CRCR Certification Exam Question and
Answers2023/2024
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.
The soft cost of a dissatisfied customer is -
✔️The customer passing on info about their negative experience to potential pts or
through social media channels
An advantage of a pre-registration program is -
✔️The opportunity to reduce the corporate compliance failures within the
registration process
It is important to have high registration quality standards because -
✔️Inaccurate or incomplete patient data will delay payment or cause denials
Telemed seeks to improve a patient's health by -
✔️Permitting 2-way real time interactive communication between the patient and
the clinical professional
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons based on a
monthly fee is known as a -
✔️HMO
Answers2023/2024
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.
The soft cost of a dissatisfied customer is -
✔️The customer passing on info about their negative experience to potential pts or
through social media channels
An advantage of a pre-registration program is -
✔️The opportunity to reduce the corporate compliance failures within the
registration process
It is important to have high registration quality standards because -
✔️Inaccurate or incomplete patient data will delay payment or cause denials
Telemed seeks to improve a patient's health by -
✔️Permitting 2-way real time interactive communication between the patient and
the clinical professional
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons based on a
monthly fee is known as a -
✔️HMO
