CRCR ANSWERS AND QUESTIONS SET A+
✔✔What core financial activities are resolved within patient access? - ✔✔Scheduling,
insurance verification, discharge processing, and payment of point-of-service receipts
✔✔What statement applies to the scheduled outpatient? - ✔✔The services do not
involve an overnight stay
✔✔How is a mis-posted contractual allowance resolved? - ✔✔Comparing the contract
reimbursement rates with the contract on the admittance advice to identify the correct
amount
✔✔What type of patient status is used to evaluate the patient's need for inpatient care?
- ✔✔Observation
✔✔Coverage rules for Medicare beneficiaries receiving skilled nursing care require that
the beneficiary has received what? - ✔✔Medically necessary inpatient hospital services
for at least 3 consecutive days before the skilled nursing care admission
✔✔When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? -
✔✔When the patient is the insured
✔✔What are non-emergency patients who come for service without prior notification to
the provider called? - ✔✔Unscheduled patients
✔✔If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse? - ✔✔Neither enrolled not entitled to
benefits
✔✔Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what? - ✔✔Disclosure rules for consumer credit sales and
consumer loans
✔✔What is a principal diagnosis? - ✔✔Primary reason for the patient's admission
, ✔✔Collecting patient liability dollars after service leads to what? - ✔✔Lower accounts
receivable levels
✔✔What is the daily out-of-pocket amount for each lifetime reserve day used? - ✔✔50%
of the current deductible amount
✔✔What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not
billable as an RHC services? - ✔✔Inpatient care
✔✔What code indicates the disposition of the patient at the conclusion of service? -
✔✔Patient discharge status code
✔✔What are hospitals required to do for Medicare credit balance accounts? - ✔✔They
result in lost reimbursement and additional cost to collect
✔✔When an undue delay of payment results from a dispute between the patient and
the third party payer, who is responsible for payment? - ✔✔Patient
✔✔Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the
information provided on the order must include: - ✔✔A valid CPT or HCPCS code
✔✔With advances in internet security and encryption, revenue-cycle processes are
expanding to allow patients to do what? - ✔✔Access their information and perform
functions on-line
✔✔What date is required on all CMS 1500 claim forms? - ✔✔onset date of current
illness
✔✔What does scheduling allow provider staff to do - ✔✔Review appropriateness of the
service request
✔✔What code is used to report the provider's most common semiprivate room rate? -
✔✔Condition code
✔✔Regulations and requirements for coding accountable care organizations, which
allows providers to begin creating these organizations, were finalized in: - ✔✔2012
✔✔What is a primary responsibility of the Recover Audit Contractor? - ✔✔To correctly
identify proper payments for Medicare Part A & B claims
✔✔How must providers handle credit balances? - ✔✔Comply with state statutes
concerning reporting credit balance
✔✔What core financial activities are resolved within patient access? - ✔✔Scheduling,
insurance verification, discharge processing, and payment of point-of-service receipts
✔✔What statement applies to the scheduled outpatient? - ✔✔The services do not
involve an overnight stay
✔✔How is a mis-posted contractual allowance resolved? - ✔✔Comparing the contract
reimbursement rates with the contract on the admittance advice to identify the correct
amount
✔✔What type of patient status is used to evaluate the patient's need for inpatient care?
- ✔✔Observation
✔✔Coverage rules for Medicare beneficiaries receiving skilled nursing care require that
the beneficiary has received what? - ✔✔Medically necessary inpatient hospital services
for at least 3 consecutive days before the skilled nursing care admission
✔✔When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? -
✔✔When the patient is the insured
✔✔What are non-emergency patients who come for service without prior notification to
the provider called? - ✔✔Unscheduled patients
✔✔If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse? - ✔✔Neither enrolled not entitled to
benefits
✔✔Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what? - ✔✔Disclosure rules for consumer credit sales and
consumer loans
✔✔What is a principal diagnosis? - ✔✔Primary reason for the patient's admission
, ✔✔Collecting patient liability dollars after service leads to what? - ✔✔Lower accounts
receivable levels
✔✔What is the daily out-of-pocket amount for each lifetime reserve day used? - ✔✔50%
of the current deductible amount
✔✔What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not
billable as an RHC services? - ✔✔Inpatient care
✔✔What code indicates the disposition of the patient at the conclusion of service? -
✔✔Patient discharge status code
✔✔What are hospitals required to do for Medicare credit balance accounts? - ✔✔They
result in lost reimbursement and additional cost to collect
✔✔When an undue delay of payment results from a dispute between the patient and
the third party payer, who is responsible for payment? - ✔✔Patient
✔✔Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the
information provided on the order must include: - ✔✔A valid CPT or HCPCS code
✔✔With advances in internet security and encryption, revenue-cycle processes are
expanding to allow patients to do what? - ✔✔Access their information and perform
functions on-line
✔✔What date is required on all CMS 1500 claim forms? - ✔✔onset date of current
illness
✔✔What does scheduling allow provider staff to do - ✔✔Review appropriateness of the
service request
✔✔What code is used to report the provider's most common semiprivate room rate? -
✔✔Condition code
✔✔Regulations and requirements for coding accountable care organizations, which
allows providers to begin creating these organizations, were finalized in: - ✔✔2012
✔✔What is a primary responsibility of the Recover Audit Contractor? - ✔✔To correctly
identify proper payments for Medicare Part A & B claims
✔✔How must providers handle credit balances? - ✔✔Comply with state statutes
concerning reporting credit balance
