CRCR COMPLETE QUESTIONS AND
CORRECT ANSWERS EXAM REVIEW
◉ Self-funded benefit plans may choose to coordinate benefits
using the gender rule or what other rule?
Answer: Birthday
◉ In what type of payment methodology is a lump sum or
bundled payment negotiated between the payer and some or all
providers?
Answer: Case rates
◉ What customer service improvements might improve the
patient accounts department?
Answer: Holding staff accountable for customer service during
performance reviews
◉ What is an ABN (Advance Beneficiary Notice of Non-coverage)
required to do?
Answer: Inform a Medicare beneficiary that Medicare may not pay
for the order or service
◉ What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance?
Answer: Bad debt adjustment
,◉ What is the initial hospice benefit?
Answer: Two 90-day periods and an unlimited number of
subsequent periods
◉ When does a hospital add ambulance charges to the Medicare
inpatient claim?
Answer: If the patient requires ambulance transportation to a
skilled nursing facility
◉ How should a provider resolve a late-charge credit posted after
an account is billed?
Answer: Post a late-charge adjustment to the account
◉ an increase in the dollars aged greater than 90 days from date
of service indicate what about accounts
Answer: They are not being processed in a timely manner
◉ What is an advantage of a preregistration program?
Answer: It reduces processing times at the time of service
◉ What are the two statutory exclusions from hospice coverage?
Answer: Medically unnecessary services and custodial care
, ◉ What core financial activities are resolved within patient
access?
Answer: Scheduling, insurance verification, discharge processing,
and payment of point-of-service receipts
◉ What statement applies to the scheduled outpatient?
Answer: The services do not involve an overnight stay
◉ How is a mis-posted contractual allowance resolved?
Answer: Comparing the contract reimbursement rates with the
contract on the admittance advice to identify the correct amount
◉ What type of patient status is used to evaluate the patient's
need for inpatient care?
Answer: Observation
◉ Coverage rules for Medicare beneficiaries receiving skilled
nursing care require that the beneficiary has received what?
Answer: Medically necessary inpatient hospital services for at
least 3 consecutive days before the skilled nursing care admission
◉ When is the word "SAME" entered on the CMS 1500 billing
form in Field 0$?
Answer: When the patient is the insured
CORRECT ANSWERS EXAM REVIEW
◉ Self-funded benefit plans may choose to coordinate benefits
using the gender rule or what other rule?
Answer: Birthday
◉ In what type of payment methodology is a lump sum or
bundled payment negotiated between the payer and some or all
providers?
Answer: Case rates
◉ What customer service improvements might improve the
patient accounts department?
Answer: Holding staff accountable for customer service during
performance reviews
◉ What is an ABN (Advance Beneficiary Notice of Non-coverage)
required to do?
Answer: Inform a Medicare beneficiary that Medicare may not pay
for the order or service
◉ What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance?
Answer: Bad debt adjustment
,◉ What is the initial hospice benefit?
Answer: Two 90-day periods and an unlimited number of
subsequent periods
◉ When does a hospital add ambulance charges to the Medicare
inpatient claim?
Answer: If the patient requires ambulance transportation to a
skilled nursing facility
◉ How should a provider resolve a late-charge credit posted after
an account is billed?
Answer: Post a late-charge adjustment to the account
◉ an increase in the dollars aged greater than 90 days from date
of service indicate what about accounts
Answer: They are not being processed in a timely manner
◉ What is an advantage of a preregistration program?
Answer: It reduces processing times at the time of service
◉ What are the two statutory exclusions from hospice coverage?
Answer: Medically unnecessary services and custodial care
, ◉ What core financial activities are resolved within patient
access?
Answer: Scheduling, insurance verification, discharge processing,
and payment of point-of-service receipts
◉ What statement applies to the scheduled outpatient?
Answer: The services do not involve an overnight stay
◉ How is a mis-posted contractual allowance resolved?
Answer: Comparing the contract reimbursement rates with the
contract on the admittance advice to identify the correct amount
◉ What type of patient status is used to evaluate the patient's
need for inpatient care?
Answer: Observation
◉ Coverage rules for Medicare beneficiaries receiving skilled
nursing care require that the beneficiary has received what?
Answer: Medically necessary inpatient hospital services for at
least 3 consecutive days before the skilled nursing care admission
◉ When is the word "SAME" entered on the CMS 1500 billing
form in Field 0$?
Answer: When the patient is the insured
