CRCR EXAM PREP 2025 QUESTIONS AND 100% VERIFIED
ANSWERS | GRADED A+ |GUARANTEED PASS!!
What do Case Managers do?
- answer-Monitor high resource cases to ensure effective utilization
What is HIM responsible for?
- answer-all pt medical records: transcribe, coding, release to biling, answer
requests for documentation
What is utilization management responsible for?
- answer-manage cases: services correct, on time
What are the three types of utilization review?
- answer-Prospective, Concurrent, Retrospective
Where can home health services be offered?
- answer-Home, Assist Living, neighbors: just not SNF nor Hospital
To receive -Care payments, what must a SNF have when receiving a pt from a
hosp?
- answer-A transfer agreement approved by -Care.
Can a home health agency employ another agency to provide services?
- answer-Yes, so long as at least one employee of the original agency provides
care.
What is the Net Collection Rate?
- answer-how much cash was collected as a % of available to collect?
What is the Net Collection Rate benchmark?
- answer-95%
What is the benchmark for denials
- answer-<2% on first submission
Formual for cost to collect
- answer-total PFS expenses/gross pt care collections
, What is the benchmark for cost to collect
- answer-2.25%
What % of the UB-04 source of data is from pt access?
- answer-40%
What % of the UB-04 source of data is from service depts?
- answer-11%
What % of the UB-04 source of data is from HIM?
- answer-20%
What % of the UB-04 source of data is from billing?
- answer-20%
What % of the UB-04 source of data is not used?
- answer-9%
What % of the CMS 1500 source of data is from pt access?
- answer-53%
What % of the CMS 1500 source of data is from service?
- answer-14%
What % of the CMS 1500 source of data is from HIM
- answer-7%
What % of the CMS 1500 source of data is from billing?
- answer-26%
From whom is the UB-04 directed?
- answer-institutional: hospitals, SNF, hospice
From whom is the CMS 1500?
- answer-non-institutional: physicians, DME
In the FDCA, what is Title I
- answer-Truth in Lending Act
ANSWERS | GRADED A+ |GUARANTEED PASS!!
What do Case Managers do?
- answer-Monitor high resource cases to ensure effective utilization
What is HIM responsible for?
- answer-all pt medical records: transcribe, coding, release to biling, answer
requests for documentation
What is utilization management responsible for?
- answer-manage cases: services correct, on time
What are the three types of utilization review?
- answer-Prospective, Concurrent, Retrospective
Where can home health services be offered?
- answer-Home, Assist Living, neighbors: just not SNF nor Hospital
To receive -Care payments, what must a SNF have when receiving a pt from a
hosp?
- answer-A transfer agreement approved by -Care.
Can a home health agency employ another agency to provide services?
- answer-Yes, so long as at least one employee of the original agency provides
care.
What is the Net Collection Rate?
- answer-how much cash was collected as a % of available to collect?
What is the Net Collection Rate benchmark?
- answer-95%
What is the benchmark for denials
- answer-<2% on first submission
Formual for cost to collect
- answer-total PFS expenses/gross pt care collections
, What is the benchmark for cost to collect
- answer-2.25%
What % of the UB-04 source of data is from pt access?
- answer-40%
What % of the UB-04 source of data is from service depts?
- answer-11%
What % of the UB-04 source of data is from HIM?
- answer-20%
What % of the UB-04 source of data is from billing?
- answer-20%
What % of the UB-04 source of data is not used?
- answer-9%
What % of the CMS 1500 source of data is from pt access?
- answer-53%
What % of the CMS 1500 source of data is from service?
- answer-14%
What % of the CMS 1500 source of data is from HIM
- answer-7%
What % of the CMS 1500 source of data is from billing?
- answer-26%
From whom is the UB-04 directed?
- answer-institutional: hospitals, SNF, hospice
From whom is the CMS 1500?
- answer-non-institutional: physicians, DME
In the FDCA, what is Title I
- answer-Truth in Lending Act
