HFMA CRCR Practice Test Exam Questions and
Answers Verified
Terms in this set (329) QUESTIONS VERIFIED ANSWERS
1) Pre-Service activities 1. Requested service is screened for
med necessity, health coverage/benefits
verified, preauthorization obtained and
estimate to patient oop costs generated
within guidelines of NSA and state
regulations.
2. Patient notified of financial
responsibility including copayment and
health plan deductibles, eligibility of
financial assistance assessed.
3. Patient is scheduled
4. Encounter record is generated and
patient and guarantor info is obtained
and updates as part of preregistration.
, 5. Cost of the scheduled service
identified patients health plan benefits
are used to calculate the price of the
services to the patient. - includes
deductible, coinsurance and or
copayment amounts.
2) Time of service Financial account review is completed
prior to patient visit.
Patient arrives at service unit where
pre-registration record is activated,
consents are signed, copayments and
agreed upon amounts are collected.
Positive identification is completed,
and the patient is given an armband
with acct number.
Scheduled preprocessed patients report
to designated express arrival desk
located in centralized area upon arrival.
3) Unscheduled patients - Time of Service Comprehensive registration and
financial processing is completed at
time of service. Mirroring scheduled
patients who is OON with provider
furnishing services during their
, encounter all federal and state
transparency and NSA provisions are
followed to provide consent to patient
of their rights
4) Time of Service steps Case management and discharge
planning are provided.
Orders are entered.
Results are reported.
Charges are generated.
Diagnostic and procedural coding is
completed.
ONGOING:
Monitor of charges
Managed care resolution
Patient liabilities resolution, as needed.
Ensure health plan requirements and
liability calculations change - vet the
changes against fed/state guidelines.
Consent and updated estimates are
communicated to patient and health
plan.
5) Post Service Includes the account activities that
occur after the patient is discharged
, until the acct reaches zero balance, such
as final coding of all services,
preparation and submission of claims,
payment processing and balance billing
and resolution.
6) Best practices recognize all three Consumer Experience
critical segments of the contemporary
revenue cycle. Each segment includes a
series of processes which are
specifically designed to ensure accurate
data collection, consistent quality, and a
high level of patient satisfaction.
Preservice - patient is scheduled and
registered for service. Patients service
costs are calculated.
Time of service - Case mgmt and
discharge planing services are
provided. Consents are signed.
Post Service - Bill sent electronically to
7) Each segment of the revenue cycle Patient Experience
interacts involving patients. The key to
success is establishing a clear and ever
present focus on the patient.
Answers Verified
Terms in this set (329) QUESTIONS VERIFIED ANSWERS
1) Pre-Service activities 1. Requested service is screened for
med necessity, health coverage/benefits
verified, preauthorization obtained and
estimate to patient oop costs generated
within guidelines of NSA and state
regulations.
2. Patient notified of financial
responsibility including copayment and
health plan deductibles, eligibility of
financial assistance assessed.
3. Patient is scheduled
4. Encounter record is generated and
patient and guarantor info is obtained
and updates as part of preregistration.
, 5. Cost of the scheduled service
identified patients health plan benefits
are used to calculate the price of the
services to the patient. - includes
deductible, coinsurance and or
copayment amounts.
2) Time of service Financial account review is completed
prior to patient visit.
Patient arrives at service unit where
pre-registration record is activated,
consents are signed, copayments and
agreed upon amounts are collected.
Positive identification is completed,
and the patient is given an armband
with acct number.
Scheduled preprocessed patients report
to designated express arrival desk
located in centralized area upon arrival.
3) Unscheduled patients - Time of Service Comprehensive registration and
financial processing is completed at
time of service. Mirroring scheduled
patients who is OON with provider
furnishing services during their
, encounter all federal and state
transparency and NSA provisions are
followed to provide consent to patient
of their rights
4) Time of Service steps Case management and discharge
planning are provided.
Orders are entered.
Results are reported.
Charges are generated.
Diagnostic and procedural coding is
completed.
ONGOING:
Monitor of charges
Managed care resolution
Patient liabilities resolution, as needed.
Ensure health plan requirements and
liability calculations change - vet the
changes against fed/state guidelines.
Consent and updated estimates are
communicated to patient and health
plan.
5) Post Service Includes the account activities that
occur after the patient is discharged
, until the acct reaches zero balance, such
as final coding of all services,
preparation and submission of claims,
payment processing and balance billing
and resolution.
6) Best practices recognize all three Consumer Experience
critical segments of the contemporary
revenue cycle. Each segment includes a
series of processes which are
specifically designed to ensure accurate
data collection, consistent quality, and a
high level of patient satisfaction.
Preservice - patient is scheduled and
registered for service. Patients service
costs are calculated.
Time of service - Case mgmt and
discharge planing services are
provided. Consents are signed.
Post Service - Bill sent electronically to
7) Each segment of the revenue cycle Patient Experience
interacts involving patients. The key to
success is establishing a clear and ever
present focus on the patient.
