CRCR EXAM QUESTIONS AND ANSWERS

Which of the following statements are true of HFMA's Patient Financial Communications Best Practices? - Answer- The best practices were developed specifically to help patients understand the cost of services, their individual insurance benefits, and their responsibility for balances after insurance, if any. The patient experience includes all of the following except: - Answer- Recognition that revenue cycle processes must be patient-centric and efficient. This is especially true in the areas of scheduling, registration, admitting, financial counseling and account resolution conversation with patients. Corporate compliance programs play an important role in protecting the integrity of operations and ensuring compliance with federal and state requirements. The code of conduct is: - Answer- A critical tool to ensure compliance, essential and integral component, fosters an environment, (all of the above) Specific to Medicare free-for-service patients, which of the following payers have always been liable for payment? - Answer- Black lung service programs, veteran affairs program, working aged programs, ESRD, and disability Provider policies and procedures should be in place to reduce the risk of ethics violations. Examples include: - Answer- financial misconduct, theft of property, applying policies in inconsistent manner (all of the above) What is the intended outcome of collaborations made through an ACO delivery system for a population of patients? - Answer- To eliminate duplicate services, prevent medical errors and ensure appropriateness of care What is the new terminology now employed in the calculation of net patient service revenues? - Answer- explicit price concessions and implicit price concessions What are the two KPIs used to monitor performance related to the production and submission of claims to third party payers and patients (self-pay)? - Answer- Elapsed days from discharge to final bill and elapsed days from final bill to claim/bill submission What happens during the post-service stage? - Answer- Final coding of all services, preparation and submission of claims, payment processing and balance billing and resolution. The following statements describe best practices established by the Medicaid Debt Task Force. Select true statements. - Answer- educate patients, coordinate to avoid duplicate patient contacts, be consistent in key aspects of account resolution, follow best practices for communication Whi