CRCR CERTIFICATION MOCK EXAM AND
STUDY MATERIAL WITH REVENUE CYCLE
SCENARIOS AND PATIENT FINANCIAL
SERVICES PRACTICE
◉ What do the MSP disability rules require?
Answer: That the patient's spouse's employer must have less than
20 employees in the group health plan
◉ what organization originated the concept of insuring prepaid
health care services?
Answer: Blue Cross and blue Shield
◉ What is true about screening a beneficiary for possible MSP
situations?
Answer: It is acceptable to complete the screening form after the
patient has completed the registration process and been sent to the
service department
◉ If the patient cannot agree to payment arrangements, what is the
next option?
,Answer: Warn the patient that unpaid accounts are placed with
collection agencies for further processing
◉ In services lines such as cardiology or orthopedics, what does the
case-rate payment methodology allow providers to do?
Answer: Receive a fixed for specific procedures
◉ What will comprehensive patient access processing accomplish?
Answer: Minimize the need for follow-up on insurance accounts
◉ Through what document does a hospital establish compliance
standards?
Answer: Code of conduct
◉ How does utilization review staff use correct insurance
information?
Answer: To obtain approval for inpatient days and coordinate
services
◉ When is it not appropriate to use observation status?
Answer: As a substitute for an inpatient admission
,◉ What is a serious consequence of misidentifying a patient in the
MPI?
Answer: The services will be documented in the wrong record
◉ When a patient reports directly to a clinical department for
service, what will the clinical department staff do?
Answer: Redirect the patient to the patient access department for
registration
◉ What process can be used to shorten claim turnaround time?
Answer: Send high-dollar hard-copy claims with required
attachments by overnight mail or registered mail
◉ How are patient reminder calls used?
Answer: To make sure the patient follows the prep instructions and
arrives at the scheduled time for service
◉ If a patient declares a straight bankruptcy, what must the provider
do?
Answer: Write off the account to the contractual adjustment account
◉ According to the Department of Health and Human Services
guidelines, what is NOT considered income?
Answer: Sale of property, house, or car
, ◉ The situation where neither the patient nor spouse is employed is
described to the patient using:
Answer: A condition code
◉ What option is an alternative to valid long-term payment plans?
Answer: Bank loans
◉ What is an advantage of using a collection agency to collect
delinquent patient accounts?
Answer: Collection agencies collect accounts faster than hospital
does
◉ What statement DOES NOT apply to revenue codes?
Answer: revenue codes identify the payer
◉ When a patient's illness results in an unusually high amount of
medical bills not covered by insurance or other patient pay
resources, what type of account is created
Answer: catastrophic charity
◉ What happens when a patient receives non-emergent services
from and out-of-network provider?
STUDY MATERIAL WITH REVENUE CYCLE
SCENARIOS AND PATIENT FINANCIAL
SERVICES PRACTICE
◉ What do the MSP disability rules require?
Answer: That the patient's spouse's employer must have less than
20 employees in the group health plan
◉ what organization originated the concept of insuring prepaid
health care services?
Answer: Blue Cross and blue Shield
◉ What is true about screening a beneficiary for possible MSP
situations?
Answer: It is acceptable to complete the screening form after the
patient has completed the registration process and been sent to the
service department
◉ If the patient cannot agree to payment arrangements, what is the
next option?
,Answer: Warn the patient that unpaid accounts are placed with
collection agencies for further processing
◉ In services lines such as cardiology or orthopedics, what does the
case-rate payment methodology allow providers to do?
Answer: Receive a fixed for specific procedures
◉ What will comprehensive patient access processing accomplish?
Answer: Minimize the need for follow-up on insurance accounts
◉ Through what document does a hospital establish compliance
standards?
Answer: Code of conduct
◉ How does utilization review staff use correct insurance
information?
Answer: To obtain approval for inpatient days and coordinate
services
◉ When is it not appropriate to use observation status?
Answer: As a substitute for an inpatient admission
,◉ What is a serious consequence of misidentifying a patient in the
MPI?
Answer: The services will be documented in the wrong record
◉ When a patient reports directly to a clinical department for
service, what will the clinical department staff do?
Answer: Redirect the patient to the patient access department for
registration
◉ What process can be used to shorten claim turnaround time?
Answer: Send high-dollar hard-copy claims with required
attachments by overnight mail or registered mail
◉ How are patient reminder calls used?
Answer: To make sure the patient follows the prep instructions and
arrives at the scheduled time for service
◉ If a patient declares a straight bankruptcy, what must the provider
do?
Answer: Write off the account to the contractual adjustment account
◉ According to the Department of Health and Human Services
guidelines, what is NOT considered income?
Answer: Sale of property, house, or car
, ◉ The situation where neither the patient nor spouse is employed is
described to the patient using:
Answer: A condition code
◉ What option is an alternative to valid long-term payment plans?
Answer: Bank loans
◉ What is an advantage of using a collection agency to collect
delinquent patient accounts?
Answer: Collection agencies collect accounts faster than hospital
does
◉ What statement DOES NOT apply to revenue codes?
Answer: revenue codes identify the payer
◉ When a patient's illness results in an unusually high amount of
medical bills not covered by insurance or other patient pay
resources, what type of account is created
Answer: catastrophic charity
◉ What happens when a patient receives non-emergent services
from and out-of-network provider?
