HFMA CRCR EXAM LATEST EXAM 170+
QUESTIONS AND CORRECT
ANSWERS(VERIFIED ANSWERS)
What are collection agency fees based on? ...ANSWER...A percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule? ...ANSWER...Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the payer
and some or all providers? ...ANSWER...Case rates
What customer service improvements might improve the patient accounts
department? ...ANSWER...Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? ...ANSWER...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? ...ANSWER...Bad debt adjustment
What is the initial hospice benefit? ...ANSWER...Two 90-day periods and an unlimited number of
subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? ...ANSWER...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? ...ANSWER...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 ...ANSWER...They are not being processed in a timely manner
What is an advantage of a preregistration program? ...ANSWER...It reduces processing times at the time
of service
What are the two statutory exclusions from hospice coverage? ...ANSWER...Medically unnecessary
services and custodial care
What core financial activities are resolved within patient access? ...ANSWER...Scheduling, insurance
verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? ...ANSWER...The services do not involve an
overnight stay
How is a mis-posted contractual allowance resolved? ...ANSWER...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? ...ANSWER...Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has
received what? ...ANSWER...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$? ...ANSWER...When the
patient is the insured
What are non-emergency patients who come for service without prior notification to the provider
called? ...ANSWER...Unscheduled patients
QUESTIONS AND CORRECT
ANSWERS(VERIFIED ANSWERS)
What are collection agency fees based on? ...ANSWER...A percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule? ...ANSWER...Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the payer
and some or all providers? ...ANSWER...Case rates
What customer service improvements might improve the patient accounts
department? ...ANSWER...Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? ...ANSWER...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? ...ANSWER...Bad debt adjustment
What is the initial hospice benefit? ...ANSWER...Two 90-day periods and an unlimited number of
subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? ...ANSWER...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? ...ANSWER...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 ...ANSWER...They are not being processed in a timely manner
What is an advantage of a preregistration program? ...ANSWER...It reduces processing times at the time
of service
What are the two statutory exclusions from hospice coverage? ...ANSWER...Medically unnecessary
services and custodial care
What core financial activities are resolved within patient access? ...ANSWER...Scheduling, insurance
verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? ...ANSWER...The services do not involve an
overnight stay
How is a mis-posted contractual allowance resolved? ...ANSWER...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? ...ANSWER...Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has
received what? ...ANSWER...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$? ...ANSWER...When the
patient is the insured
What are non-emergency patients who come for service without prior notification to the provider
called? ...ANSWER...Unscheduled patients
