HFMA CRCR COMPLETE EXAMINATION
TEST QUESTIONS WITH VERIFIED
SOLUTIONS
●● Time of service
Answer: Financial account review is completed prior to patient visit.
Patient arrives at service unit where pre-registration record is activated,
consents are signed, copayments and agreed upon amounts are collected.
Positive identification is completed, and the patient is given an armband
with acct number.
Scheduled preprocessed patients report to designated express arrival
desk located in centralized area upon arrival.
●● Unscheduled patients - Time of Service
Answer: Comprehensive registration and financial processing is
completed at time of service. Mirroring scheduled patients who is OON
with provider furnishing services during their encounter all federal and
state transparency and NSA provisions are followed to provide consent
to patient of their rights
●● Time of Service steps
Answer: Case management and discharge planning are provided.
Orders are entered.
,Results are reported.
Charges are generated.
Diagnostic and procedural coding is completed.
ONGOING:
Monitor of charges
Managed care resolution
Patient liabilities resolution, as needed.
Ensure health plan requirements and liability calculations change - vet
the changes against fed/state guidelines. Consent and updated estimates
are communicated to patient and health plan.
●● Post Service
Answer: Includes the account activities that occur after the patient is
discharged until the acct reaches zero balance, such as final coding of all
services, preparation and submission of claims, payment processing and
balance billing and resolution.
●● Best practices recognize all three critical segments of the
contemporary revenue cycle. Each segment includes a series of
processes which are specifically designed to ensure accurate data
collection, consistent quality, and a high level of patient satisfaction.
Preservice - patient is scheduled and registered for service. Patients
service costs are calculated.
Time of service - Case mgmt and discharge planing services are
provided. Consents are signed.
,Post Service - Bill sent electronically to
Answer:
●● Consumer Experience
Answer: Each segment of the revenue cycle interacts involving patients.
The key to success is establishing a clear and ever present focus on the
patient.
●● Patient Experience
Answer: Patients are demanding info and choices.
Regulations are demanding price transparency. For all known charges -
even those not employed by the provider.
Expect quality - health care and financial care.
Health plans care about quality - HCACPS stars is a measure of
satisfaction.
With poor scores - Medicare will be reduced.
●● Customer Experience
Answer: Customer service is paramount.
Empowering front line staff to provide patient focused solutions is basic
component of great patient experience.
Best practice communication strategies, scripting and training are good
tactics.
, ●● Healthcare Dollars and Sense
Answer: HFMA revenue cycle initiatives:
Patients Financial communications best practices
Best practice for price transparency
medical account resolution
●● Financial Discussions
Answer: In ED Setting - no patient financial discussions should occur
before a patient is screened and stabilized, in accordance with local
regulations governing the ed.
●● Emergency med conditions
Answer: If medical screening determines that a patient has an emergency
med condition, the financial discussion should occur during the
discharge process.
For patients who do not have emergency condition following the
medical screening, discussion may occur during registration at bedside
or discharge process.
●● Non-emergency conditions
Answer: Outside ED Setting discussions may take place during
registration or discharge process in a location that does not disrupt
patient flow.
TEST QUESTIONS WITH VERIFIED
SOLUTIONS
●● Time of service
Answer: Financial account review is completed prior to patient visit.
Patient arrives at service unit where pre-registration record is activated,
consents are signed, copayments and agreed upon amounts are collected.
Positive identification is completed, and the patient is given an armband
with acct number.
Scheduled preprocessed patients report to designated express arrival
desk located in centralized area upon arrival.
●● Unscheduled patients - Time of Service
Answer: Comprehensive registration and financial processing is
completed at time of service. Mirroring scheduled patients who is OON
with provider furnishing services during their encounter all federal and
state transparency and NSA provisions are followed to provide consent
to patient of their rights
●● Time of Service steps
Answer: Case management and discharge planning are provided.
Orders are entered.
,Results are reported.
Charges are generated.
Diagnostic and procedural coding is completed.
ONGOING:
Monitor of charges
Managed care resolution
Patient liabilities resolution, as needed.
Ensure health plan requirements and liability calculations change - vet
the changes against fed/state guidelines. Consent and updated estimates
are communicated to patient and health plan.
●● Post Service
Answer: Includes the account activities that occur after the patient is
discharged until the acct reaches zero balance, such as final coding of all
services, preparation and submission of claims, payment processing and
balance billing and resolution.
●● Best practices recognize all three critical segments of the
contemporary revenue cycle. Each segment includes a series of
processes which are specifically designed to ensure accurate data
collection, consistent quality, and a high level of patient satisfaction.
Preservice - patient is scheduled and registered for service. Patients
service costs are calculated.
Time of service - Case mgmt and discharge planing services are
provided. Consents are signed.
,Post Service - Bill sent electronically to
Answer:
●● Consumer Experience
Answer: Each segment of the revenue cycle interacts involving patients.
The key to success is establishing a clear and ever present focus on the
patient.
●● Patient Experience
Answer: Patients are demanding info and choices.
Regulations are demanding price transparency. For all known charges -
even those not employed by the provider.
Expect quality - health care and financial care.
Health plans care about quality - HCACPS stars is a measure of
satisfaction.
With poor scores - Medicare will be reduced.
●● Customer Experience
Answer: Customer service is paramount.
Empowering front line staff to provide patient focused solutions is basic
component of great patient experience.
Best practice communication strategies, scripting and training are good
tactics.
, ●● Healthcare Dollars and Sense
Answer: HFMA revenue cycle initiatives:
Patients Financial communications best practices
Best practice for price transparency
medical account resolution
●● Financial Discussions
Answer: In ED Setting - no patient financial discussions should occur
before a patient is screened and stabilized, in accordance with local
regulations governing the ed.
●● Emergency med conditions
Answer: If medical screening determines that a patient has an emergency
med condition, the financial discussion should occur during the
discharge process.
For patients who do not have emergency condition following the
medical screening, discussion may occur during registration at bedside
or discharge process.
●● Non-emergency conditions
Answer: Outside ED Setting discussions may take place during
registration or discharge process in a location that does not disrupt
patient flow.
