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CERTIFIED REVENUE CYCLE REPRESENTATIVE EXAM 2 REVIEW AND ACTUAL TEST PAPER QUESTIONS CORRECT ANSWERS GRADED A PLUS

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Voorbeeld 3 van de 19 pagina's

CERTIFIED REVENUE CYCLE REPRESENTATIVE EXAM 2 REVIEW AND ACTUAL TEST PAPER QUESTIONS CORRECT ANSWERS GRADED A PLUS

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CERTIFIED REVENUE CYCLE REPRESENTATIVE EXAM 2 REVIEW AND ACTUAL TEST
PAPER QUESTIONS CORRECT ANSWERS GRADED A PLUS
Certified Revenue Cycle Representative EXAM 2
Review AND Solutions Questions and Answers
Verified Solutions Latest Update 2026/2027

Question:
What is the intended outcome of collaborations made through an ACO delivery system?

Answer:
**A. To ensure appropriateness of care, elimination of duplicate services, and prevention of medical
errors for a population of patients. B. To create cost-containment provisions to reform the healthcare
delivery system. C. To reform the healthcare system into a system that rewards greater value,
improves the quality of care and increases efficiency in the delivery of services. D. To provide
financial incentives to physicians for reporting quality data to CMS.



Question:
Which of these statements describes the new methodology for the determination of net patient
service revenue:

Answer:
A. Net patient service revenue is defined as the average payment amount for the payer but not
recorded until the end of the month processing is completed. B. Gross patient service revenue is
recorded as net patient service revenue until such time as all payments are received. **C. Net patient
service revenue is defined as the total incurred charges, less the explicit price concession, less any
applicable implicit price concession(s) as applied to the specific portfolio of accounts. D. Net patient
service revenue is gross revenue minus any contractual adjustments applicable to the account. Any
additional adjustments are not recorded until the account reaches a zero balance. E. Net patient
service revenue is the sum of the balances of all charges and payments recorded in the accounting
period.



Question:
What are KPIs?

Answer:

,A. Benchmarks which are used to compare Key Performance Indicators in an organization to an
agreed upon average or expected standard within the same industry. **B. Key performance
indicators, which set standards for accounts receivable (A/R) and provide a method of measuring the
collection and control of A/R. C. Days in A/R is calculated based on the value of the total accounts
receivable on a specific date. D. A component that can divide the accounts receivable into 30, 60,
90, 120 days, and over 120 days categories, based on the date of service/discharge



Question:
While the highest level of differentiation among patients is scheduled patient vs unscheduled
patient, a variety of patient types are routinely identified in both the acute and non-acute settings.
Which patient types are typically considered acute care patient types?

Answer:
Observation, newborn, Emergency (ED)



Question:
Accurate identification of the patient is the first step in the scheduling process. Identifiers used in
various combination to achieve accurate patient identification include?

Answer:
Full legal name, date of birth, sex and social security number



Question:
Pre-registration is defined as:

Answer:
The collection of demographic information, insurance data, financial information, providing
reminders, prep information, and identifying the potential need for financial assistance for scheduled
patients.



Question:
Medicare has unique features not found in other health plan programs. It is government sponsored
and financed through taxes and general revenue funds. Which of the following statements accurately
describes the various Medicare benefits programs:

, Answer:
Medicare Part A provides benefits for inpatient hospital services, skilled nursing care and home
health care; Medicare Part B covers outpatient and professional services, Medicare Part C or
Medicare Advantage plans are managed care plans combining Part A and Part B Coverages; and
Medicare Part D is the prescription drug coverage benefit.



Question:
Which of the following statements about Medicaid eligibility is not true?

Answer:
Medicaid categories are restricted to children, pregnant women and elderly in nursing homes.



Question:
Examples of managed care plans include:

Answer:
All of the above



Question:
Patient Financial Communications best practices include all of the following activities except:

Answer:
Collecting payment or initiating the process to immediately remove the patient from the service
schedule.



Question:
Which statement includes the required components of an accurate pricing determination?

Answer:
Insurance coverage and benefits, service or test involved, diagnosis and procedure codes, total
estimated charges, adjudication calculations based on the patient's benefit package.

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