CRCR Certification Exam: CRCR Certified Revenue Cycle
Representative Revenue Cycle: Questions & Answers:
Latest Updated
Overall aggregate payments made to a hospice are subject to a computed "cap
amount" calculated by - ANSWERThe Medicare Administrative Contractor (MAC) at
the end of the hospice cap period
Which of the following is required for participation in Medicaid - ANSWERMeet
Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and
foremost - ANSWERRespect the patients privacy
A nightly room charge will be incorrect if the patient's - ANSWERTransfer 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 - ANSWERPurchase qualified health
benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing
includes: - ANSWERCharitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate
payment from Medicare? - ANSWERRevenue 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 - ANSWERPatient 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 - ANSWERCase management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor
Act) violation? - ANSWERRegistration 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 - ANSWERThe Internal Revenue Service
, Checks received through mail, cash received through mail, and lock box are all
examples of - ANSWERControl points for cash posting
What are some core elements if a board-approved financial assistance policy? -
ANSWEREligibility, application process, and nonpayment collection activities
A recurring/series registration is characterized by - ANSWERThe 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
- ANSWERAssist patients in understanding their insurance coverage and their
financial obligation
The purpose of a financial report is to: - ANSWERPresent financial information to
decision makers
Patient financial communications best practices produce communications that are -
ANSWERConsistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD)
and National Coverage Determinations (NCD) that establish - ANSWERWhat 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 - ANSWERThe Provider Reimbursement Review Board
Concurrent review and discharge planning - ANSWEROccurs during service
Duplicate payments occur: - ANSWERWhen 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 - ANSWERA beneficiary appeal
Insurance verification results in which of the following - ANSWERThe 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: - ANSWERJudicial 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?
- ANSWERMedical screening and stabilizing treatment
Representative Revenue Cycle: Questions & Answers:
Latest Updated
Overall aggregate payments made to a hospice are subject to a computed "cap
amount" calculated by - ANSWERThe Medicare Administrative Contractor (MAC) at
the end of the hospice cap period
Which of the following is required for participation in Medicaid - ANSWERMeet
Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and
foremost - ANSWERRespect the patients privacy
A nightly room charge will be incorrect if the patient's - ANSWERTransfer 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 - ANSWERPurchase qualified health
benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing
includes: - ANSWERCharitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate
payment from Medicare? - ANSWERRevenue 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 - ANSWERPatient 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 - ANSWERCase management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor
Act) violation? - ANSWERRegistration 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 - ANSWERThe Internal Revenue Service
, Checks received through mail, cash received through mail, and lock box are all
examples of - ANSWERControl points for cash posting
What are some core elements if a board-approved financial assistance policy? -
ANSWEREligibility, application process, and nonpayment collection activities
A recurring/series registration is characterized by - ANSWERThe 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
- ANSWERAssist patients in understanding their insurance coverage and their
financial obligation
The purpose of a financial report is to: - ANSWERPresent financial information to
decision makers
Patient financial communications best practices produce communications that are -
ANSWERConsistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD)
and National Coverage Determinations (NCD) that establish - ANSWERWhat 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 - ANSWERThe Provider Reimbursement Review Board
Concurrent review and discharge planning - ANSWEROccurs during service
Duplicate payments occur: - ANSWERWhen 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 - ANSWERA beneficiary appeal
Insurance verification results in which of the following - ANSWERThe 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: - ANSWERJudicial 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?
- ANSWERMedical screening and stabilizing treatment
