CRCR CERTIFICATION EXAM 2024/2025
WITH 100% ACCURATE SOLUTIONS
Overall aggregate payments made to a hospice are subject to a computed
"cap amount" calculated by - Precise Answer ✔✔The Medicare
Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid -
Precise Answer ✔✔Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations
should first and foremost - Precise Answer ✔✔Respect the patients
privacy
A nightly room charge will be incorrect if the patient's - Precise Answer
✔✔Transfer from ICU (intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance
Exchanges, where individuals and small businesses can - Precise
Answer ✔✔Purchase qualified health benefit plans regardless of
insured's
health status
,A portion of the accounts receivable inventory which has NOT qualified
for billing includes: - Precise Answer ✔✔Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to
generate payment from Medicare? - Precise Answer ✔✔Revenue codes
This directive was developed to promote and ensure healthcare quality
and value and also to protect consumers and workers in the healthcare
system. This directive is called - Precise Answer ✔✔Patient bill of
rights
The activity which results in the accurate recording of patient bed and
level of care assessment, patient transfer and patient discharge status on
a real-time basis is known as - Precise Answer ✔✔Case management
Which statement is an EMTALA (Emergency Medical Treatment and
Active Labor Act) violation? - Precise Answer ✔✔Registration staff
may routinely contact managed are plans for prior authorizations before
the patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used
in standard transactions to identify the employer of an individual
described in a transaction EIN's are
assigned by - Precise Answer ✔✔The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box
are all examples of - Precise Answer ✔✔Control points for cash posting
,What are some core elements if a board-approved financial assistance
policy? - Precise Answer ✔✔Eligibility, application process, and
nonpayment collection activities
A recurring/series registration is characterized by - Precise Answer
✔✔The creation of one registration record for multiple days of service
With the advent of the Affordable Care Act Health Insurance
Marketplaces and the expansion of Medicaid in some states, it is more
important than ever for hospitals to - Precise Answer ✔✔Assist patients
in understanding their insurance coverage and their financial obligation
The purpose of a financial report is to: - Precise Answer ✔✔Present
financial information to decision makers
Patient financial communications best practices produce
communications that are - Precise Answer ✔✔Consistent, clear and
transparent
Medicare has established guidelines called the Local Coverage
Determinations (LCD) and National Coverage Determinations (NCD)
that establish - Precise Answer ✔✔What services or healthcare items are
covered under Medicare
Any provider that has filed a timely cost report may appeal an adverse
final decision received from the Medicare Administrative Contractor
, (MAC). This appeal may be filed with - Precise Answer ✔✔The
Provider Reimbursement Review Board
Concurrent review and discharge planning - Precise Answer ✔✔Occurs
during service
Duplicate payments occur: - Precise Answer ✔✔When providers re-bill
claims based on nonpayment from the initial bill submission
An individual enrolled in Medicare who is dissatisfied with the
government's claim determination is entitled to reconsideration of the
decision. This type of appeal is known as - Precise Answer ✔✔A
beneficiary appeal
Insurance verification results in which of the following - Precise Answer
✔✔The accurate identification of the patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and
providers includes all of the following levels EXCEPT: - Precise
Answer ✔✔Judicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the providermay not ask about a patient's insurance
information if it would delay what? - Precise Answer ✔✔Medical
screening and stabilizing treatment
WITH 100% ACCURATE SOLUTIONS
Overall aggregate payments made to a hospice are subject to a computed
"cap amount" calculated by - Precise Answer ✔✔The Medicare
Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid -
Precise Answer ✔✔Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations
should first and foremost - Precise Answer ✔✔Respect the patients
privacy
A nightly room charge will be incorrect if the patient's - Precise Answer
✔✔Transfer from ICU (intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance
Exchanges, where individuals and small businesses can - Precise
Answer ✔✔Purchase qualified health benefit plans regardless of
insured's
health status
,A portion of the accounts receivable inventory which has NOT qualified
for billing includes: - Precise Answer ✔✔Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to
generate payment from Medicare? - Precise Answer ✔✔Revenue codes
This directive was developed to promote and ensure healthcare quality
and value and also to protect consumers and workers in the healthcare
system. This directive is called - Precise Answer ✔✔Patient bill of
rights
The activity which results in the accurate recording of patient bed and
level of care assessment, patient transfer and patient discharge status on
a real-time basis is known as - Precise Answer ✔✔Case management
Which statement is an EMTALA (Emergency Medical Treatment and
Active Labor Act) violation? - Precise Answer ✔✔Registration staff
may routinely contact managed are plans for prior authorizations before
the patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used
in standard transactions to identify the employer of an individual
described in a transaction EIN's are
assigned by - Precise Answer ✔✔The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box
are all examples of - Precise Answer ✔✔Control points for cash posting
,What are some core elements if a board-approved financial assistance
policy? - Precise Answer ✔✔Eligibility, application process, and
nonpayment collection activities
A recurring/series registration is characterized by - Precise Answer
✔✔The creation of one registration record for multiple days of service
With the advent of the Affordable Care Act Health Insurance
Marketplaces and the expansion of Medicaid in some states, it is more
important than ever for hospitals to - Precise Answer ✔✔Assist patients
in understanding their insurance coverage and their financial obligation
The purpose of a financial report is to: - Precise Answer ✔✔Present
financial information to decision makers
Patient financial communications best practices produce
communications that are - Precise Answer ✔✔Consistent, clear and
transparent
Medicare has established guidelines called the Local Coverage
Determinations (LCD) and National Coverage Determinations (NCD)
that establish - Precise Answer ✔✔What services or healthcare items are
covered under Medicare
Any provider that has filed a timely cost report may appeal an adverse
final decision received from the Medicare Administrative Contractor
, (MAC). This appeal may be filed with - Precise Answer ✔✔The
Provider Reimbursement Review Board
Concurrent review and discharge planning - Precise Answer ✔✔Occurs
during service
Duplicate payments occur: - Precise Answer ✔✔When providers re-bill
claims based on nonpayment from the initial bill submission
An individual enrolled in Medicare who is dissatisfied with the
government's claim determination is entitled to reconsideration of the
decision. This type of appeal is known as - Precise Answer ✔✔A
beneficiary appeal
Insurance verification results in which of the following - Precise Answer
✔✔The accurate identification of the patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and
providers includes all of the following levels EXCEPT: - Precise
Answer ✔✔Judicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the providermay not ask about a patient's insurance
information if it would delay what? - Precise Answer ✔✔Medical
screening and stabilizing treatment
