CRCR CERTIFICATION EXAMS STUDY QUESTIONS AND ANSWERS 2024 CURATED ACTUAL EXAMINATION QUESTIONS AND ANSWERS A+ GUARANTEE

CRCR CERTIFICATION EXAMS STUDY QUESTIONS AND ANSWERS 2024 CURATED ACTUAL EXAMINATION QUESTIONS AND ANSWERS A+ GUARANTEE 1. code of conduct ANS hospital establish compliance standards 2. Purpose of OIG work plan ANS communicate issues that will be reviewed during the year for compliance with Medicare regulations 3. Medicare pt. admitted on Friday, what services fall within the three day window rule ANS Dx services and related charges provided on the W,R, and F before adm. 4. What does modifier allow a provider to do ANS Report a specific circumstance that affected a procedure or service without changing the code or its definition 5. Out pt. dx services provided within 3 days of adm. of a medicare benef. to an IPPS hospt, what must happen to these charges ANS combined with the in pt. bill and paid under the MS-DRG system 6. Why is OIG pursuing the medicare Secondary Payer ANS reviews medicare payments for beneficiaries who have other insurance and assesses the effect. of procedures in preventing inappro. medcare payments for benef. with other ins. Coverage 7. Recurring or series registration days of service ANS one reg. record is created for multi 8. Nonemergency pt. who comes for service w/out prior notif. to the provider called ANS unscheduled pt. 9. Stmnts apply to observ. pt. type adm. 10. which services are hospice programs required to provide on an around the clock basis ANS physician, nursing, pharmacy 11. purpose of initial step in put pt. testing scheduling process ANS identifying the correct pt. in the providers database or add the pt. to the database 12. scheduler instructions are used to prompt the scheduler to do what ANS - complete the scheduling process correctly based on service requested 13. medicare guidelines require that when a test is ordered for which an LCD or NCD exists, the info provided on the order must include which of the following ANS documentation of the medical necessity for the test 14. advantage of pre reg. program time of service ANS reduces processing times at the 15. what data are required to est. a new MPI entry ANS pts. name, DOB, sex 16. Which HIPAA tr ANS. set provides electronic processing of ins, verif re- quests and responses ANS the 270-271 set 17. a mother and father both cover their 16 yo child as a dep. on their health ins, pl ANS, which both follow the bday rule. mothers dob is 1-19-68 and fathers dob is 7-19-67; whose plan is primary ANS mothers 18. true about third party payers ANS payments received by the provider from the payer respon. for reimbursing the provider for the pts. covered services 19. co-payment ANS fixed amt. that is due for a specific service 20. pts annual out of pocket limitation is 3000, excluding deduct. to date this cal. year the pt has satisfied the 500 deduct. and has paid 2300 in co insurance to various providers. max amount of coinsurance the pt will owe ANS 700 21. type of plan that allows the subscriber to pay lower premium costs in return for a higher deductible ANS consumer directed health plan 22. characteristic of a managed care contracted methodology prospectively set rates for in pt. and out pt. services ANS 23. which provision protects the pt. from medical expenses that exceed a pre set level ANS stop loss 24. what document must a primary care phys. send to an HMO pt. to authorize a visit to a specialist for add. testing or care ANS referral 25. activities are completed when a scheduled, pre reg pt. arrives for ser- vice ANS activating the record, obtaining signatures, and finalizing financial issues 26. under EMTALA reg., the provider may not ask about a pts. ins. info if it would delay what ANS medical screening and stabilizing treatment 27. collecting pt liability dollars after service leads to what efforts by pt acct staff to resolve these balanaces ANS increased 28. important message from medicare provides beneficiaries with info con- cerning what ANS right to appeal a discharge decision if the pt disagrees with the plan 29. which of the following is a step in the discharge process case management services complete the discharge plan ANS have