HFMA CRCR.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/HFMA%20CRCR
HFMA CRCR Questions & Answers
1. Through what document does a hospital establish compliance standards?-
Answer code of conduct
2. What is the purpose OIG work plant?
Answer Identify Acceptable compliance pro-grams in various provider setting
3. If a Medicare patient is admitted on Friday, what services fall within
the three-day DRG window rule?
Answer Non-diagnostic service provided on Tuesdaythrough Friday
4. What does a modifier allow a provider to do?
Answer Report a specific circumstancethat affected a procedure or service without
changing the code or its definition
5. IF outpatient diagnostic services are provided within three days of the ad-
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,HFMA CRCR.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/HFMA%20CRCR
mission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment
System) hospital, what must happen to these charges
Answer They must be billed separately to the part B Carrier
6. what is a recurring or series registration?
Answer One registration record is createdfor multiple days of service
7. What are nonemergency patients who come for service without prior notifi-
cation to the provider called?
Answer Unscheduled patients
8. Which of the following statement apply to the observation patient type?
Answer Itis used to evaluate the need for an inpatient admission
9. which services are hospice programs required to provide around the clock
patient
Answer Physician, Nursing, Pharmacy
10. Scheduler instructions are used to prompt the scheduler to do what?
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,HFMA CRCR.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/HFMA%20CRCR
Answer -
Complete the scheduling process correctly based on service requeste
11. The Time needed to prepare the patient before service is the difference
between the patients arrival time and which of the following?
Answer Procedure time
12. Medicare guidelines require that when a test is ordered for a LCD or NCD
exists, the information provided on the order must include
Answer Documentation ofthe medical necessity for the test
13. What is the advantage of a pre-registration program
Answer It reduces processingtimes at the time of service
14. What date are required to establish a new MPI(Master patient Index) entry-
Answer The responsible party's full legal name, date of birth, and social security
number
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,HFMA CRCR.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/HFMA%20CRCR
15. Which of the following statements is true about third-party payments?
Answer Thepayments are received by the provider from the payer responsible for
reimbursing the provider for the patient's covered services.
16. Which provision protects the patient from medical expenses that exceed
the pre-set level
Answer stop loss
17. what documentation must a primary care physician send to HMO patientto
authorize a visit to a specialist for additional testing or care?
Answer Referral
4 of 33 10/30/2024, 9:51
HFMA CRCR Questions & Answers
1. Through what document does a hospital establish compliance standards?-
Answer code of conduct
2. What is the purpose OIG work plant?
Answer Identify Acceptable compliance pro-grams in various provider setting
3. If a Medicare patient is admitted on Friday, what services fall within
the three-day DRG window rule?
Answer Non-diagnostic service provided on Tuesdaythrough Friday
4. What does a modifier allow a provider to do?
Answer Report a specific circumstancethat affected a procedure or service without
changing the code or its definition
5. IF outpatient diagnostic services are provided within three days of the ad-
1 of 33 10/30/2024, 9:51
,HFMA CRCR.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/HFMA%20CRCR
mission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment
System) hospital, what must happen to these charges
Answer They must be billed separately to the part B Carrier
6. what is a recurring or series registration?
Answer One registration record is createdfor multiple days of service
7. What are nonemergency patients who come for service without prior notifi-
cation to the provider called?
Answer Unscheduled patients
8. Which of the following statement apply to the observation patient type?
Answer Itis used to evaluate the need for an inpatient admission
9. which services are hospice programs required to provide around the clock
patient
Answer Physician, Nursing, Pharmacy
10. Scheduler instructions are used to prompt the scheduler to do what?
2 of 33 10/30/2024, 9:51
,HFMA CRCR.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/HFMA%20CRCR
Answer -
Complete the scheduling process correctly based on service requeste
11. The Time needed to prepare the patient before service is the difference
between the patients arrival time and which of the following?
Answer Procedure time
12. Medicare guidelines require that when a test is ordered for a LCD or NCD
exists, the information provided on the order must include
Answer Documentation ofthe medical necessity for the test
13. What is the advantage of a pre-registration program
Answer It reduces processingtimes at the time of service
14. What date are required to establish a new MPI(Master patient Index) entry-
Answer The responsible party's full legal name, date of birth, and social security
number
3 of 33 10/30/2024, 9:51
,HFMA CRCR.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/HFMA%20CRCR
15. Which of the following statements is true about third-party payments?
Answer Thepayments are received by the provider from the payer responsible for
reimbursing the provider for the patient's covered services.
16. Which provision protects the patient from medical expenses that exceed
the pre-set level
Answer stop loss
17. what documentation must a primary care physician send to HMO patientto
authorize a visit to a specialist for additional testing or care?
Answer Referral
4 of 33 10/30/2024, 9:51
