CRCR Exam Prep 2023/2024

CRCR Exam Prep 2023/2024 What are collection agency fees based on? - ANSWERS A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - ANSWERS Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - ANSWERS Case rates What customer service improvements might improve the patient accounts department? - ANSWERS Holding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - ANSWERS 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? - ANSWERS Bad debt adjustment What is the initial hospice benefit? - ANSWERS Two 90-day periods and an unlimited number of subsequent periods When does a hospital add ambulance charges to the Medicare inpatient claim? - ANSWERS 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? - ANSWERS 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 - ANSWERS They are not being processed in a timely manner What is an advantage of a preregistration program? - ANSWERS It reduces processing times at the time of service What are the two statutory exclusions from hospice coverage? - ANSWERS Medically unnecessary services and custodial care What core financial activities are resolved within patient access? - ANSWERS Scheduling, insurance verification, discharge processing, and payment of point-ofservice receipts What statement applies to the scheduled outpatient? - ANSWERS The services do not involve an overnight stay How is a mis-posted contractual allowance resolved? - ANSWERS 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? - ANSWERS Observation Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has received what? - ANSWERS 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$? - ANSWERS When the patient is the insured What are non-emergency patients who come for service without prior notification to the provider called? - ANSWERS Unscheduled patients If the insurance verification response reports that a subscriber has a single policy, what is the status of the subscriber's spouse? - ANSWERS Neither enrolled not entitled to benefits Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes what? - ANSWERS Disclosure rules for consumer credit sales and consumer loans