CRCR Certification exam with correct answers
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Overall |aggregate |payments |made |to |a |hospice |are |subject |to |a |computed |"cap |amount" |
calculated |by |- |correct |answer |The |Medicare |Administrative |Contractor |(MAC) |at |the |end |of |
the |hospice |cap |period
Which |of |the |following |is |required |for |participation |in |Medicaid |- |correct |answer |Meet |Income
|and |Assets |Requirements
In |choosing |a |setting |for |patient |financial |discussions, |organizations |should |first |and |foremost |-
|correct |answer |Respect |the |patients |privacy
A |nightly |room |charge |will |be |incorrect |if |the |patient's |- |correct |answer |Transfer |from |ICU |
(intensive |care |unit) |to |the |Medical/Surgical
floor |is |not |reflected |in |the |registration |system
The |Affordable |Care |Act |legislated |the |development |of |Health |Insurance |Exchanges, |where |
individuals |and |small |businesses |can |- |correct |answer |Purchase |qualified |health |benefit |plans |
regardless |of |insured's
health |status
A |portion |of |the |accounts |receivable |inventory |which |has |NOT |qualified |for |billing |includes: |- |
correct |answer |Charitable |pledges
What |is |required |for |the |UB-04/837-I, |used |by |Rural |Health |Clinics |to |generate |payment |from |
Medicare? |- |correct |answer |Revenue |codes
,This |directive |was |developed |to |promote |and |ensure |healthcare |quality |and |value |and |also |to |
protect |consumers |and |workers |in |the |healthcare |system. |This |directive |is |called |- |correct |
answer |Patient |bill |of |rights
The |activity |which |results |in |the |accurate |recording |of |patient |bed |and |level |of |care |
assessment, |patient |transfer |and |patient |discharge |status |on |a |real-time |basis |is |known |as |- |
correct |answer |Case |management
Which |statement |is |an |EMTALA |(Emergency |Medical |Treatment |and |Active |Labor |Act) |
violation? |- |correct |answer |Registration |staff |may |routinely |contact |managed |are |plans |for |
prior |authorizations |before |the |patient |is |seen |by |the |on-duty |physician
HIPAA |had |adopted |Employer |Identification |Numbers |(EIN) |to |be |used |in |standard |transactions
|to |identify |the |employer |of |an |individual |described |in |a |transaction |EIN's |are
assigned |by |- |correct |answer |The |Internal |Revenue |Service
Checks |received |through |mail, |cash |received |through |mail, |and |lock |box |are |all |examples |of |- |
correct |answer |Control |points |for |cash |posting
What |are |some |core |elements |if |a |board-approved |financial |assistance |policy? |- |correct |
answer |Eligibility, |application |process, |and |nonpayment |collection |activities
A |recurring/series |registration |is |characterized |by |- |correct |answer |The |creation |of |one |
registration |record |for |multiple |days |of |service
With |the |advent |of |the |Affordable |Care |Act |Health |Insurance |Marketplaces |and |the |expansion |
of |Medicaid |in |some |states, |it |is |more |important |than |ever |for |hospitals |to |- |correct |answer |
Assist |patients |in |understanding |their |insurance |coverage |and |their |financial |obligation
, The |purpose |of |a |financial |report |is |to: |- |correct |answer |Present |financial |information |to |
decision |makers
Patient |financial |communications |best |practices |produce |communications |that |are |- |correct |
answer |Consistent, |clear |and |transparent
Medicare |has |established |guidelines |called |the |Local |Coverage |Determinations |(LCD) |and |
National |Coverage |Determinations |(NCD) |that |establish |- |correct |answer |What |services |or |
healthcare |items |are |covered |under |Medicare
Any |provider |that |has |filed |a |timely |cost |report |may |appeal |an |adverse |final |decision |received |
from |the |Medicare |Administrative |Contractor |(MAC). |This |appeal |may |be |filed |with |- |correct |
answer |The |Provider |Reimbursement |Review |Board
Concurrent |review |and |discharge |planning |- |correct |answer |Occurs |during |service
Duplicate |payments |occur: |- |correct |answer |When |providers |re-bill |claims |based |on |
nonpayment |from |the |initial |bill |submission
An |individual |enrolled |in |Medicare |who |is |dissatisfied |with |the |government's |claim |
determination |is |entitled |to |reconsideration |of |the |decision. |This |type |of |appeal |is |known |as |- |
correct |answer |A |beneficiary |appeal
Insurance |verification |results |in |which |of |the |following |- |correct |answer |The |accurate |
identification |of |the |patient's |eligibility |and |benefits
The |Medicare |fee-for |service |appeal |process |for |both |beneficiaries |and |providers |includes |all |
of |the |following |levels |EXCEPT: |- |correct |answer |Judicial |review |by |a |federal |district |court
