CRCR Questions and Answers
Which of the following statements are true of HFMA's Patient Financial Communications
Best Practices? - ANS-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: - ANS-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: - ANS-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? - ANS-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: - ANS-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? - ANS-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? - ANS-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)? - ANS-Elapsed days
from discharge to final bill and elapsed days from final bill to claim/bill submission
What happens during the post-service stage? - ANS-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. - ANS-educate patients, coordinate to avoid duplicate
patient contacts, be consistent in key aspects of account resolution, follow best
practices for communication
Which option is NOT a main HFMA Healthcare Dollars & Sense revenue cycle
initiative? - ANS-Process Compliance
What is the objective of the HCAHPS initiative? - ANS-To provide a standardized
method for evaluating patient's perspective on hospital care
Which option is NOT a department that supports and collaborates with the revenue
cycle? - ANS-Assisted Living Services
Which option is NOT a continuum of care provider? - ANS-Health Plan Contracting
Which of the following are essential elements of an effective compliance program? -
ANS-established compliance standards and procedures, oversight of personnel by
high-level personnel, reasonable methods to achieve compliance with standards,
including monitoring systems and hotlines
Annually, the OIG publishes a work plan of compliance issues and objects that will be
focused on the throughout the following year. Identify which option is NOT a work plan
task mentioned in this course. - ANS-Standard Unique Employer Identifier
In order to promote the use of correct coding methods on a national basis and prevent
payment errors due to improper coding, CMS developed what? - ANS-The Correct
Coding Initiative(CCI)
What do business/organizational ethics represent? - ANS-Principles and standards by
which organizations operate
What is the intended outcome of collaborations made through an ACO delivery system?
- ANS-To ensure appropriateness of care, elimination of duplicate services, and
prevention of medical errors for a population of patients
Which of these statements describes the new methodology for the determinations of net
patient service revenue? - ANS-Net patient service revenue is defined a the total
Which of the following statements are true of HFMA's Patient Financial Communications
Best Practices? - ANS-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: - ANS-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: - ANS-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? - ANS-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: - ANS-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? - ANS-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? - ANS-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)? - ANS-Elapsed days
from discharge to final bill and elapsed days from final bill to claim/bill submission
What happens during the post-service stage? - ANS-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. - ANS-educate patients, coordinate to avoid duplicate
patient contacts, be consistent in key aspects of account resolution, follow best
practices for communication
Which option is NOT a main HFMA Healthcare Dollars & Sense revenue cycle
initiative? - ANS-Process Compliance
What is the objective of the HCAHPS initiative? - ANS-To provide a standardized
method for evaluating patient's perspective on hospital care
Which option is NOT a department that supports and collaborates with the revenue
cycle? - ANS-Assisted Living Services
Which option is NOT a continuum of care provider? - ANS-Health Plan Contracting
Which of the following are essential elements of an effective compliance program? -
ANS-established compliance standards and procedures, oversight of personnel by
high-level personnel, reasonable methods to achieve compliance with standards,
including monitoring systems and hotlines
Annually, the OIG publishes a work plan of compliance issues and objects that will be
focused on the throughout the following year. Identify which option is NOT a work plan
task mentioned in this course. - ANS-Standard Unique Employer Identifier
In order to promote the use of correct coding methods on a national basis and prevent
payment errors due to improper coding, CMS developed what? - ANS-The Correct
Coding Initiative(CCI)
What do business/organizational ethics represent? - ANS-Principles and standards by
which organizations operate
What is the intended outcome of collaborations made through an ACO delivery system?
- ANS-To ensure appropriateness of care, elimination of duplicate services, and
prevention of medical errors for a population of patients
Which of these statements describes the new methodology for the determinations of net
patient service revenue? - ANS-Net patient service revenue is defined a the total
