CRCR Multiple Choice questions with verified solutions

CRCR Multiple Choice questions with
verified solutions

The disadvantages of outsourcing include all of the following EXCEPT:
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a) The impact of customer service or patient relations
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b) The impact of loss of direct control of accounts receivable services
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c) Increased costs due to vendor ineffectiveness
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d) Reduced internal staffing costs and a reliance on outsourced staff - answersD
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The Medicare fee-for service appeal process for both beneficiaries and providers
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includes all of the following levels EXCEPT: me, me , me, me , me, me,




a) Medical necessity review by an independent physician's panel
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b) Judicial review by a federal district court
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c) Redetermination by the company that handles claims for
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Medicare
d) Review by the Medicare Appeals Council (Appeals Council) - answersB
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Business ethics, or organizational ethics represent: me, me, me, me, me,




a) The principles and standards by which organizations operate
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b) Regulations that must be followed by law
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c) Definitions of appropriate customer service
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d) The code of acceptable conduct - answersA
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A portion of the accounts receivable inventory which has NOT qualified for billing
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includes:

a) Charitable pledges
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b) Accounts created during pre-registration but not activated
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c) Accounts coded but held within the suspense period
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d) Accounts assigned to a pre-collection agency - answersA
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Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) are
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Medicare established guideline(s) used to determine: me, me, me , me, me,




a) Medicare and Medicaid provider eligibility
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b) Medicare outpatient reimbursement rates
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c) Which diagnoses, signs, or symptoms are reimbursable
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d) What Medicare reimburses and what should be referred to
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Medicaid - answersC me, me ,




Days in A/R is calculated based on the value of:
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,a) The total accounts receivable on a specific date
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b) Total anticipated revenue minus expenses
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c) The time it takes to collect anticipated revenue
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d) Total cash received to date - answersC
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Patients are contacting hospitals to proactively inquire about costs and fees prior to
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agreeing to service. The problem for hospitals in providing such information is: me, me, me, me , me, me, me, me, me, me, me,




a) That hospitals don't want to establish a price without knowing if
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the patient has insurance and how much reimbursement can be
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expected
b) The fact that charge master lists the total charge, not net charges
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that reflect charges after a payer's contractual adjustment
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c) That hospitals don't want to be put in the position of
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"guaranteeing" price without having room for additional charges me , me, me, me, me, me, me,




that may arise in the course of treatment
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d) Their reluctance to share proprietary information - answersB
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Across all care settings, if a patient consents to a financial discussion during a medical
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encounter to expedite discharge, the HFMA best practice is to: me , me, me, me, me , me, me , me, me,




a) Make sure that the attending staff can answer questions and
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assist in obtaining required patient financial data
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b) Have a patient financial responsibilities kit ready for the patient,
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containing all of the required registration forms and instructions me, me, me, me, me, me, me, me ,




c) Support that choice, providing that the discussion does not
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interfere with patient care or disrupt patient flow me, me, me, me , me , me, me,




d) Decline such request as finance discussions can disrupt patient
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care and patient flow - answersC
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A comprehensive "Compliance Program" is defined as
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a) Annual legal audit and review for adherence to regulations
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b) Educating staff on regulations
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c) Systematic procedures to ensure that the provisions of
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regulations imposed by a government agency are being met me, me, me, me, me , me, me, me,




d) The development of operational policies that correspond to
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regulations - answersC me, me,




Case Management requires that a case manager be assigned
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a) To patients of any physician requesting case management
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b) To a select patient group
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c) To every patient
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d) To specific cases designated by third party contractual agreement - answersB
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Pricing transparency is defined as readily available information on the price of
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healthcare services, that together with other information, help define the value of those me, me, me, me, me, me, me, me, me, me, me, me,

, services and enable consumers to me, me , me , me ,




a) Identify, compare, and choose providers that offer the desired
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level of value me, me,




b) Customize health care with a personally chosen mix of providers
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c) Negotiate the cost of health plan premiums
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d) Verify the cost of individual clinicians - answersA
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Any healthcare insurance plan that provides or ensures comprehensive health
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maintenance and treatment services for an enrolled group of persons based on a me, me, me, me, me, me, me, me , me, me , me, m e,




monthly fee is known as a me, me, me, me, me,




a) MSO
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b) HMO
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c) PPO
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d) GPO - answersB
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In a Chapter 7 Straight Bankruptcy filing
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a) The court liquidates the debtor's nonexempt property, pays
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creditors, and discharges the debtor from the debt me, me, me, me, me, me, me,




b) The court liquidates the debtor's nonexempt property, pays
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creditors, and begins to pay off the largest claims first. All claims me, me, me, me , me, me, me , me, me, me, me ,




are paid some portion of the amount owed
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c) The court vacates all claims against a debtor with the
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understanding that the debtor may not apply for credit without me, me, me, me, me, me, me, me , me,




court supervision me,




d) The court establishes a creditor payment schedule with the
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longest outstanding claims paid first - answersA me, me, me, me, me, me,




The core financial activities resolved within patient access include:
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a) Scheduling, pre-registration, insurance verification and managed
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care processing me,




b) Scheduling, insurance verification, clinical discharge processing
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and payment posting of point of service receipts
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c) Scheduling, registration, charge entry and managed care
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processing
d) Scheduling, pre-registration, registration, medical necessity
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screening and patient refunds - answersA me, me, me , me, me,




Which of the following is NOT contained in a collection agency agreement?
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a) A clear understanding that the provider retains ownership of any
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outsourced activities me ,




b) Specific language as to who will pay legal fees, if needed
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c) An annual renewal clause
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d) A mutual hold-harmless clause - answersD
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