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CRCR Exam Prep Questions and Answers with 100%
Correct Solutions UPDATED!!!
What do Case Managers do? - ANSWER Monitor high resource
cases to ensure effective utilization
What is HIM responsible for? - ANSWER all pt medical records:
transcribe, coding, release to biling, answer requests for
documentation
What is utilization management responsible for? - ANSWER
manage cases: services correct, on time
What are the three types of utilization review? - ANSWER
Prospective, Concurrent, Retrospective
Where can home health services be offered? - ANSWER Home,
Assist Living, neighbors: just not SNF nor Hospital
To receive -Care payments, what must a SNF have when
receiving a pt from a hosp? - ANSWER A transfer agreement
approved by -Care.
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Can a home health agency employ another agency to provide
services? - ANSWER Yes, so long as at least one employee of the
original agency provides care.
What is the Net Collection Rate? - ANSWER how much cash was
collected as a % of available to collect?
What is the Net Collection Rate benchmark? - ANSWER 95%
What is the benchmark for denials - ANSWER <2% on first
submission
Formual for cost to collect - ANSWER total PFS expenses/gross
pt care collections
What is the benchmark for cost to collect - ANSWER 2.25%
What % of the UB-04 source of data is from pt access? -
ANSWER 40%
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What % of the UB-04 source of data is from service depts? -
ANSWER 11%
What % of the UB-04 source of data is from HIM? - ANSWER
20%
What % of the UB-04 source of data is from billing? - ANSWER
20%
What % of the UB-04 source of data is not used? - ANSWER 9%
What % of the CMS 1500 source of data is from pt access? -
ANSWER 53%
What % of the CMS 1500 source of data is from service? -
ANSWER 14%
What % of the CMS 1500 source of data is from HIM - ANSWER
7%
CRCR Exam Prep Questions and Answers with 100%
Correct Solutions UPDATED!!!
What do Case Managers do? - ANSWER Monitor high resource
cases to ensure effective utilization
What is HIM responsible for? - ANSWER all pt medical records:
transcribe, coding, release to biling, answer requests for
documentation
What is utilization management responsible for? - ANSWER
manage cases: services correct, on time
What are the three types of utilization review? - ANSWER
Prospective, Concurrent, Retrospective
Where can home health services be offered? - ANSWER Home,
Assist Living, neighbors: just not SNF nor Hospital
To receive -Care payments, what must a SNF have when
receiving a pt from a hosp? - ANSWER A transfer agreement
approved by -Care.
,2|Page
Can a home health agency employ another agency to provide
services? - ANSWER Yes, so long as at least one employee of the
original agency provides care.
What is the Net Collection Rate? - ANSWER how much cash was
collected as a % of available to collect?
What is the Net Collection Rate benchmark? - ANSWER 95%
What is the benchmark for denials - ANSWER <2% on first
submission
Formual for cost to collect - ANSWER total PFS expenses/gross
pt care collections
What is the benchmark for cost to collect - ANSWER 2.25%
What % of the UB-04 source of data is from pt access? -
ANSWER 40%
, 3|Page
What % of the UB-04 source of data is from service depts? -
ANSWER 11%
What % of the UB-04 source of data is from HIM? - ANSWER
20%
What % of the UB-04 source of data is from billing? - ANSWER
20%
What % of the UB-04 source of data is not used? - ANSWER 9%
What % of the CMS 1500 source of data is from pt access? -
ANSWER 53%
What % of the CMS 1500 source of data is from service? -
ANSWER 14%
What % of the CMS 1500 source of data is from HIM - ANSWER
7%
