Certified Revenue Cycle Representative (CRCR) UPDATED
ACTUAL Exam Questions and CORRECT Answers
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Terms in this set (68)
Pricing transparency is defined as readily available Identify, compare, and choose providers that offer the desired level of value.
information on the price of healthcare services, that
together with other information, help define the value
of those services and enable consumers to
Because case managers document the clinical reasons A good resource when developing written appeals and denials.
for treatment, they are
All of the following information describe claim edits The claim editing process slowed down the receipt of payments, increases
EXCEPT account receivable outstanding, and decreases cash flow.
What types of services are classified as non-acute? Hospice Care, Clinic Services & Skilled Nursing
The unscheduled "direct" admission represents a patient Is admitted from a physician's office on an urgent basis.
who:
The process of creating the pre-registration record That access staff will have complete and valid information needed to finalize
ensures any remaining pre-access activities.
An advantage of a pre-registration program is The opportunity to reduce processing times at the time of service.
, Claim edits are Rules developed to verify the accuracy of claims based on each health plan's
policies.
Examples of ethic violations that impact the revenue Seeking payment options for patient self-pay
cycle include all of the following EXCEPT
EMTALA and HFMA best practices specify that, in an No patient financial discussions should occur before a patient is screened and
Emergency Department setting stabilized.
Which of the following is usually covered on a Release of information
Conditions of Admission form
The nuanced data resulting from detailed ICD-10 Obtain higher compensation for physicians
coding allows senior leadership to work with physicians
to do all of the following EXCEPT
Selecting the wrong insurance plan code can lead to Estimating the wrong reimbursement
the following problems or denials, except
Eliminating mail time and reducing data entry time, The electronic submission of claims using electronic transactions
electronically monitoring the receipt of claims and
online claim adjudication; more prompt payment are all
benefits achieved by
Process observation is a part of what framework of Compliance
Revenue Cycle?
ICD-10-CM and ICD-10-PCS code sets are The international ICD-10 codes as developed by the WHO (World Health
modifications of Organization)
In the balance resolution process, providers should: Ask the patient if he or she would like to receive information about payment
options and supportive financial assistance programs
A claim is denied for the following reasons, EXCEPT The submitted claim does not have the physicians signature
What is a component of HFMA's "Healthcare Dollars & Medical Account Resolution
Sense" initiative?
Charges, as the most appropriate measurement of Accuracy of expense and cost capture in the revenue cycle
utilization enables
Net Accounts Receivable is The amount an entity is reasonably confident of collection from overall
accounts receivables
ACTUAL Exam Questions and CORRECT Answers
Leave the first rating
Save
Students also studied
Flashcard sets Study guides
WGU D033 Glossary Terms Epic CLN 251/252 Exam Review Exa... RHIT STUDY GUIDE!! WHITE BOARD... HI
Teacher 322 terms Teacher 55 terms Teacher 148 terms Te
laban_munyao Preview quizlette46715940 Preview Tyler_Gilbert654 Preview
Terms in this set (68)
Pricing transparency is defined as readily available Identify, compare, and choose providers that offer the desired level of value.
information on the price of healthcare services, that
together with other information, help define the value
of those services and enable consumers to
Because case managers document the clinical reasons A good resource when developing written appeals and denials.
for treatment, they are
All of the following information describe claim edits The claim editing process slowed down the receipt of payments, increases
EXCEPT account receivable outstanding, and decreases cash flow.
What types of services are classified as non-acute? Hospice Care, Clinic Services & Skilled Nursing
The unscheduled "direct" admission represents a patient Is admitted from a physician's office on an urgent basis.
who:
The process of creating the pre-registration record That access staff will have complete and valid information needed to finalize
ensures any remaining pre-access activities.
An advantage of a pre-registration program is The opportunity to reduce processing times at the time of service.
, Claim edits are Rules developed to verify the accuracy of claims based on each health plan's
policies.
Examples of ethic violations that impact the revenue Seeking payment options for patient self-pay
cycle include all of the following EXCEPT
EMTALA and HFMA best practices specify that, in an No patient financial discussions should occur before a patient is screened and
Emergency Department setting stabilized.
Which of the following is usually covered on a Release of information
Conditions of Admission form
The nuanced data resulting from detailed ICD-10 Obtain higher compensation for physicians
coding allows senior leadership to work with physicians
to do all of the following EXCEPT
Selecting the wrong insurance plan code can lead to Estimating the wrong reimbursement
the following problems or denials, except
Eliminating mail time and reducing data entry time, The electronic submission of claims using electronic transactions
electronically monitoring the receipt of claims and
online claim adjudication; more prompt payment are all
benefits achieved by
Process observation is a part of what framework of Compliance
Revenue Cycle?
ICD-10-CM and ICD-10-PCS code sets are The international ICD-10 codes as developed by the WHO (World Health
modifications of Organization)
In the balance resolution process, providers should: Ask the patient if he or she would like to receive information about payment
options and supportive financial assistance programs
A claim is denied for the following reasons, EXCEPT The submitted claim does not have the physicians signature
What is a component of HFMA's "Healthcare Dollars & Medical Account Resolution
Sense" initiative?
Charges, as the most appropriate measurement of Accuracy of expense and cost capture in the revenue cycle
utilization enables
Net Accounts Receivable is The amount an entity is reasonably confident of collection from overall
accounts receivables
