CRCR CERTIFICATION GUIDE 2025: 120+ QUESTIONS AND
100% VERIFIED ANSWERS | GRADED A+ | GUARANTEED
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270 Health Care Eligibility Benefit Inquiry
- answer-270 transaction is the outbound inquiry from the provider to the health
plan. Includes the IDnumber/DOB of insured party
837-I or UB 04 paper form
- answer-hospital inpatient and outpatient services are submitted to medicare and
medicare advantage plans electronically using these forms
837-P orCMS 1500 paper form
- answer-Physician servicesare submitted electronically using these forms
Accountable Care Organization (ACO)
- answer-delivery system of physicians, hospitals, and other healthcare providers,
who work collaboratively to manage and coordinate the care of a patient
population. Includes appropriateness of care, elimination of duplicate services, and
prevention of medical errors for a population of patients
Accrual Accounting
- answer-revenue is recorded when it is earned to permit the alignment of revenue
with the associated expenses.
Activities of HIM
- answer-ensuring the security and completion of electronic and hardcopy medical
records, transcribing physician dictation including histories and physicals operative
reports and discharge summaries/ analyzing information necessary for decision
support/performing chart analysis/reviewing the medical record, assigning
diagnosis and procedure codes and classifying data for reimbursement
,Activities to be completed before bill submission
- answer-completion of all charging/completion of final medicare record
coding/inclusion of insurance verification activities
Admission Orders: Inpatient
- answer-patients are admitted to inpatient status if further treatment can only be
provided in a hospital setting, the patient's condition cannot be evaluated and/or
treated within 24 hours or there is not an anticipation of improvement in the
patient's condition within 24 hours
Admission Orders: Observation
- answer-observation is an outpatient status used to evaluate patients for possible
inpatient admission or to resolve problems where the treatment is expected to last
less than 24 hours. Patient is placed on a bed either on a regular unit or in a
separate observation unti
Affordable Care Act (ACA)
- answer-includes provisions to improve the quality of care/reform the healthcare
delivery system/encourage pricing transparency and modernized financing
systems/address the issues of waste,fraud, and abuse
Affordable Care Act(ACA)
- answer-lays out requirements for:community health needs assessments, policies
related to financial assistance, emergency medical care, billing and collections
activities
Aging Analysis
- answer-important to age from date of service to understand the impact that timely
billing, or lack of timely billing, has on collection of accounts receivable
ASC 606 change to Accounting rules
, - answer-created 2 types of adjustment to incurred charges:explicit price
concessions and implicit price concessions
Attending Physician
- answer-physician who wrote the order for service and is the physician in charge
of the patient's care for a specific period of time. Also referred to as the admitting
physician
Balance Sheet
- answer-statement is a summary of the organizations wealth as of the date of the
statement. it represents the summary of the organizations assets, liabilities and
accumulated excesses from operations less any accumulated losses.
Beneficiary Appeals
- answer-any enrolled individual in medicare dissatisfiedwith the govt claim
determination is entitled to reconsiderationof the decision, a hearing, and a judicial
review of the final decision after hearing.
Billing Issues with HBP's
- answer-they are contracted with the hospital but may not be contracted with a
patient's health plan
Billing RHC Services
- answer-on UB04/837I specific CPTcodes are collapsed into a single revenue code
(520/521) these codes will be usedto determine medical necessity
Bipartisan Budget Act
- answer-2018 provided a permanent exceptions process for the physical therapy
and speech language pathology and the separate occupational therapy caps
Bundled Payments for Care Improvement (BPCI)
- answer-initiative was developed by the Center for Medicare and Medicaid
100% VERIFIED ANSWERS | GRADED A+ | GUARANTEED
PASS!!
270 Health Care Eligibility Benefit Inquiry
- answer-270 transaction is the outbound inquiry from the provider to the health
plan. Includes the IDnumber/DOB of insured party
837-I or UB 04 paper form
- answer-hospital inpatient and outpatient services are submitted to medicare and
medicare advantage plans electronically using these forms
837-P orCMS 1500 paper form
- answer-Physician servicesare submitted electronically using these forms
Accountable Care Organization (ACO)
- answer-delivery system of physicians, hospitals, and other healthcare providers,
who work collaboratively to manage and coordinate the care of a patient
population. Includes appropriateness of care, elimination of duplicate services, and
prevention of medical errors for a population of patients
Accrual Accounting
- answer-revenue is recorded when it is earned to permit the alignment of revenue
with the associated expenses.
Activities of HIM
- answer-ensuring the security and completion of electronic and hardcopy medical
records, transcribing physician dictation including histories and physicals operative
reports and discharge summaries/ analyzing information necessary for decision
support/performing chart analysis/reviewing the medical record, assigning
diagnosis and procedure codes and classifying data for reimbursement
,Activities to be completed before bill submission
- answer-completion of all charging/completion of final medicare record
coding/inclusion of insurance verification activities
Admission Orders: Inpatient
- answer-patients are admitted to inpatient status if further treatment can only be
provided in a hospital setting, the patient's condition cannot be evaluated and/or
treated within 24 hours or there is not an anticipation of improvement in the
patient's condition within 24 hours
Admission Orders: Observation
- answer-observation is an outpatient status used to evaluate patients for possible
inpatient admission or to resolve problems where the treatment is expected to last
less than 24 hours. Patient is placed on a bed either on a regular unit or in a
separate observation unti
Affordable Care Act (ACA)
- answer-includes provisions to improve the quality of care/reform the healthcare
delivery system/encourage pricing transparency and modernized financing
systems/address the issues of waste,fraud, and abuse
Affordable Care Act(ACA)
- answer-lays out requirements for:community health needs assessments, policies
related to financial assistance, emergency medical care, billing and collections
activities
Aging Analysis
- answer-important to age from date of service to understand the impact that timely
billing, or lack of timely billing, has on collection of accounts receivable
ASC 606 change to Accounting rules
, - answer-created 2 types of adjustment to incurred charges:explicit price
concessions and implicit price concessions
Attending Physician
- answer-physician who wrote the order for service and is the physician in charge
of the patient's care for a specific period of time. Also referred to as the admitting
physician
Balance Sheet
- answer-statement is a summary of the organizations wealth as of the date of the
statement. it represents the summary of the organizations assets, liabilities and
accumulated excesses from operations less any accumulated losses.
Beneficiary Appeals
- answer-any enrolled individual in medicare dissatisfiedwith the govt claim
determination is entitled to reconsiderationof the decision, a hearing, and a judicial
review of the final decision after hearing.
Billing Issues with HBP's
- answer-they are contracted with the hospital but may not be contracted with a
patient's health plan
Billing RHC Services
- answer-on UB04/837I specific CPTcodes are collapsed into a single revenue code
(520/521) these codes will be usedto determine medical necessity
Bipartisan Budget Act
- answer-2018 provided a permanent exceptions process for the physical therapy
and speech language pathology and the separate occupational therapy caps
Bundled Payments for Care Improvement (BPCI)
- answer-initiative was developed by the Center for Medicare and Medicaid
