CRCR EXAM PREP
EXPECTED QUESTIONS WITH VERIFIED ANSWERS
Question 1.
What do EMTALA regulations require on-call physicians to do?
ANSWER
Personally appear in the emergency department and attend to the patient within a reasonable
time
Question 2.
How should a provider resolve a late-charge credit posted after an account is billed?
ANSWER
Post a late-charge adjustment to the account
Question 3.
Why does the financial counselor need pricing for services?
ANSWER
To calculate the patient's financial responsibility
Question 4.
What core financial activities are resolved within patient access?
ANSWER
Scheduling, insurance verification, discharge processing, and payment of point-of-service
receipts
Question 5.
Third-part administrator (TPA)
ANSWER
Provides services to employers or insurance companies for utilization review, claims payment
and benefit design
,Question 6.
What customer service improvements might improve the patient accounts department?
ANSWER
Holding staff accountable for customer service during performance reviews
Question 7.
What is a characteristic
of a managed contracting methodology?
ANSWER
Prospectively set rates for inpatient and outpatient services
Question 8.
When is it not appropriate to use observation status?
ANSWER
As a substitute for an inpatient admission
Question 9.
What code is used to report the provider's most common semiprivate room rate?
ANSWER
Condition code
Question 10.
Claim
ANSWER
A demand by an insured person for the benefits provided by the group contract
Question 11.
What MSP situation requires LGHP
ANSWER
Disability
, Question 12.
In services lines such as cardiology or orthopedics, what does the case-rate payment methodology
allow providers to do?
ANSWER
Receive a fixed for specific procedures
Question 13.
What statement applies to the scheduled outpatient?
ANSWER
The services do not involve an overnight stay
Question 14.
Regulations and requirements for coding accountable care organizations, which allows providers to
begin creating these organizations, were finalized in:
ANSWER
2012
Question 15.
What results from a denied claim?
ANSWER
The provider incurs rework and appeal costs
Question 16.
FERA
ANSWER
Fraud Enforcement and Recovery act
Question 17.
Access
ANSWER
An individual's ability to obtain medical services on a timely and financially acceptable level
EXPECTED QUESTIONS WITH VERIFIED ANSWERS
Question 1.
What do EMTALA regulations require on-call physicians to do?
ANSWER
Personally appear in the emergency department and attend to the patient within a reasonable
time
Question 2.
How should a provider resolve a late-charge credit posted after an account is billed?
ANSWER
Post a late-charge adjustment to the account
Question 3.
Why does the financial counselor need pricing for services?
ANSWER
To calculate the patient's financial responsibility
Question 4.
What core financial activities are resolved within patient access?
ANSWER
Scheduling, insurance verification, discharge processing, and payment of point-of-service
receipts
Question 5.
Third-part administrator (TPA)
ANSWER
Provides services to employers or insurance companies for utilization review, claims payment
and benefit design
,Question 6.
What customer service improvements might improve the patient accounts department?
ANSWER
Holding staff accountable for customer service during performance reviews
Question 7.
What is a characteristic
of a managed contracting methodology?
ANSWER
Prospectively set rates for inpatient and outpatient services
Question 8.
When is it not appropriate to use observation status?
ANSWER
As a substitute for an inpatient admission
Question 9.
What code is used to report the provider's most common semiprivate room rate?
ANSWER
Condition code
Question 10.
Claim
ANSWER
A demand by an insured person for the benefits provided by the group contract
Question 11.
What MSP situation requires LGHP
ANSWER
Disability
, Question 12.
In services lines such as cardiology or orthopedics, what does the case-rate payment methodology
allow providers to do?
ANSWER
Receive a fixed for specific procedures
Question 13.
What statement applies to the scheduled outpatient?
ANSWER
The services do not involve an overnight stay
Question 14.
Regulations and requirements for coding accountable care organizations, which allows providers to
begin creating these organizations, were finalized in:
ANSWER
2012
Question 15.
What results from a denied claim?
ANSWER
The provider incurs rework and appeal costs
Question 16.
FERA
ANSWER
Fraud Enforcement and Recovery act
Question 17.
Access
ANSWER
An individual's ability to obtain medical services on a timely and financially acceptable level
