HFMA CRCR ACTUAL TEST PAPER WITH
VERIFIED ANSWERS
●● What are other names for Three-Day Payment Window?
Answer: ALL OF THE ABOVE
72-hour rule, DRG window, Three-Day Window, 1 day window or 24-
hour rule
●● What happens during the post-service stage?
Answer: Final coding, preparation and submission of claims, payment
processing, balance billing and resolution.
●● What are the below tasks part of?
- Educate patients
- Coordinate to avoid duplicate patient contacts
- Be consistent in key aspects of account resolution
- Follow best practices for communication
Answer: Best practices created by the Medical Debt Task Force
●● Which option is NOT a main HFMA Healthcare Dollars & Sense®
revenue cycle initiative?
,Answer: Process Compliance
●● Which option is NOT a continuum of care provider?
A. Physician
B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
Answer: B. Health Plan Contracting
●● What is "implied certification"?
Answer: When it is implied that a provider met all compliance standards
before submitting a claim
●● Which of the following are essential elements of an effective
compliance program?
A. Established compliance standards and procedures.
B. Designation of a compliance officer employed within the Billing
Department.
C. Oversight of personnel by high-level personnel.
D. Automatic dismissal of any employee excluded from participation in
a federal healthcare program.
,E. Reasonable methods to achieve compliance with standards, including
monitoring systems and hotlines.
Answer: A. Established compliance standards and procedures.
C. Oversight of personnel by high-level personnel.
E. Reasonable methods to achieve compliance with standards, including
monitoring systems and hotlines.
●● When was Health Information Technology for Economic and
Clinical Health (HITECH) Act signed into law?
Answer: FEB 17, 2009
●● When did HITECH Act become effective?
Answer: 2013
●● Annually, the OIG publishes a work plan of compliance issues and
objectives that will be focused on throughout the following year. Identify
which option is NOT a work plan task mentioned in this course.
A. Payments to Physicians for Co-Surgery Procedures
B. Denials and Appeals in Medicare Part D
C. Medicare Hospital Payments for Claims Involving the Acute- and
Post-Acute-Care Transfer Policies
, D. Standard Unique Employer Identifier
Answer: D. Standard Unique Employer Identifier
●● What Plan are the tasks below a part of?
- Medicare Payments Made Outside of the Hospice Benefit
- Denials and Appeals in Medicare Part C and Part D
- Medicare Part B Payments for End-Stage Renal Disease Dialysis
Services
- Review of Home Health Claims for Services With 5 to 10 Skilled
Visits
Answer: The 2020 OIG Work Plan
●● When was the Preservation of Access to Care for Medicare
Beneficiaries and Pension Relief Act signed into law?
Answer: JUNE 25 2010
●● What is the Medicare DRG Three-Day Payment Window?
Answer: All Diagnostic services provided to a Medicare patient by a
hospital on the Date of the patient's Inpatient admission or during the 3
calendar days (or in the case of a non-IPPS hospital: 1 calendar day)
immediately BEFORE the Date of Admission are REQUIRED to be
included on the bill for the IP stay (unless there is no Part A coverage)
VERIFIED ANSWERS
●● What are other names for Three-Day Payment Window?
Answer: ALL OF THE ABOVE
72-hour rule, DRG window, Three-Day Window, 1 day window or 24-
hour rule
●● What happens during the post-service stage?
Answer: Final coding, preparation and submission of claims, payment
processing, balance billing and resolution.
●● What are the below tasks part of?
- Educate patients
- Coordinate to avoid duplicate patient contacts
- Be consistent in key aspects of account resolution
- Follow best practices for communication
Answer: Best practices created by the Medical Debt Task Force
●● Which option is NOT a main HFMA Healthcare Dollars & Sense®
revenue cycle initiative?
,Answer: Process Compliance
●● Which option is NOT a continuum of care provider?
A. Physician
B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
Answer: B. Health Plan Contracting
●● What is "implied certification"?
Answer: When it is implied that a provider met all compliance standards
before submitting a claim
●● Which of the following are essential elements of an effective
compliance program?
A. Established compliance standards and procedures.
B. Designation of a compliance officer employed within the Billing
Department.
C. Oversight of personnel by high-level personnel.
D. Automatic dismissal of any employee excluded from participation in
a federal healthcare program.
,E. Reasonable methods to achieve compliance with standards, including
monitoring systems and hotlines.
Answer: A. Established compliance standards and procedures.
C. Oversight of personnel by high-level personnel.
E. Reasonable methods to achieve compliance with standards, including
monitoring systems and hotlines.
●● When was Health Information Technology for Economic and
Clinical Health (HITECH) Act signed into law?
Answer: FEB 17, 2009
●● When did HITECH Act become effective?
Answer: 2013
●● Annually, the OIG publishes a work plan of compliance issues and
objectives that will be focused on throughout the following year. Identify
which option is NOT a work plan task mentioned in this course.
A. Payments to Physicians for Co-Surgery Procedures
B. Denials and Appeals in Medicare Part D
C. Medicare Hospital Payments for Claims Involving the Acute- and
Post-Acute-Care Transfer Policies
, D. Standard Unique Employer Identifier
Answer: D. Standard Unique Employer Identifier
●● What Plan are the tasks below a part of?
- Medicare Payments Made Outside of the Hospice Benefit
- Denials and Appeals in Medicare Part C and Part D
- Medicare Part B Payments for End-Stage Renal Disease Dialysis
Services
- Review of Home Health Claims for Services With 5 to 10 Skilled
Visits
Answer: The 2020 OIG Work Plan
●● When was the Preservation of Access to Care for Medicare
Beneficiaries and Pension Relief Act signed into law?
Answer: JUNE 25 2010
●● What is the Medicare DRG Three-Day Payment Window?
Answer: All Diagnostic services provided to a Medicare patient by a
hospital on the Date of the patient's Inpatient admission or during the 3
calendar days (or in the case of a non-IPPS hospital: 1 calendar day)
immediately BEFORE the Date of Admission are REQUIRED to be
included on the bill for the IP stay (unless there is no Part A coverage)
