CRCR Certification
Study online at https://quizlet.com/_al75bz
1. Overall aggregate payments made to a hospice are The Medicare Administra-
subject to a computed "cap amount" calculated by tive Contractor (MAC) at
the end of the hospice cap
period
2. Which of the following is required for participation in Meet Income and Assets
Medicaid Requirements
3. In choosing a setting for patient financial discussions, Respect the patients pri-
organizations should first and foremost vacy
4. A nightly room charge will be incorrect if the patient's Transfer from ICU (inten-
sive care unit) to the Med-
ical/Surgical
floor is not reflected in the
registration system
5. The Affordable Care Act legislated the development Purchase qualified health
of Health Insurance Exchanges, where individuals and benefit plans regardless
small businesses can of insured's
health status
6. A portion of the accounts receivable inventory which Charitable pledges
has NOT qualified for billing includes:
7. What is required for the UB-04/837-I, used by Rural Revenue codes
Health Clinics to generate payment from Medicare?
8. This directive was developed to promote and ensure Patient bill of rights
healthcare quality and value and also to protect con-
sumers and workers in the healthcare system. This
directive is called
, CRCR Certification
Study online at https://quizlet.com/_al75bz
9. The activity which results in the accurate recording Case management
of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time
basis is known as
10. Which statement is an EMTALA (Emergency Medical Registration staff may rou-
Treatment and Active Labor Act) violation? tinely contact managed
are plans for prior au-
thorizations before the
patient is seen by the
on-duty physician
11. HIPAA had adopted Employer Identification Numbers The Internal Revenue Ser-
(EIN) to be used in standard transactions to identify vice
the employer of an individual described in a transac-
tion EIN's are
assigned by
12. Checks received through mail, cash received through Control points for cash
mail, and lock box are all examples of posting
13. What are some core elements if a board-approved Eligibility, application
financial assistance policy? process, and nonpayment
collection activities
14. A recurring/series registration is characterized by The creation of one regis-
tration record for multiple
days of service
15. With the advent of the Affordable Care Act Health In- Assist patients in under-
surance Marketplaces and the expansion of Medicaid standing their insurance
in some states, it is more important than ever for coverage and their finan-
hospitals to cial obligation
, CRCR Certification
Study online at https://quizlet.com/_al75bz
16. The purpose of a financial report is to: Present financial informa-
tion to decision makers
17. Patient financial communications best practices pro- Consistent, clear and
duce communications that are transparent
18. Medicare has established guidelines called the Local What services or health-
Coverage Determinations (LCD) and National Cover- care items are covered un-
age Determinations (NCD) that establish der Medicare
19. Any provider that has filed a timely cost report may The Provider Reimburse-
appeal an adverse final decision received from the ment Review Board
Medicare Administrative Contractor (MAC). This ap-
peal may be filed with
20. Concurrent review and discharge planning Occurs during service
21. Duplicate payments occur: When providers re-bill
claims based on nonpay-
ment from the initial bill
submission
22. An individual enrolled in Medicare who is dissatisfied A beneficiary appeal
with the government's claim determination is entitled
to reconsideration of the decision. This type of appeal
is known as
23. Insurance verification results in which of the following The accurate identification
of the patient's eligibility
and benefits
24. Judicial review by a federal
district court
Study online at https://quizlet.com/_al75bz
1. Overall aggregate payments made to a hospice are The Medicare Administra-
subject to a computed "cap amount" calculated by tive Contractor (MAC) at
the end of the hospice cap
period
2. Which of the following is required for participation in Meet Income and Assets
Medicaid Requirements
3. In choosing a setting for patient financial discussions, Respect the patients pri-
organizations should first and foremost vacy
4. A nightly room charge will be incorrect if the patient's Transfer from ICU (inten-
sive care unit) to the Med-
ical/Surgical
floor is not reflected in the
registration system
5. The Affordable Care Act legislated the development Purchase qualified health
of Health Insurance Exchanges, where individuals and benefit plans regardless
small businesses can of insured's
health status
6. A portion of the accounts receivable inventory which Charitable pledges
has NOT qualified for billing includes:
7. What is required for the UB-04/837-I, used by Rural Revenue codes
Health Clinics to generate payment from Medicare?
8. This directive was developed to promote and ensure Patient bill of rights
healthcare quality and value and also to protect con-
sumers and workers in the healthcare system. This
directive is called
, CRCR Certification
Study online at https://quizlet.com/_al75bz
9. The activity which results in the accurate recording Case management
of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time
basis is known as
10. Which statement is an EMTALA (Emergency Medical Registration staff may rou-
Treatment and Active Labor Act) violation? tinely contact managed
are plans for prior au-
thorizations before the
patient is seen by the
on-duty physician
11. HIPAA had adopted Employer Identification Numbers The Internal Revenue Ser-
(EIN) to be used in standard transactions to identify vice
the employer of an individual described in a transac-
tion EIN's are
assigned by
12. Checks received through mail, cash received through Control points for cash
mail, and lock box are all examples of posting
13. What are some core elements if a board-approved Eligibility, application
financial assistance policy? process, and nonpayment
collection activities
14. A recurring/series registration is characterized by The creation of one regis-
tration record for multiple
days of service
15. With the advent of the Affordable Care Act Health In- Assist patients in under-
surance Marketplaces and the expansion of Medicaid standing their insurance
in some states, it is more important than ever for coverage and their finan-
hospitals to cial obligation
, CRCR Certification
Study online at https://quizlet.com/_al75bz
16. The purpose of a financial report is to: Present financial informa-
tion to decision makers
17. Patient financial communications best practices pro- Consistent, clear and
duce communications that are transparent
18. Medicare has established guidelines called the Local What services or health-
Coverage Determinations (LCD) and National Cover- care items are covered un-
age Determinations (NCD) that establish der Medicare
19. Any provider that has filed a timely cost report may The Provider Reimburse-
appeal an adverse final decision received from the ment Review Board
Medicare Administrative Contractor (MAC). This ap-
peal may be filed with
20. Concurrent review and discharge planning Occurs during service
21. Duplicate payments occur: When providers re-bill
claims based on nonpay-
ment from the initial bill
submission
22. An individual enrolled in Medicare who is dissatisfied A beneficiary appeal
with the government's claim determination is entitled
to reconsideration of the decision. This type of appeal
is known as
23. Insurance verification results in which of the following The accurate identification
of the patient's eligibility
and benefits
24. Judicial review by a federal
district court
