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HFMA CRCR exam 2023 with 100% correct answers
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GRADED A/LATEST VERSION
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Through what document does a hospital establish compliance standards? ✔Ans✔ code of conduct
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What is the purpose OIG work plant? ✔Ans✔ Identify Acceptable compliance programs in various
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provider setting
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If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule?
✔Ans✔ Non-diagnostic service provided on Tuesday through Friday
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What does a modifier allow a provider to do? ✔Ans✔ Report a specific circumstance that affected a
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procedure or service without changing the code or its definition
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IF outpatient diagnostic services are provided within three days of the admission of a Medicare
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beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these
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charges ✔Ans✔ They must be billed separately to the part B Carrier
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what is a recurring or series registration? ✔Ans✔ One registration record is created for multiple days of
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service
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What are nonemergency patients who come for service without prior notification to the provider called?
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✔Ans✔ Unscheduled patients
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Which of the following statement apply to the observation patient type? ✔Ans✔ It is used to evaluate
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the need for an inpatient admission
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which services are hospice programs required to provide around the clock patient ✔Ans✔ Physician,
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Nursing, Pharmacy
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Scheduler instructions are used to prompt the scheduler to do what? ✔Ans✔ Complete the scheduling
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process correctly based on service requeste
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The Time needed to prepare the patient before service is the difference between the patients arrival
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time and which of the following? ✔Ans✔ Procedure time
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Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
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provided on the order must include: ✔Ans✔ Documentation of the medical necessity for the test
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What is the advantage of a pre-registration program ✔Ans✔ It reduces processing times at the time of
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service
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What date are required to establish a new MPI(Master patient Index) entry ✔Ans✔ The responsible
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party's full legal name, date of birth, and social security number
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Which of the following statements is true about third-party payments? ✔Ans✔ The payments are
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received by the provider from the payer responsible for reimbursing the provider for the patient's
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covered services.
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Which provision protects the patient from medical expenses that exceed the pre-set level ✔Ans✔ stop
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loss
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what documentation must a primary care physician send to HMO patient to authorize a visit to a
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specialist for additional testing or care? ✔Ans✔ Referral
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Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not ask
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about a patient's insurance information if it would delay what? ✔Ans✔ Medical screening and
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stabilizing treatment
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Which of the following is a step in the discharge process? ✔Ans✔ Have a case management service
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complete the discharge plan
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The hospital has a APC based contract for the payment of outpatient services. Total anticipated charges
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for the visit are $2,380. The approved APC payment rate is $780. Where will the patients benefit
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package be applied? ✔Ans✔ To the approved APC payment rate
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HFMA CRCR exam 2023 with 100% correct answers
la
GRADED A/LATEST VERSION
tz
sh
Sp
ne
la
tz
sh
Sp
ne
la
tz
sh
Sp
ne
Through what document does a hospital establish compliance standards? ✔Ans✔ code of conduct
la
tz
sh
Sp
What is the purpose OIG work plant? ✔Ans✔ Identify Acceptable compliance programs in various
ne
provider setting
la
tz
sh
Sp
ne
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule?
✔Ans✔ Non-diagnostic service provided on Tuesday through Friday
la
tz
sh
Sp
ne
What does a modifier allow a provider to do? ✔Ans✔ Report a specific circumstance that affected a
la
procedure or service without changing the code or its definition
tz
sh
Sp
ne
IF outpatient diagnostic services are provided within three days of the admission of a Medicare
la
beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these
tz
sh
charges ✔Ans✔ They must be billed separately to the part B Carrier
Sp
ne
la
tz
what is a recurring or series registration? ✔Ans✔ One registration record is created for multiple days of
sh
Sp
service
ne
la
tz
What are nonemergency patients who come for service without prior notification to the provider called?
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Sp
✔Ans✔ Unscheduled patients
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tz
sh
Which of the following statement apply to the observation patient type? ✔Ans✔ It is used to evaluate
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the need for an inpatient admission
la
sh
which services are hospice programs required to provide around the clock patient ✔Ans✔ Physician,
Sp
Nursing, Pharmacy
la
Sp
, ne
tz
sh
ne
la
Scheduler instructions are used to prompt the scheduler to do what? ✔Ans✔ Complete the scheduling
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process correctly based on service requeste
sh
Sp
ne
la
tz
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Sp
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The Time needed to prepare the patient before service is the difference between the patients arrival
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time and which of the following? ✔Ans✔ Procedure time
tz
sh
Sp
ne
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
la
provided on the order must include: ✔Ans✔ Documentation of the medical necessity for the test
tz
sh
Sp
ne
What is the advantage of a pre-registration program ✔Ans✔ It reduces processing times at the time of
la
tz
service
sh
Sp
ne
la
What date are required to establish a new MPI(Master patient Index) entry ✔Ans✔ The responsible
tz
party's full legal name, date of birth, and social security number
sh
Sp
ne
la
Which of the following statements is true about third-party payments? ✔Ans✔ The payments are
tz
sh
received by the provider from the payer responsible for reimbursing the provider for the patient's
Sp
covered services.
ne
la
tz
sh
Which provision protects the patient from medical expenses that exceed the pre-set level ✔Ans✔ stop
Sp
ne
loss
la
tz
sh
Sp
what documentation must a primary care physician send to HMO patient to authorize a visit to a
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specialist for additional testing or care? ✔Ans✔ Referral
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tz
sh
Sp
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not ask
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about a patient's insurance information if it would delay what? ✔Ans✔ Medical screening and
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stabilizing treatment
tz
sh
Sp
ne
Which of the following is a step in the discharge process? ✔Ans✔ Have a case management service
la
tz
complete the discharge plan
sh
Sp
ne
la
The hospital has a APC based contract for the payment of outpatient services. Total anticipated charges
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for the visit are $2,380. The approved APC payment rate is $780. Where will the patients benefit
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Sp
package be applied? ✔Ans✔ To the approved APC payment rate
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