CRCR CERTIFICATION COMPREHENSIVE
QUESTIONS AND SOLUTIONS
◉ Which of the following is required for participation in Medicaid
Answer: Meet Income and Assets Requirements
◉ In choosing a setting for patient financial discussions,
organizations should first and foremost
Answer: Respect the patients privacy
◉ A nightly room charge will be incorrect if the patient's
Answer: Transfer from ICU (intensive care unit) to the
Medical/Surgical
floor is not reflected in the registration system
◉ The Affordable Care Act legislated the development of Health
Insurance Exchanges, where individuals and small businesses can
Answer: Purchase qualified health benefit plans regardless of
insured's
health status
◉ A portion of the accounts receivable inventory which has NOT
qualified for billing includes:
,Answer: Charitable pledges
◉ What is required for the UB-04/837-I, used by Rural Health
Clinics to generate payment from Medicare?
Answer: Revenue codes
◉ 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
Answer: Patient bill of rights
◉ The activity which results in the accurate recording of patient
bed and level of care assessment, patient transfer and patient
discharge status on a real-time basis is known as
Answer: Case management
◉ Which statement is an EMTALA (Emergency Medical Treatment
and Active Labor Act) violation?
Answer: Registration staff may routinely contact managed are
plans for prior authorizations before the patient is seen by the on-
duty physician
◉ HIPAA had adopted Employer Identification Numbers (EIN) to
be used in standard transactions to identify the employer of an
individual described in a transaction EIN's are
assigned by
,Answer: The Internal Revenue Service
◉ Checks received through mail, cash received through mail, and
lock box are all examples of
Answer: Control points for cash posting
◉ What are some core elements if a board-approved financial
assistance policy?
Answer: Eligibility, application process, and nonpayment
collection activities
◉ A recurring/series registration is characterized by
Answer: The creation of one registration record for multiple days
of service
◉ 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
Answer: Assist patients in understanding their insurance
coverage and their financial obligation
◉ The purpose of a financial report is to:
Answer: Present financial information to decision makers
, ◉ Patient financial communications best practices produce
communications that are
Answer: Consistent, clear and transparent
◉ Medicare has established guidelines called the Local Coverage
Determinations (LCD) and National Coverage Determinations
(NCD) that establish
Answer: What services or healthcare items are covered under
Medicare
◉ Any provider that has filed a timely cost report may appeal an
adverse final decision received from the Medicare Administrative
Contractor (MAC). This appeal may be filed with
Answer: The Provider Reimbursement Review Board
◉ Concurrent review and discharge planning
Answer: Occurs during service
◉ Duplicate payments occur:
Answer: When providers re-bill claims based on nonpayment
from the initial bill submission
◉ An individual enrolled in Medicare who is dissatisfied with the
government's claim determination is entitled to reconsideration
of the decision. This type of appeal is known as
Answer: A beneficiary appeal
QUESTIONS AND SOLUTIONS
◉ Which of the following is required for participation in Medicaid
Answer: Meet Income and Assets Requirements
◉ In choosing a setting for patient financial discussions,
organizations should first and foremost
Answer: Respect the patients privacy
◉ A nightly room charge will be incorrect if the patient's
Answer: Transfer from ICU (intensive care unit) to the
Medical/Surgical
floor is not reflected in the registration system
◉ The Affordable Care Act legislated the development of Health
Insurance Exchanges, where individuals and small businesses can
Answer: Purchase qualified health benefit plans regardless of
insured's
health status
◉ A portion of the accounts receivable inventory which has NOT
qualified for billing includes:
,Answer: Charitable pledges
◉ What is required for the UB-04/837-I, used by Rural Health
Clinics to generate payment from Medicare?
Answer: Revenue codes
◉ 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
Answer: Patient bill of rights
◉ The activity which results in the accurate recording of patient
bed and level of care assessment, patient transfer and patient
discharge status on a real-time basis is known as
Answer: Case management
◉ Which statement is an EMTALA (Emergency Medical Treatment
and Active Labor Act) violation?
Answer: Registration staff may routinely contact managed are
plans for prior authorizations before the patient is seen by the on-
duty physician
◉ HIPAA had adopted Employer Identification Numbers (EIN) to
be used in standard transactions to identify the employer of an
individual described in a transaction EIN's are
assigned by
,Answer: The Internal Revenue Service
◉ Checks received through mail, cash received through mail, and
lock box are all examples of
Answer: Control points for cash posting
◉ What are some core elements if a board-approved financial
assistance policy?
Answer: Eligibility, application process, and nonpayment
collection activities
◉ A recurring/series registration is characterized by
Answer: The creation of one registration record for multiple days
of service
◉ 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
Answer: Assist patients in understanding their insurance
coverage and their financial obligation
◉ The purpose of a financial report is to:
Answer: Present financial information to decision makers
, ◉ Patient financial communications best practices produce
communications that are
Answer: Consistent, clear and transparent
◉ Medicare has established guidelines called the Local Coverage
Determinations (LCD) and National Coverage Determinations
(NCD) that establish
Answer: What services or healthcare items are covered under
Medicare
◉ Any provider that has filed a timely cost report may appeal an
adverse final decision received from the Medicare Administrative
Contractor (MAC). This appeal may be filed with
Answer: The Provider Reimbursement Review Board
◉ Concurrent review and discharge planning
Answer: Occurs during service
◉ Duplicate payments occur:
Answer: When providers re-bill claims based on nonpayment
from the initial bill submission
◉ An individual enrolled in Medicare who is dissatisfied with the
government's claim determination is entitled to reconsideration
of the decision. This type of appeal is known as
Answer: A beneficiary appeal
