CRCR Exam Prep Questions and Answers
1. What are collection agency fees based on?: A percentage of dollars collected
2. Self-funded benefit plans may choose to coordinate benefits
using the gen- der rule or what other rule?: Birthday
3. In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all
providers?: Case rates
4. What customer service improvements might improve the patient
accounts department?: Holding statt accountable for customer service during performance
reviews
5. What is an ABN (Advance Beneficiary Notice of Non-coverage)
required to do?: Inform a Medicare beneficiary that Medicare may not pay for the order or
service
6. What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance?: Bad debt adjustment
7. What is the initial hospice benefit?: Two 90-day periods and an unlimited number of
subsequent periods
,8. When does a hospital add ambulance charges to the Medicare
inpatient claim?: If the patient requires ambulance transportation to a skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an
account is billed?: Post a late-charge adjustment to the account
10. an increase in the dollars aged greater than 90 days from
date of service indicate what about accounts: They are not being processed in
a timely manner
11. What is an advantage of a preregistration program?: It reduces
processing times at the time of service
12. What are the two statutory exclusions from hospice coverage?:
Medically unnec- essary services and custodial care
13. What core financial activities are resolved within patient
access?: Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
14. What statement applies to the scheduled outpatient?: The services do
not involve an overnight stay
15. How is a mis-posted contractual allowance resolved?: Comparing
, the contract reim- bursement rates with the contract on the admittance advice to identify the
correct amount
16. What type of patient status is used to evaluate the patient's
need for inpa- tient care?: Observation
17. Coverage rules for Medicare beneficiaries receiving skilled
nursing care re- quire that the beneficiary has received what?: Medically
necessary inpatient hospital services for at least 3 consecutive days before the skilled nursing
care admission
18. When is the word "SAME" entered on the CMS 1500 billing
form in Field 0$?: When the patient is the insured
19. What are non-emergency patients who come for service
without prior noti- fication to the provider called?: Unscheduled patients
20. 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
21. 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
1. What are collection agency fees based on?: A percentage of dollars collected
2. Self-funded benefit plans may choose to coordinate benefits
using the gen- der rule or what other rule?: Birthday
3. In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all
providers?: Case rates
4. What customer service improvements might improve the patient
accounts department?: Holding statt accountable for customer service during performance
reviews
5. What is an ABN (Advance Beneficiary Notice of Non-coverage)
required to do?: Inform a Medicare beneficiary that Medicare may not pay for the order or
service
6. What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance?: Bad debt adjustment
7. What is the initial hospice benefit?: Two 90-day periods and an unlimited number of
subsequent periods
,8. When does a hospital add ambulance charges to the Medicare
inpatient claim?: If the patient requires ambulance transportation to a skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an
account is billed?: Post a late-charge adjustment to the account
10. an increase in the dollars aged greater than 90 days from
date of service indicate what about accounts: They are not being processed in
a timely manner
11. What is an advantage of a preregistration program?: It reduces
processing times at the time of service
12. What are the two statutory exclusions from hospice coverage?:
Medically unnec- essary services and custodial care
13. What core financial activities are resolved within patient
access?: Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
14. What statement applies to the scheduled outpatient?: The services do
not involve an overnight stay
15. How is a mis-posted contractual allowance resolved?: Comparing
, the contract reim- bursement rates with the contract on the admittance advice to identify the
correct amount
16. What type of patient status is used to evaluate the patient's
need for inpa- tient care?: Observation
17. Coverage rules for Medicare beneficiaries receiving skilled
nursing care re- quire that the beneficiary has received what?: Medically
necessary inpatient hospital services for at least 3 consecutive days before the skilled nursing
care admission
18. When is the word "SAME" entered on the CMS 1500 billing
form in Field 0$?: When the patient is the insured
19. What are non-emergency patients who come for service
without prior noti- fication to the provider called?: Unscheduled patients
20. 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
21. 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
