CRCR Certification UPDATED ACTUAL QUESTIONS
WITH CORRECT ANSWERS
Question 1.
Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by
ANSWER
The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Question 2.
Which of the following is required for participation in Medicaid
ANSWER
Meet Income and Assets Requirements
Question 3.
In choosing a setting for patient financial discussions, organizations should first and foremost
ANSWER
Respect the patients privacy
Question 4.
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
Question 5.
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
,Question 6.
A portion of the accounts receivable inventory which has NOT qualified for billing includes:
ANSWER
Charitable pledges
Question 7.
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare?
ANSWER
Revenue codes
Question 8.
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
Question 9.
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
Question 10.
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
,Question 11.
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
Question 12.
Checks received through mail, cash received through mail, and lock box are all examples of
ANSWER
Control points for cash posting
Question 13.
What are some core elements if a board-approved financial assistance policy?
ANSWER
Eligibility, application process, and nonpayment collection activities
Question 14.
A recurring/series registration is characterized by
ANSWER
The creation of one registration record for multiple days of service
Question 15.
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
Question 16.
The purpose of a financial report is to:
ANSWER
Present financial information to decision makers
, Question 17.
Patient financial communications best practices produce communications that are
ANSWER
Consistent, clear and transparent
Question 18.
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
Question 19.
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
Question 20.
Concurrent review and discharge planning
ANSWER
Occurs during service
Question 21.
Duplicate payments occur:
ANSWER
When providers re-bill claims based on nonpayment from the initial bill submission
Question 22.
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
WITH CORRECT ANSWERS
Question 1.
Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by
ANSWER
The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Question 2.
Which of the following is required for participation in Medicaid
ANSWER
Meet Income and Assets Requirements
Question 3.
In choosing a setting for patient financial discussions, organizations should first and foremost
ANSWER
Respect the patients privacy
Question 4.
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
Question 5.
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
,Question 6.
A portion of the accounts receivable inventory which has NOT qualified for billing includes:
ANSWER
Charitable pledges
Question 7.
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare?
ANSWER
Revenue codes
Question 8.
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
Question 9.
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
Question 10.
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
,Question 11.
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
Question 12.
Checks received through mail, cash received through mail, and lock box are all examples of
ANSWER
Control points for cash posting
Question 13.
What are some core elements if a board-approved financial assistance policy?
ANSWER
Eligibility, application process, and nonpayment collection activities
Question 14.
A recurring/series registration is characterized by
ANSWER
The creation of one registration record for multiple days of service
Question 15.
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
Question 16.
The purpose of a financial report is to:
ANSWER
Present financial information to decision makers
, Question 17.
Patient financial communications best practices produce communications that are
ANSWER
Consistent, clear and transparent
Question 18.
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
Question 19.
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
Question 20.
Concurrent review and discharge planning
ANSWER
Occurs during service
Question 21.
Duplicate payments occur:
ANSWER
When providers re-bill claims based on nonpayment from the initial bill submission
Question 22.
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
