CRCR UPDATED ACTUAL EXAM QUESTIONS AND
CORRECT ANSWERS
Question 1.
Health care plan coverage allowed to cover patients for emergency situation outside of the prescribed
geographic area of the HMO
ANSWER
Preadmission review
Question 2.
The HCAHPS (Hospital consumer assessment of healthcare providers and systems) initiative was
launched to
ANSWER
Provide a standardize method for evaluating patients perspective on hospital care
Question 3.
If the insurance verification response reports that a subscriber has a single policy what is the status of
the scribers spouse
ANSWER
Neither enrolled not entitled to benefits
Question 4.
TeleMed seeks to improve a patient's health by
ANSWER
Permitting to buy real time interactive communication between the patient and the clinical
professional
Question 5.
Case management requires that a case manager be assigned
ANSWER
To a select patient group
,Question 6.
At the end of each shift what must happen to cash checks and credit card transaction documents
ANSWER
They must be balanced
Question 7.
In Chapter 7 straight bankruptcy filling
a) The court establishes a creditor payment schedule with the longest outstanding claims
paid first
b) The court liquidates the debtor's nonexempt property, pays creditors,
and discharges the debtor from the debt
c) The court vacates all claims against a debtor with the understanding that the debtor
may not apply for credit without court supervision
d) The court liquidates the debtor's nonexempt property, pays creditors, and begins to
pay off the largest claims first. All claims are paid some portions of the amount owed.
ANSWER
The court liquidates debtors non-exempt property pays creditors and discharges debtors from
the debt
Question 8.
When is it not appropriate to use observation status
ANSWER
As a substitute for an inpatient admission
Question 9.
Health insurance plan reimbursement method that limits payments to the lower bill charges the
provider customary charge or the prevailing charge for the service in the community
ANSWER
Utilization review
Question 10.
Comprehensive compliance program is defined as
ANSWER
Systematic procedures to ensure that the provisions of regulations imposed by government
agencies are being met
,Question 11.
What type of patient status is used to evaluate the patients need for inpatient care
ANSWER
Observation
Question 12.
The ACO investment model will test the use of pre-paid shared savings to
a) Raise quality ratings in designated hospitals.
b) Encourage new ACOs to form in rural and underserved areas
c) Attract physicians to participate in the ACO payment system
d) Invest in treatment protocols that reduce costs to Medicare
ANSWER
Encouraging new ACO To form in rural and underserved areas
Question 13.
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
a) Payer quality monitoring
b) Medicare patient and staff safety standards
c) Joint Commission for Accreditation of Healthcare Organizations
(JCAHO) safety
d) Patient bill of rights
ANSWER
Patient bill of rights
Question 14.
Portion of the accounts receivable inventory which had not qualified for billing includes
ANSWER
Charity pledges
Question 15.
What is the initial hospice benefit
ANSWER
Two 90-day periods and an unlimited number of subsequent periods
, Question 16.
In a self insured plan the cost of Medical care are
ANSWER
Born by the employer on a pay as you go basis
Question 17.
The soft cost of a Dissatisfied customer is
ANSWER
The customer passing on info about the negative experience to potential patients or through
social media channels
Question 18.
Business ethics or organizational ethic presents
ANSWER
The principles and standards by which organizations operate
Question 19.
Claim is denied for the following reasons except
ANSWER
The submitted claim does not have the physician signature
Question 20.
Which of the following is not contained in a collection agency agreement
ANSWER
A mutual hold harmless clause
CORRECT ANSWERS
Question 1.
Health care plan coverage allowed to cover patients for emergency situation outside of the prescribed
geographic area of the HMO
ANSWER
Preadmission review
Question 2.
The HCAHPS (Hospital consumer assessment of healthcare providers and systems) initiative was
launched to
ANSWER
Provide a standardize method for evaluating patients perspective on hospital care
Question 3.
If the insurance verification response reports that a subscriber has a single policy what is the status of
the scribers spouse
ANSWER
Neither enrolled not entitled to benefits
Question 4.
TeleMed seeks to improve a patient's health by
ANSWER
Permitting to buy real time interactive communication between the patient and the clinical
professional
Question 5.
Case management requires that a case manager be assigned
ANSWER
To a select patient group
,Question 6.
At the end of each shift what must happen to cash checks and credit card transaction documents
ANSWER
They must be balanced
Question 7.
In Chapter 7 straight bankruptcy filling
a) The court establishes a creditor payment schedule with the longest outstanding claims
paid first
b) The court liquidates the debtor's nonexempt property, pays creditors,
and discharges the debtor from the debt
c) The court vacates all claims against a debtor with the understanding that the debtor
may not apply for credit without court supervision
d) The court liquidates the debtor's nonexempt property, pays creditors, and begins to
pay off the largest claims first. All claims are paid some portions of the amount owed.
ANSWER
The court liquidates debtors non-exempt property pays creditors and discharges debtors from
the debt
Question 8.
When is it not appropriate to use observation status
ANSWER
As a substitute for an inpatient admission
Question 9.
Health insurance plan reimbursement method that limits payments to the lower bill charges the
provider customary charge or the prevailing charge for the service in the community
ANSWER
Utilization review
Question 10.
Comprehensive compliance program is defined as
ANSWER
Systematic procedures to ensure that the provisions of regulations imposed by government
agencies are being met
,Question 11.
What type of patient status is used to evaluate the patients need for inpatient care
ANSWER
Observation
Question 12.
The ACO investment model will test the use of pre-paid shared savings to
a) Raise quality ratings in designated hospitals.
b) Encourage new ACOs to form in rural and underserved areas
c) Attract physicians to participate in the ACO payment system
d) Invest in treatment protocols that reduce costs to Medicare
ANSWER
Encouraging new ACO To form in rural and underserved areas
Question 13.
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
a) Payer quality monitoring
b) Medicare patient and staff safety standards
c) Joint Commission for Accreditation of Healthcare Organizations
(JCAHO) safety
d) Patient bill of rights
ANSWER
Patient bill of rights
Question 14.
Portion of the accounts receivable inventory which had not qualified for billing includes
ANSWER
Charity pledges
Question 15.
What is the initial hospice benefit
ANSWER
Two 90-day periods and an unlimited number of subsequent periods
, Question 16.
In a self insured plan the cost of Medical care are
ANSWER
Born by the employer on a pay as you go basis
Question 17.
The soft cost of a Dissatisfied customer is
ANSWER
The customer passing on info about the negative experience to potential patients or through
social media channels
Question 18.
Business ethics or organizational ethic presents
ANSWER
The principles and standards by which organizations operate
Question 19.
Claim is denied for the following reasons except
ANSWER
The submitted claim does not have the physician signature
Question 20.
Which of the following is not contained in a collection agency agreement
ANSWER
A mutual hold harmless clause
