HFMA CERTIFIED REVENUE CYCLE
REPRESENTATIVE COMPREHENSIVE EXAM
STUDY GUIDE COMPLETE QUESTIONS AND
SOLUTIONS
●● Which of the following is required for participation in Medicaid
Answer: Meet Income and Assets Requirements
●● In choosing a setting for patient financial discussions, organizations
should first and foremost
Answer: Respect the patients privacy
●● Overall aggregate payments made to a hospice are subject to a
computed "cap amount" calculated by
Answer: The Medicare Administrative Contractor (MAC) at the end of
the hospice cap period
●● A nightly room charge will be incorrect if the patient's
Answer: 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
,Answer: 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:
Answer: Charitable pledges
●● What is required for the UB-04/837-I, used by Rural Health Clinics
to generate payment from Medicare?
Answer: 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
Answer: 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
Answer: Case management
●● Which statement is an EMTALA (Emergency Medical Treatment and
Active Labor Act) violation?
,Answer: 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
Answer: The Internal Revenue Service
●● Checks received through mail, cash received through mail, and lock
box are all examples of
Answer: Control points for cash posting
●● What are some core elements if a board-approved financial
assistance policy?
Answer: Eligibility, application process, and nonpayment collection
activities
●● A recurring/series registration is characterized by
Answer: 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
Answer: Assist patients in understanding their insurance coverage and
their financial obligation
●● The purpose of a financial report is to:
Answer: Present financial information to decision makers
●● Patient financial communications best practices produce
communications that are
Answer: Consistent, clear and transparent
●● Medicare has established guidelines called the Local Coverage
Determinations (LCD) and National Coverage Determinations (NCD)
that establish
Answer: 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
Answer: The Provider Reimbursement Review Board
●● Concurrent review and discharge planning
REPRESENTATIVE COMPREHENSIVE EXAM
STUDY GUIDE COMPLETE QUESTIONS AND
SOLUTIONS
●● Which of the following is required for participation in Medicaid
Answer: Meet Income and Assets Requirements
●● In choosing a setting for patient financial discussions, organizations
should first and foremost
Answer: Respect the patients privacy
●● Overall aggregate payments made to a hospice are subject to a
computed "cap amount" calculated by
Answer: The Medicare Administrative Contractor (MAC) at the end of
the hospice cap period
●● A nightly room charge will be incorrect if the patient's
Answer: 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
,Answer: 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:
Answer: Charitable pledges
●● What is required for the UB-04/837-I, used by Rural Health Clinics
to generate payment from Medicare?
Answer: 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
Answer: 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
Answer: Case management
●● Which statement is an EMTALA (Emergency Medical Treatment and
Active Labor Act) violation?
,Answer: 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
Answer: The Internal Revenue Service
●● Checks received through mail, cash received through mail, and lock
box are all examples of
Answer: Control points for cash posting
●● What are some core elements if a board-approved financial
assistance policy?
Answer: Eligibility, application process, and nonpayment collection
activities
●● A recurring/series registration is characterized by
Answer: 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
Answer: Assist patients in understanding their insurance coverage and
their financial obligation
●● The purpose of a financial report is to:
Answer: Present financial information to decision makers
●● Patient financial communications best practices produce
communications that are
Answer: Consistent, clear and transparent
●● Medicare has established guidelines called the Local Coverage
Determinations (LCD) and National Coverage Determinations (NCD)
that establish
Answer: 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
Answer: The Provider Reimbursement Review Board
●● Concurrent review and discharge planning
