CRCR Exam Practice Questions and Answers (Already Graded A+) 2023

CRCR - Certified Revenue Cycle Representative CRCR Exam Practice Questions and Answers (Already Graded A+) 2023. What is a principal diagnosis? - ANSWER-Primary reason for the patient's admission Collecting patient liability dollars after service leads to what? - ANSWER-Lower accounts receivable levels What is the daily out-of-pocket amount for each lifetime reserve day used? - ANSWER50% of the current deductible amount What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not billable as an RHC services? - ANSWER-Inpatient care What code indicates the disposition of the patient at the conclusion of service? - ANSWER-Patient discharge status code What are hospitals required to do for Medicare credit balance accounts? - ANSWERThey result in lost reimbursement and additional cost to collect When an undue delay of payment results from a dispute between the patient and the third party payer, who is responsible for payment? - ANSWER-Patient Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information provided on the order must include: - ANSWER-A valid CPT or HCPCS code With advances in internet security and encryption, revenue-cycle processes are expanding to allow patients to do what? - ANSWER-Access their information and perform functions on-line What date is required on all CMS 1500 claim forms? - ANSWER-onset date of current illness What does scheduling allow provider staff to do - ANSWER-Review appropriateness of the service request What code is used to report the provider's most common semiprivate room rate? - ANSWER-Condition code Regulations and requirements for coding accountable care organizations, which allows providers to begin creating these organizations, were finalized in: - ANSWER-2012 What is a primary responsibility of the Recover Audit Contractor? - ANSWER-To correctly identify proper payments for Medicare Part A & B claims How must providers handle credit balances? - ANSWER-Comply with state statutes concerning reporting credit balance Insurance verification results in what? - ANSWER-The accurate identification of the patient's eligibility and benefits What form is used to bill Medicare for rural health clinics? - ANSWER-CMS 1500 What activities are completed when a scheduled pre-registered patient arrives for service? - ANSWER-Registering the patient and directing the patient to the service area In addition to being supported by information found in the patient's chart, a CMS 1500 claim must be coded using what? - ANSWER-HCPCS (Healthcare Common Procedure Coding system) What results from a denied claim? - ANSWER-The provider incurs rework and appeal costs Why does the financial counselor need pricing for services? - ANSWER-To calculate the patient's financial responsibility What type of provider bills third-party payers using CMS 1500 form - ANSWERHospital-based mammography centers How are disputes with nongovernmental payers resolved? - ANSWER-Appeal conditions specified in the individual payer's contract The important message from Medicare provides beneficiaries with information concerning what? - ANSWER-Right to appeal a discharge decision if the patient disagrees with the services Why do managed care plans have agreements with hospitals, physicians, and other healthcare providers to offer a range of services to plan members? - ANSWER-To improve access to quality healthcare If a patient remains an inpatient of an SNF (skilled nursing facility for more than 30 days, what is the SNF permitted to do? - ANSWER-Submit interim bills to the Medicare program. 90. MSP (Medicare Secondary Payer) rules allow providers to bill Medicare for liability claims after what happens? - ANSWER-120 days passes, but the claim then be withdrawn from the liability carrier