CRCR Exam Prep UPDATED
QUESTIONS AND CORRECT ANSWERS
What are collection agency fees based on? - CORRECT ANSWER A percentage of dollars
collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule?
- CORRECT ANSWER Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the
payer and some or all providers? - CORRECT ANSWER Case rates
What customer service improvements might improve the patient accounts department? - CORRECT
ANSWER Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - CORRECT
ANSWER Inform a Medicare beneficiary that Medicare may not pay for the order or service
What type of account adjustment results from the patient's unwillingness to pay for a self-pay
balance? - CORRECT ANSWER Bad debt adjustment
What is the initial hospice benefit? - CORRECT ANSWER Two 90-day periods and an
unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? - CORRECT
ANSWER If the patient requires ambulance transportation to a skilled nursing facility
How should a provider resolve a late-charge credit posted after an account is billed? - CORRECT
ANSWER Post a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service indicate what about accounts
- CORRECT ANSWER They are not being processed in a timely manner
, What is an advantage of a preregistration program? - CORRECT ANSWER It reduces
processing times at the time of service
What are the two statutory exclusions from hospice coverage? - CORRECT ANSWER
Medically unnecessary services and custodial care
What core financial activities are resolved within patient access? - CORRECT ANSWER
Scheduling, insurance verification, discharge processing, and payment of point-of-service
receipts
What statement applies to the scheduled outpatient? - CORRECT ANSWER The services do
not involve an overnight stay
How is a mis-posted contractual allowance resolved? - CORRECT ANSWER 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? - CORRECT
ANSWER Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary
has received what? - CORRECT ANSWER 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$? - CORRECT
ANSWER When the patient is the insured
What are non-emergency patients who come for service without prior notification to the provider
called? - CORRECT ANSWER Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the status of
the subscriber's spouse? - CORRECT ANSWER Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act,
establishes what? - CORRECT ANSWER Disclosure rules for consumer credit sales and
consumer loans
QUESTIONS AND CORRECT ANSWERS
What are collection agency fees based on? - CORRECT ANSWER A percentage of dollars
collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule?
- CORRECT ANSWER Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated between the
payer and some or all providers? - CORRECT ANSWER Case rates
What customer service improvements might improve the patient accounts department? - CORRECT
ANSWER Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - CORRECT
ANSWER Inform a Medicare beneficiary that Medicare may not pay for the order or service
What type of account adjustment results from the patient's unwillingness to pay for a self-pay
balance? - CORRECT ANSWER Bad debt adjustment
What is the initial hospice benefit? - CORRECT ANSWER Two 90-day periods and an
unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? - CORRECT
ANSWER If the patient requires ambulance transportation to a skilled nursing facility
How should a provider resolve a late-charge credit posted after an account is billed? - CORRECT
ANSWER Post a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service indicate what about accounts
- CORRECT ANSWER They are not being processed in a timely manner
, What is an advantage of a preregistration program? - CORRECT ANSWER It reduces
processing times at the time of service
What are the two statutory exclusions from hospice coverage? - CORRECT ANSWER
Medically unnecessary services and custodial care
What core financial activities are resolved within patient access? - CORRECT ANSWER
Scheduling, insurance verification, discharge processing, and payment of point-of-service
receipts
What statement applies to the scheduled outpatient? - CORRECT ANSWER The services do
not involve an overnight stay
How is a mis-posted contractual allowance resolved? - CORRECT ANSWER 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? - CORRECT
ANSWER Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary
has received what? - CORRECT ANSWER 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$? - CORRECT
ANSWER When the patient is the insured
What are non-emergency patients who come for service without prior notification to the provider
called? - CORRECT ANSWER Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the status of
the subscriber's spouse? - CORRECT ANSWER Neither enrolled not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act,
establishes what? - CORRECT ANSWER Disclosure rules for consumer credit sales and
consumer loans
