CRCR Multiple Choice
questions and
answers 100%
guaranteed success.
The disadvantages of outsourcing include all of the following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff correct
answer. D
The Medicare fee-for service appeal process for both beneficiaries and
providers includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles
claims for Medicare
d) Review by the Medicare Appeals Council (Appeals Council) correct answer.
B
Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct correct answer. A
,A portion of the accounts receivable inventory which has NOT qualified for
billing includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency correct answer. A
Local Coverage Determinations (LCD) and National Coverage Determinations
(NCD) are
Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be
referred to Medicaid correct answer. C
Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date correct answer. C
Patients are contacting hospitals to proactively inquire about costs and fees
prior to agreeing to service. The problem for hospitals in providing such
information is:
a) That hospitals don't want to establish a price without
knowing if the patient has insurance and how much
reimbursement can be expected
b) The fact that charge master lists the total charge, not
net charges that reflect charges after a payer's contractual
adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for
additional charges that may arise in the course of
treatment
d) Their reluctance to share proprietary information correct answer. B
Across all care settings, if a patient consents to a financial discussion during a
medical encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer
questions and assist in obtaining required patient
financial data
b) Have a patient financial responsibilities kit ready for
the patient, containing all of the required registration
,forms and instructions
, c) Support 3that 3choice, 3providing 3that 3the 3discussion
3does 3not 3interfere 3with 3patient 3care 3or 3disrupt
3patient 3flow
d) Decline 3such 3request 3as 3finance 3discussions 3can
3disrupt 3patient 3care 3and 3patient 3flow 3correct 3answer. C
A 3comprehensive 3"Compliance 3Program" 3is 3defined 3as
a) Annual 3legal 3audit 3and 3review 3for 3adherence 3to 3regulations
b) Educating 3staff 3on 3regulations
c) Systematic 3procedures 3to 3ensure 3that 3the
3provisions 3of 3regulations 3imposed 3by 3a 3government
3agency 3are 3being 3met
d) The 3development 3of 3operational 3policies 3that
3correspond 3to 3regulations 3correct 3answer. C
Case 3Management 3requires 3that 3a 3case 3manager 3be 3assigned
a) To 3patients 3of 3any 3physician 3requesting 3case 3management
b) To 3a 3select 3patient 3group
c) To 3every 3patient
d) To 3specific 3cases 3designated 3by 3third 3party 3contractual 3agreement
3correct 3answer. 3B
Pricing 3transparency 3is 3defined 3as 3readily 3available 3information 3on 3the 3price
3of 3healthcare 3services, 3that 3together 3with 3other 3information, 3help 3define
3the 3value 3of 3those 3services 3and 3enable 3consumers 3to
a) Identify, 3compare, 3and 3choose 3providers 3that 3offer
3the 3desired 3level 3of 3value
b) Customize 3health 3care 3with 3a 3personally 3chosen 3mix 3of 3providers
c) Negotiate 3the 3cost 3of 3health 3plan 3premiums
d) Verify 3the 3cost 3of 3individual 3clinicians 3correct 3answer. A
Any 3healthcare 3insurance 3plan 3that 3provides 3or 3ensures 3comprehensive
3health 3maintenance 3and 3treatment 3services 3for 3an 3enrolled 3group 3of
3persons 3based 3on 3a 3monthly 3fee 3is 3known 3as 3a
a) MSO
b) HMO
c) PPO
d) GPO 3correct 3answer. B
In 3a 3Chapter 37 3Straight 3Bankruptcy 3filing
a) The 3court 3liquidates 3the 3debtor's 3nonexempt
3property, 3pays 3creditors, 3and 3discharges 3the 3debtor
3from 3the 3debt
b) The 3court 3liquidates 3the 3debtor's 3nonexempt 3property, 3pays
questions and
answers 100%
guaranteed success.
The disadvantages of outsourcing include all of the following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff correct
answer. D
The Medicare fee-for service appeal process for both beneficiaries and
providers includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles
claims for Medicare
d) Review by the Medicare Appeals Council (Appeals Council) correct answer.
B
Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct correct answer. A
,A portion of the accounts receivable inventory which has NOT qualified for
billing includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency correct answer. A
Local Coverage Determinations (LCD) and National Coverage Determinations
(NCD) are
Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be
referred to Medicaid correct answer. C
Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date correct answer. C
Patients are contacting hospitals to proactively inquire about costs and fees
prior to agreeing to service. The problem for hospitals in providing such
information is:
a) That hospitals don't want to establish a price without
knowing if the patient has insurance and how much
reimbursement can be expected
b) The fact that charge master lists the total charge, not
net charges that reflect charges after a payer's contractual
adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for
additional charges that may arise in the course of
treatment
d) Their reluctance to share proprietary information correct answer. B
Across all care settings, if a patient consents to a financial discussion during a
medical encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer
questions and assist in obtaining required patient
financial data
b) Have a patient financial responsibilities kit ready for
the patient, containing all of the required registration
,forms and instructions
, c) Support 3that 3choice, 3providing 3that 3the 3discussion
3does 3not 3interfere 3with 3patient 3care 3or 3disrupt
3patient 3flow
d) Decline 3such 3request 3as 3finance 3discussions 3can
3disrupt 3patient 3care 3and 3patient 3flow 3correct 3answer. C
A 3comprehensive 3"Compliance 3Program" 3is 3defined 3as
a) Annual 3legal 3audit 3and 3review 3for 3adherence 3to 3regulations
b) Educating 3staff 3on 3regulations
c) Systematic 3procedures 3to 3ensure 3that 3the
3provisions 3of 3regulations 3imposed 3by 3a 3government
3agency 3are 3being 3met
d) The 3development 3of 3operational 3policies 3that
3correspond 3to 3regulations 3correct 3answer. C
Case 3Management 3requires 3that 3a 3case 3manager 3be 3assigned
a) To 3patients 3of 3any 3physician 3requesting 3case 3management
b) To 3a 3select 3patient 3group
c) To 3every 3patient
d) To 3specific 3cases 3designated 3by 3third 3party 3contractual 3agreement
3correct 3answer. 3B
Pricing 3transparency 3is 3defined 3as 3readily 3available 3information 3on 3the 3price
3of 3healthcare 3services, 3that 3together 3with 3other 3information, 3help 3define
3the 3value 3of 3those 3services 3and 3enable 3consumers 3to
a) Identify, 3compare, 3and 3choose 3providers 3that 3offer
3the 3desired 3level 3of 3value
b) Customize 3health 3care 3with 3a 3personally 3chosen 3mix 3of 3providers
c) Negotiate 3the 3cost 3of 3health 3plan 3premiums
d) Verify 3the 3cost 3of 3individual 3clinicians 3correct 3answer. A
Any 3healthcare 3insurance 3plan 3that 3provides 3or 3ensures 3comprehensive
3health 3maintenance 3and 3treatment 3services 3for 3an 3enrolled 3group 3of
3persons 3based 3on 3a 3monthly 3fee 3is 3known 3as 3a
a) MSO
b) HMO
c) PPO
d) GPO 3correct 3answer. B
In 3a 3Chapter 37 3Straight 3Bankruptcy 3filing
a) The 3court 3liquidates 3the 3debtor's 3nonexempt
3property, 3pays 3creditors, 3and 3discharges 3the 3debtor
3from 3the 3debt
b) The 3court 3liquidates 3the 3debtor's 3nonexempt 3property, 3pays
