CRCR CERTIFICATION QUESTIONS
WITH COMPLETE SOLUTION
Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by -
The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid - Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost - Respect
the patients privacy
A nightly room charge will be incorrect if the patient's - Transfer from ICU (intensive care unit) to the
Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals
and small businesses can - Purchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes: - Charitable
pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare? -
Revenue codes
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 - Patient bill of rights
The activity which results in the accurate recording of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time basis is known as - Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? -
Registration staff may routinely contact managed are plans for prior authorizations before the patient is
seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to identify
the employer of an individual described in a transaction EIN's are
assigned by - The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all examples of - Control
points for cash posting
What are some core elements if a board-approved financial assistance policy? - Eligibility, application
process, and nonpayment collection activities
, A recurring/series registration is characterized by - The creation of one registration record for multiple
days of service
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of
Medicaid in some states, it is more important than ever for hospitals to - Assist patients in understanding
their insurance coverage and their financial obligation
The purpose of a financial report is to: - Present financial information to decision makers
Patient financial communications best practices produce communications that are - Consistent, clear and
transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD) and National
Coverage Determinations (NCD) that establish - What services or healthcare items are covered under
Medicare
Any provider that has filed a timely cost report may appeal an adverse final decision received from the
Medicare Administrative Contractor (MAC). This appeal may be filed with - The Provider Reimbursement
Review Board
Concurrent review and discharge planning - Occurs during service
Duplicate payments occur: - When providers re-bill claims based on nonpayment from the initial bill
submission
An individual enrolled in Medicare who is dissatisfied with the government's claim determination is
entitled to reconsideration of the decision. This type of appeal is known as - A beneficiary appeal
Insurance verification results in which of the following - The accurate identification of the patient's
eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the
following levels EXCEPT: - Judicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask
about a patient's insurance information if it would delay what? - Medical screening and stabilizing
treatment
Ambulance services are billed directly to the health plan for - Services provided before a patient is
admitted and for ambulance rides arranged to pick up the patient from the hospital after discharge to
take him/her home or to another facility
Key performance indicators (KPIs) set standards for accounts receivables (A/R) and - Provide a method of
measuring the collection and control of A/R
he patient discharge process begins when - The physician writes the discharge orders
The nightly room charge will be incorrect if the patient's - Transfer from ICU to the Medical/Surgical floor
is not reflected in the registration system.
WITH COMPLETE SOLUTION
Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by -
The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid - Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost - Respect
the patients privacy
A nightly room charge will be incorrect if the patient's - Transfer from ICU (intensive care unit) to the
Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals
and small businesses can - Purchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes: - Charitable
pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare? -
Revenue codes
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 - Patient bill of rights
The activity which results in the accurate recording of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time basis is known as - Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? -
Registration staff may routinely contact managed are plans for prior authorizations before the patient is
seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to identify
the employer of an individual described in a transaction EIN's are
assigned by - The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all examples of - Control
points for cash posting
What are some core elements if a board-approved financial assistance policy? - Eligibility, application
process, and nonpayment collection activities
, A recurring/series registration is characterized by - The creation of one registration record for multiple
days of service
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of
Medicaid in some states, it is more important than ever for hospitals to - Assist patients in understanding
their insurance coverage and their financial obligation
The purpose of a financial report is to: - Present financial information to decision makers
Patient financial communications best practices produce communications that are - Consistent, clear and
transparent
Medicare has established guidelines called the Local Coverage Determinations (LCD) and National
Coverage Determinations (NCD) that establish - What services or healthcare items are covered under
Medicare
Any provider that has filed a timely cost report may appeal an adverse final decision received from the
Medicare Administrative Contractor (MAC). This appeal may be filed with - The Provider Reimbursement
Review Board
Concurrent review and discharge planning - Occurs during service
Duplicate payments occur: - When providers re-bill claims based on nonpayment from the initial bill
submission
An individual enrolled in Medicare who is dissatisfied with the government's claim determination is
entitled to reconsideration of the decision. This type of appeal is known as - A beneficiary appeal
Insurance verification results in which of the following - The accurate identification of the patient's
eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the
following levels EXCEPT: - Judicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask
about a patient's insurance information if it would delay what? - Medical screening and stabilizing
treatment
Ambulance services are billed directly to the health plan for - Services provided before a patient is
admitted and for ambulance rides arranged to pick up the patient from the hospital after discharge to
take him/her home or to another facility
Key performance indicators (KPIs) set standards for accounts receivables (A/R) and - Provide a method of
measuring the collection and control of A/R
he patient discharge process begins when - The physician writes the discharge orders
The nightly room charge will be incorrect if the patient's - Transfer from ICU to the Medical/Surgical floor
is not reflected in the registration system.
