CRCR CERTIFICATION PREP QUESTION AND
ANSWERS LATEST VERSION VERIFIED RATIONALE
GRADED A+
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of
Medicaid in some states, it is more important than ever for hospitals to - ansAssist patients in
understanding their insurance coverage and their financial obligation
With any remaining open balances, after insurance payments have been posted, the account financial
liability is - ansPotentially transferred to the patient
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? -
ansRegistration staff may routinely contact managed are plans for prior authorizations before the patient
is seen by the on-duty physician
Which option is a government-sponsored health care program that is financed through taxes and general
revenue funds - ansMedicare
Which option is a benefit of pre-registering a patient for services - ansThe patient arrival process is
expedited, reducing wait times and delays
Which of the following is usually covered on a Conditions of Admission form - ansRelease of information
Which of the following is required for participation in Medicaid? - ansMeet income and assets
requirements
Which of the following is required for participation in Medicaid - ansMeet Income and Assets
Requirements
Which of the following is NOT included in the Standardized Quality Measures? - ans
Which of the following is NOT contained in a collection agency agreement? - ansA mutual hold-harmless
clause
Which of the following is NOT a factor in self-pay follow-up? - ansThe type of patient (inpatient, out-
patient)
Which of the following is a violation of the EMTALA (Emergency Medical Treatment and Labor Act?) -
ansRegistration staff members routinely contact managed care plans for prior authorizations before the
patient is seen by the on duty physician
Which of the following in NOT included in the Standardized Quality Measures - ansCost of services
Which department supports/collaborates with the revenue cycle? - ansInformation Technology
When there is a request for service, the scheduling staff member must confirm the patient's unique
identification information to - ansEnsure that she/he accesses the correct information in the historical
database
When there is a request for service the scheduling staff member must confirm the patient's - ansEnsure
that she/he accesses the correct information in the historical database
,CRCR CERTIFICATION PREP QUESTION AND
ANSWERS LATEST VERSION VERIFIED RATIONALE
GRADED A+
When recovery audit contractors (RAC) identify improper payments as over payments the claims
processing contractor must - ansSend a demand letter to the provider to recover the over payment
amount
When Recovery Audit Contractors (RAC) identify improper payments as over payments, the - ansSend a
demand letter to the provider to recover the over payment amount
When primary payment is received, the actual reimbursement - ansIs compared to the expected
reimbursement, the remaining contractual adjustments are posted, and secondary claims are submitted
When billing Rural Health Clinic services on a UB-04/837-I, specific CPT codes are collapsed into a single
revenue code (520 or 521). Although codes are collapsed into a single revenue code, it is still important
to list the appropriate CPT codes as part - ansThese codes will be used to determine medical necessity
and useful in determining what happened during the encounter
What type of account adjustment results from the patient's unwillingness to pay a self-pay balance? -
ansBad debt adjustment
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare? -
ansRevenue codes
What is likely to occur if credit balances are not identified separately from debit balances in accounts
receivable? - ansThe accounts receivable level would be understated
What is Continuum of Care? - ansThe coordination and linkage of resources needed to avoid the
duplication of services and the facilitation of a seamless movement among care settings
What are some core elements if a board-approved financial assistance policy? - ansEligibility, application
process, and nonpayment collection activities
Vital to accurate calculations of a patient's self-pay amount is - ans
Unless the patient encounter is an emergency, it is more efficient and effective to - ansCollect all
information after the patient has been discharged
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not ask
about a patient's insurance information if it would delay what? - ansMedical screening and stabilizing
treatment
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask
about a patient's insurance information if it would delay what? - ansMedical screening and stabilizing
treatment
To provide a patient with information that is meaningful to them, all of the following factors must be
included EXCEPT - ansThe actual physician reimbursement
, CRCR CERTIFICATION PREP QUESTION AND
ANSWERS LATEST VERSION VERIFIED RATIONALE
GRADED A+
To maximize the value derived from customer complaints, all consumer complaints should be -
