CRCR Exam Prep| 146 Questions | With Complete Solutions

What are collection agency fees based on? correct answer: A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? correct answer: Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? correct answer: Case rates What customer service improvements might improve the patient accounts department? correct answer: Holding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? correct 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? correct answer: Bad debt adjustment What is the initial hospice benefit? correct answer: Two 90-day periods and an unlimited number of subsequent periods When does a hospital add ambulance charges to the Medicare inpatient claim? correct 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? correct 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 correct answer: They are not being processed in a timely manner What is an advantage of a preregistration program? correct answer: It reduces processing times at the time of service What are the two statutory exclusions from hospice coverage? correct answer: Medically unnecessary services and custodial care What core financial activities are resolved within patient access? correct answer: Scheduling, insurance verification, discharge processing, and payment of point-of-service receipts What statement applies to the scheduled outpatient? correct answer: The services do not involve an overnight stay How is a mis-posted contractual allowance resolved? correct 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? correct answer: Observation Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has received what? correct 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$? correct answer: When the patient is the insured What are non-emergency patients who come for service wit