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Examen

CRCR EXAM TEST BANK LATEST WITH 400+ QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) 100% COMPLETE

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Escrito en
2023/2024

CRCR EXAM TEST BANK LATEST WITH 400+ QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) 100% COMPLETE 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? - ANSWERMedically unnecessary services and custodial care What core financial activities are resolved within patient access? - ANSWERScheduling, insurance verification, discharge processing, and payment of point-ofservice 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 What are non-emergency patients who come for service without prior notification to the provider called? - ANSWER- Unscheduled patients If the insurance verification response reports that a subscriber has a single policy, what is the status of the subscriber's spouse? - ANSWER- Neither enrolled not entitled to benefits Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes what? - ANSWER- Disclosure rules for consumer credit sales and consumer loans What is a principal diagnosis? - ANSWER- Primary reason for the patient's admission Collecting patient liability dollars after service leads to what? - ANSWER- Lower accounts receivable levels What is the daily out-of-pocket amount for each lifetime reserve day used? - ANSWER- 50% of the current deductible amount What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not billable as an RHC services? - ANSWER- Inpatient care What code indicates the disposition of the patient at the conclusion of service? - ANSWER- Patient discharge status code What are hospitals required to do for Medicare credit balance accounts? - ANSWER- They result in lost reimbursement and additional cost to collect When an undue delay of payment results from a dispute between the patient and the third party payer, who is responsible for payment? - ANSWER- Patient Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information provided on the order must include: - ANSWER- A valid CPT or HCPCS code With advances in internet security and encryption, revenue-cycle processes are expanding to allow patients to do what? - ANSWER- Access their information and perform functions on-line What date is required on all CMS 1500 claim forms? - ANSWER- onset date of current illness What does scheduling allow provider staff to do - ANSWER- Review appropriateness of the service request What code is used to report the provider's most common semiprivate room rate? - ANSWER- Condition code Regulations and requirements for coding accountable care organizations, which allows providers to begin creating these organizations, were finalized in: - ANSWER- 2012 What is a primary responsibility of the Recover Audit Contractor? - ANSWER- To correctly identify proper payments for Medicare Part A & B claims How must providers handle credit balances? - ANSWER- Comply with state statutes concerning reporting credit balance Insurance verification results in what? - ANSWER- The accurate identification of the patient's eligibility and benefits What form is used to bill Medicare for rural health clinics? - ANSWER- CMS 1500 What activities are completed when a scheduled pr

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