Certified Revenue Cycle Representative
- CRCR (2024)
Which of the following statements are true of HFMA's Financial Communications Best Practices
- ANSThe 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: - ANSThe average number of
positive mentions received by the health system or practice and the public comments refuting
unfriendly posts on social media sites.
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: - ANSAll
of the above
Specific to Medicare fee-for-service patients, which of the following payers have always been
liable for payment? - ANSPublic health service programs, Federal grant programs, veteran
affairs programs, black lung program services and work-related injuries and accidents (worker'
compensation claims)
Provider policies and procedures should be in place to reduce the risk of ethics violations.
Examples of ethics violations include: - ANSAll of the above
Providers are now being reimbursed with a focus on the value of the services provided, rather
than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery system for a
population of patients? - ANSTo eliminate duplicate services, prevent medical errors and ensure
appropriateness of care.
Historically, revenue cycle has delt with contractual adjustments, bad debt and charity
deductions from gross revenue. Although deductions continue to exist, the definition of net
revenue has been modified through the implementation of ASC 606. Developed by the Financial
Accounting Standards Board (FASB), this change became effective in 2018.
What is the new terminology now employed in the calculation of net patient services revenues?
- ANSExplicit prices concessions and implicit price concessions
, Key performance indicators set standards for A/R and provide a method for measuring the
control and collection of A/R.
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)? - ANSElapsed days from discharge to final
bill and elapsed days from final bill to claim/bill submission.
Consents are signed as part of the post-services process. - ANSTrue
**False
Patient service costs are calculated in the pre-service process for schedule patients -
ANS**True
False
The patient is scheduled and registered for service is a time-of-service activity - ANSTrue
**False
The patient account is monitored for payment is a time-of-service activity - ANSTrue
**False
Case management and discharge planning services are a post-service activty - ANSTrue
**False
Sending the bill electronically to the health plan is a time-of-service activity - ANSTrue
**False
What happens during the post-service stage? - ANS**A. Final coding of all services, preparation
and submission of claims, payment processing and balance billing and resolution.
B. Orders are entered, results are reported, charges are generated, and diagnostic and
procedural coding is initiated.
C. The encounter record is generated, and the patient and guarantor information is obtained
and/or updated as required.
D. The focus is on the patient and his/her financial care, in addition to the clinical care provided
for the patient.
The following statements describe best practices established by the Medical Debt Task Force.
Check the box next to the True statements - ANS**Educate Patients
**Coordinate to avoid duplicate patient contacts
Exercise moderate judgement when communicating with providers about scheduled services
**Be consistent in key aspects of account resolution
- CRCR (2024)
Which of the following statements are true of HFMA's Financial Communications Best Practices
- ANSThe 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: - ANSThe average number of
positive mentions received by the health system or practice and the public comments refuting
unfriendly posts on social media sites.
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: - ANSAll
of the above
Specific to Medicare fee-for-service patients, which of the following payers have always been
liable for payment? - ANSPublic health service programs, Federal grant programs, veteran
affairs programs, black lung program services and work-related injuries and accidents (worker'
compensation claims)
Provider policies and procedures should be in place to reduce the risk of ethics violations.
Examples of ethics violations include: - ANSAll of the above
Providers are now being reimbursed with a focus on the value of the services provided, rather
than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery system for a
population of patients? - ANSTo eliminate duplicate services, prevent medical errors and ensure
appropriateness of care.
Historically, revenue cycle has delt with contractual adjustments, bad debt and charity
deductions from gross revenue. Although deductions continue to exist, the definition of net
revenue has been modified through the implementation of ASC 606. Developed by the Financial
Accounting Standards Board (FASB), this change became effective in 2018.
What is the new terminology now employed in the calculation of net patient services revenues?
- ANSExplicit prices concessions and implicit price concessions
, Key performance indicators set standards for A/R and provide a method for measuring the
control and collection of A/R.
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)? - ANSElapsed days from discharge to final
bill and elapsed days from final bill to claim/bill submission.
Consents are signed as part of the post-services process. - ANSTrue
**False
Patient service costs are calculated in the pre-service process for schedule patients -
ANS**True
False
The patient is scheduled and registered for service is a time-of-service activity - ANSTrue
**False
The patient account is monitored for payment is a time-of-service activity - ANSTrue
**False
Case management and discharge planning services are a post-service activty - ANSTrue
**False
Sending the bill electronically to the health plan is a time-of-service activity - ANSTrue
**False
What happens during the post-service stage? - ANS**A. Final coding of all services, preparation
and submission of claims, payment processing and balance billing and resolution.
B. Orders are entered, results are reported, charges are generated, and diagnostic and
procedural coding is initiated.
C. The encounter record is generated, and the patient and guarantor information is obtained
and/or updated as required.
D. The focus is on the patient and his/her financial care, in addition to the clinical care provided
for the patient.
The following statements describe best practices established by the Medical Debt Task Force.
Check the box next to the True statements - ANS**Educate Patients
**Coordinate to avoid duplicate patient contacts
Exercise moderate judgement when communicating with providers about scheduled services
**Be consistent in key aspects of account resolution