ansResponded to within two business days
To be eligible for Medicaid, an individual must - ansmeet income and asset requirements
This form contains major items, subdivided into a total of 55 detailed items, and is used by professional
service providers and not hospitals for submitting claims for services to health plans this form is called -
ansThe 1500
This directive was developed to promote and ensure healthcare quality and value and also to protect
consumers and workers in the healthcare system. This directive is called - ansPatient bill of rights
This concept encompasses all activities required to send a request for payment to a third-party health
plan for payment of benefits - ansClaims processing
There are unique billing requirements based on - ansThe provider type
The unscheduled "direct" admission represents a patient who: - ansIs admitted from a physician's office
on an urgent basis
The two types of claims denial appeals are - ansBeneficiary and Provider
The Two Midnight Rule allows hospitals to account for total hospital time when determining if an
inpatient admission order should be written based on - ansA beneficiary needing a minimum of 48 hours
of care
The Truth in Lending Act establishes - ansDisclosure rules for consumer credit sales and consumer loans
The standard claim form used for billing by hospitals, nursing facilities, and other in-patient - ansUB-04
The standard claim form used for billing by hospitals, nursing facilities, and other inpatient - ansUB-04
The soft cost of a dissatisfied customer is - ansThe customer passing on info about their negative
experience to potential pts or through social media channels
The result of accurate census balancing on a daily basis is - ansThe correct recording of room charges
The purpose of the ACA mandated Community Health Needs Assessment is - ansTo identify significant
health needs, prioritize those needs and identify resources to address them
The purpose of a financial report is to: - ansPresent financial information to decision makers
The process of verifying health insurance coverage, identifying contract terms, and obtaining total
charges is known as - ansinsurance verification and reimbursable charges
The process of verifying health insurance coverage, identifying contract terms, and obtaining total
charges is known as - ansInsurance verification of reimbursable charges
The process of creating the pre-registration record ensures - ansAccurate billing
ANSWERS LATEST VERSION VERIFIED RATIONALE
GRADED A+
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of
Medicaid in some states, it is more important than ever for hospitals to - ansAssist patients in
understanding their insurance coverage and their financial obligation
With any remaining open balances, after insurance payments have been posted, the account financial
liability is - ansPotentially transferred to the patient
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? -
ansRegistration staff may routinely contact managed are plans for prior authorizations before the patient
is seen by the on-duty physician
Which option is a government-sponsored health care program that is financed through taxes and general
revenue funds - ansMedicare
Which option is a benefit of pre-registering a patient for services - ansThe patient arrival process is
expedited, reducing wait times and delays
Which of the following is usually covered on a Conditions of Admission form - ansRelease of information
Which of the following is required for participation in Medicaid? - ansMeet income and assets
requirements
Which of the following is required for participation in Medicaid - ansMeet Income and Assets
Requirements
Which of the following is NOT included in the Standardized Quality Measures? - ans
Which of the following is NOT contained in a collection agency agreement? - ansA mutual hold-harmless
clause
Which of the following is NOT a factor in self-pay follow-up? - ansThe type of patient (inpatient, out-
patient)
Which of the following is a violation of the EMTALA (Emergency Medical Treatment and Labor Act?) -
ansRegistration staff members routinely contact managed care plans for prior authorizations before the
patient is seen by the on duty physician
Which of the following in NOT included in the Standardized Quality Measures - ansCost of services
Which department supports/collaborates with the revenue cycle? - ansInformation Technology
When there is a request for service, the scheduling staff member must confirm the patient's unique
identification information to - ansEnsure that she/he accesses the correct information in the historical
database
When there is a request for service the scheduling staff member must confirm the patient's - ansEnsure
that she/he accesses the correct information in the historical database
,CRCR CERTIFICATION PREP QUESTION AND
ANSWERS LATEST VERSION VERIFIED RATIONALE
GRADED A+
