CRCR Questions and Answers 2023/24

CRCR Questions and Answers 2023/24

,CRCR Questions and Answers 2024/25


What are collection agency fees based on?
 A percentage of dollars collected


Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule?
 Birthday


In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers?
 Case rates


What customer service improvements might improve the patient accounts department?
 Holding staff accountable for customer service during performance reviews


What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
 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?
 Bad debt adjustment


What is the initial hospice benefit?
 Two 90-day periods and an unlimited number of subsequent periods


When does a hospital add ambulance charges to the Medicare inpatient claim?
 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?
 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

,CRCR Questions and Answers 2024/25

 They are not being processed in a timely manner


What is an advantage of a preregistration program?
 It reduces processing times at the time of service


What are the two statutory exclusions from hospice coverage?
 Medically unnecessary services and custodial care


What core financial activities are resolved within patient access?
 Scheduling, insurance verification, discharge processing, and payment of point-
of-service receipts


What statement applies to the scheduled outpatient?
 The services do not involve an overnight stay


How is a mis-posted contractual allowance resolved?
 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?
 Observation


Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what?
 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$?
 When the patient is the insured


What are non-emergency patients who come for service without prior notification to the
provider called?
 Unscheduled patients


If the insurance verification response reports that a subscriber has a single policy, what
is the status of the subscriber's spouse?

, CRCR Questions and Answers 2024/25

 Neither enrolled not entitled to benefits


Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending
Act, establishes what?
 Disclosure rules for consumer credit sales and consumer loans

What is a principal diagnosis?
 Primary reason for the patient's admission


Collecting patient liability dollars after service leads to what?
 Lower accounts receivable levels


What is the daily out-of-pocket amount for each lifetime reserve day used?
 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?
 Inpatient care


What code indicates the disposition of the patient at the conclusion of service?
 Patient discharge status code


What are hospitals required to do for Medicare credit balance accounts?
 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?
 Patient


Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the
information provided on the order must include:
 A valid CPT or HCPCS code


With advances in internet security and encryption, revenue-cycle processes are
expanding to allow patients to do what?
 Access their information and perform functions on-line