adverse final decision received
from the Medicare Administrative Contractor (MAC). This appeal may be filed with
The Provider Reimbursement Review Board
Concurrent review and discharge planning
Occurs during service
Duplicate payments occur:
When providers re-bill claims based on nonpayment from the initial bill submission
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is known as
A beneficiary appeal
Insurance verification results in which of the following
The accurate identification of the patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers includes all
of the following levels EXCEPT:
Judicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay
not ask about a patient's insurance information if it would delay what?
Medical screening and stabilizing treatment
Ambulance services are billed directly to the health plan for
Services provided before a patient is admitted and for ambulance rides arranged to pick up the
patient from the hospital after discharge to take him/her home or to another facility
Key performance indicators (KPIs) set standards for accounts receivables (A/R) and
Provide a method of measuring the collection and control of A/R
he patient discharge process begins when
The physician writes the discharge orders
The nightly room charge will be incorrect if the patient's
Transfer from ICU to the Medical/Surgical floor is not reflected in the registration system.