When recovery audit contractors (RAC) identify improper payments as over payments the claims
processing contractor must - ansSend a demand letter to the provider to recover the over payment
amount
When Recovery Audit Contractors (RAC) identify improper payments as over payments, the - ansSend a
demand letter to the provider to recover the over payment amount
When primary payment is received, the actual reimbursement - ansIs compared to the expected
reimbursement, the remaining contractual adjustments are posted, and secondary claims are submitted
When billing Rural Health Clinic services on a UB-04/837-I, specific CPT codes are collapsed into a single
revenue code (520 or 521). Although codes are collapsed into a single revenue code, it is still important
to list the appropriate CPT codes as part - ansThese codes will be used to determine medical necessity
and useful in determining what happened during the encounter
What type of account adjustment results from the patient's unwillingness to pay a self-pay balance? -
ansBad debt adjustment
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare? -
ansRevenue codes
What is likely to occur if credit balances are not identified separately from debit balances in accounts
receivable? - ansThe accounts receivable level would be understated
What is Continuum of Care? - ansThe coordination and linkage of resources needed to avoid the
duplication of services and the facilitation of a seamless movement among care settings
What are some core elements if a board-approved financial assistance policy? - ansEligibility, application
process, and nonpayment collection activities
Vital to accurate calculations of a patient's self-pay amount is - ans
Unless the patient encounter is an emergency, it is more efficient and effective to - ansCollect all
information after the patient has been discharged
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not ask
about a patient's insurance information if it would delay what? - ansMedical screening and stabilizing
treatment
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask
about a patient's insurance information if it would delay what? - ansMedical screening and stabilizing
treatment
To provide a patient with information that is meaningful to them, all of the following factors must be
included EXCEPT - ansThe actual physician reimbursement
, CRCR CERTIFICATION PREP QUESTION AND
ANSWERS LATEST VERSION VERIFIED RATIONALE
GRADED A+
To maximize the value derived from customer complaints, all consumer complaints should be -
ansResponded to within two business days
To be eligible for Medicaid, an individual must - ansmeet income and asset requirements
This form contains major items, subdivided into a total of 55 detailed items, and is used by professional
service providers and not hospitals for submitting claims for services to health plans this form is called -
ansThe 1500
This directive was developed to promote and ensure healthcare quality and value and also to protect
consumers and workers in the healthcare system. This directive is called - ansPatient bill of rights
This concept encompasses all activities required to send a request for payment to a third-party health
plan for payment of benefits - ansClaims processing
There are unique billing requirements based on - ansThe provider type
The unscheduled "direct" admission represents a patient who: - ansIs admitted from a physician's office
on an urgent basis
The two types of claims denial appeals are - ansBeneficiary and Provider
The Two Midnight Rule allows hospitals to account for total hospital time when determining if an
inpatient admission order should be written based on - ansA beneficiary needing a minimum of 48 hours
of care
The Truth in Lending Act establishes - ansDisclosure rules for consumer credit sales and consumer loans
The standard claim form used for billing by hospitals, nursing facilities, and other in-patient - ansUB-04
The standard claim form used for billing by hospitals, nursing facilities, and other inpatient - ansUB-04
The soft cost of a dissatisfied customer is - ansThe customer passing on info about their negative
experience to potential pts or through social media channels
The result of accurate census balancing on a daily basis is - ansThe correct recording of room charges
The purpose of the ACA mandated Community Health Needs Assessment is - ansTo identify significant
health needs, prioritize those needs and identify resources to address them
The purpose of a financial report is to: - ansPresent financial information to decision makers
The process of verifying health insurance coverage, identifying contract terms, and obtaining total
charges is known as - ansinsurance verification and reimbursable charges
The process of verifying health insurance coverage, identifying contract terms, and obtaining total
charges is known as - ansInsurance verification of reimbursable charges
The process of creating the pre-registration record ensures - ansAccurate billing