| | | | |
Overall |aggregate |payments |made |to |a |hospice |are |subject |to |a |computed |"cap |amount" |
calculated |by |- |correct |answer |The |Medicare |Administrative |Contractor |(MAC) |at |the |end |of |
the |hospice |cap |period
Which |of |the |following |is |required |for |participation |in |Medicaid |- |correct |answer |Meet |Income
|and |Assets |Requirements
In |choosing |a |setting |for |patient |financial |discussions, |organizations |should |first |and |foremost |-
|correct |answer |Respect |the |patients |privacy
A |nightly |room |charge |will |be |incorrect |if |the |patient's |- |correct |answer |Transfer |from |ICU |
(intensive |care |unit) |to |the |Medical/Surgical
floor |is |not |reflected |in |the |registration |system
The |Affordable |Care |Act |legislated |the |development |of |Health |Insurance |Exchanges, |where |
individuals |and |small |businesses |can |- |correct |answer |Purchase |qualified |health |benefit |plans |
regardless |of |insured's
health |status
A |portion |of |the |accounts |receivable |inventory |which |has |NOT |qualified |for |billing |includes: |- |
correct |answer |Charitable |pledges
What |is |required |for |the |UB-04/837-I, |used |by |Rural |Health |Clinics |to |generate |payment |from |
Medicare? |- |correct |answer |Revenue |codes
,This |directive |was |developed |to |promote |and |ensure |healthcare |quality |and |value |and |also |to |
protect |consumers |and |workers |in |the |healthcare |system. |This |directive |is |called |- |correct |
answer |Patient |bill |of |rights
The |activity |which |results |in |the |accurate |recording |of |patient |bed |and |level |of |care |
assessment, |patient |transfer |and |patient |discharge |status |on |a |real-time |basis |is |known |as |- |
correct |answer |Case |management
Which |statement |is |an |EMTALA |(Emergency |Medical |Treatment |and |Active |Labor |Act) |
violation? |- |correct |answer |Registration |staff |may |routinely |contact |managed |are |plans |for |
prior |authorizations |before |the |patient |is |seen |by |the |on-duty |physician
HIPAA |had |adopted |Employer |Identification |Numbers |(EIN) |to |be |used |in |standard |transactions
|to |identify |the |employer |of |an |individual |described |in |a |transaction |EIN's |are
assigned |by |- |correct |answer |The |Internal |Revenue |Service
Checks |received |through |mail, |cash |received |through |mail, |and |lock |box |are |all |examples |of |- |
correct |answer |Control |points |for |cash |posting
What |are |some |core |elements |if |a |board-approved |financial |assistance |policy? |- |correct |
answer |Eligibility, |application |process, |and |nonpayment |collection |activities
A |recurring/series |registration |is |characterized |by |- |correct |answer |The |creation |of |one |
registration |record |for |multiple |days |of |service
With |the |advent |of |the |Affordable |Care |Act |Health |Insurance |Marketplaces |and |the |expansion |
of |Medicaid |in |some |states, |it |is |more |important |than |ever |for |hospitals |to |- |correct |answer |
Assist |patients |in |understanding |their |insurance |coverage |and |their |financial |obligation
, The |purpose |of |a |financial |report |is |to: |- |correct |answer |Present |financial |information |to |
decision |makers
Patient |financial |communications |best |practices |produce |communications |that |are |- |correct |
answer |Consistent, |clear |and |transparent
Medicare |has |established |guidelines |called |the |Local |Coverage |Determinations |(LCD) |and |
National |Coverage |Determinations |(NCD) |that |establish |- |correct |answer |What |services |or |
healthcare |items |are |covered |under |Medicare
Any |provider |that |has |filed |a |timely |cost |report |may |appeal |an |adverse |final |decision |received |
from |the |Medicare |Administrative |Contractor |(MAC). |This |appeal |may |be |filed |with |- |correct |
answer |The |Provider |Reimbursement |Review |Board
Concurrent |review |and |discharge |planning |- |correct |answer |Occurs |during |service
Duplicate |payments |occur: |- |correct |answer |When |providers |re-bill |claims |based |on |
nonpayment |from |the |initial |bill |submission
An |individual |enrolled |in |Medicare |who |is |dissatisfied |with |the |government's |claim |
determination |is |entitled |to |reconsideration |of |the |decision. |This |type |of |appeal |is |known |as |- |
correct |answer |A |beneficiary |appeal
Insurance |verification |results |in |which |of |the |following |- |correct |answer |The |accurate |
identification |of |the |patient's |eligibility |and |benefits
The |Medicare |fee-for |service |appeal |process |for |both |beneficiaries |and |providers |includes |all |
of |the |following |levels |EXCEPT: |- |correct |answer |Judicial |review |by |a |federal |district |court
