HFMA CRCR; Q’s & A’s
Through what document does a hospital establish compliance standards?
✔✔code of conduct
What is the purpose OIG work plant? ✔✔Identify Acceptable compliance
programs in various
provider setting
If a Medicare patient is admitted on Friday, what services fall within the three-
day DRG window
rule? ✔✔Non-diagnostic service provided on Tuesday through Friday
What does a modifier allow a provider to do? ✔✔Report a specific circumstance
that affected a
procedure or service without changing the code or its definition
IF outpatient diagnostic services are provided within three days of the admission
of a Medicare
beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what
must happen to
these charges ✔✔They must be billed separately to the part B Carrier
, HFMA CRCR; Q’s & A’s
what is a recurring or series registration? ✔✔One registration record is created
for multiple days
of service
What are nonemergency patients who come for service without prior
notification to the provider
called? ✔✔Unscheduled patients
Which of the following statement apply to the observation patient type? ✔✔It is
used to evaluate
the need for an inpatient admission
which services are hospice programs required to provide around the clock
patient ✔✔Physician,
Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what?
✔✔Complete the scheduling
process correctly based on service requeste
, HFMA CRCR; Q’s & A’s
The Time needed to prepare the patient before service is the difference between
the patients
arrival time and which of the following? ✔✔Procedure time
Medicare guidelines require that when a test is ordered for a LCD or NCD exists,
the information
provided on the order must include: ✔✔Documentation of the medical
necessity for the test
What is the advantage of a pre-registration program ✔✔It reduces processing
times at the time of
service
What date are required to establish a new MPI(Master patient Index) entry
✔✔The responsible
party's full legal name, date of birth, and social security number
Which of the following statements is true about third-party payments? ✔✔The
payments are
, HFMA CRCR; Q’s & A’s
received by the provider from the payer responsible for reimbursing the
provider for the patient's
covered services.
Which provision protects the patient from medical expenses that exceed the
pre-set level ✔✔stop
loss
what documentation must a primary care physician send to HMO patient to
authorize a visit to a
specialist for additional testing or care? ✔✔Referral
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the
provider may
not ask about a patient's insurance information if it would delay what?
✔✔Medical screening and
stabilizing treatment
Which of the following is a step in the discharge process? ✔✔Have a case
management service
Through what document does a hospital establish compliance standards?
✔✔code of conduct
What is the purpose OIG work plant? ✔✔Identify Acceptable compliance
programs in various
provider setting
If a Medicare patient is admitted on Friday, what services fall within the three-
day DRG window
rule? ✔✔Non-diagnostic service provided on Tuesday through Friday
What does a modifier allow a provider to do? ✔✔Report a specific circumstance
that affected a
procedure or service without changing the code or its definition
IF outpatient diagnostic services are provided within three days of the admission
of a Medicare
beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what
must happen to
these charges ✔✔They must be billed separately to the part B Carrier
, HFMA CRCR; Q’s & A’s
what is a recurring or series registration? ✔✔One registration record is created
for multiple days
of service
What are nonemergency patients who come for service without prior
notification to the provider
called? ✔✔Unscheduled patients
Which of the following statement apply to the observation patient type? ✔✔It is
used to evaluate
the need for an inpatient admission
which services are hospice programs required to provide around the clock
patient ✔✔Physician,
Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what?
✔✔Complete the scheduling
process correctly based on service requeste
, HFMA CRCR; Q’s & A’s
The Time needed to prepare the patient before service is the difference between
the patients
arrival time and which of the following? ✔✔Procedure time
Medicare guidelines require that when a test is ordered for a LCD or NCD exists,
the information
provided on the order must include: ✔✔Documentation of the medical
necessity for the test
What is the advantage of a pre-registration program ✔✔It reduces processing
times at the time of
service
What date are required to establish a new MPI(Master patient Index) entry
✔✔The responsible
party's full legal name, date of birth, and social security number
Which of the following statements is true about third-party payments? ✔✔The
payments are
, HFMA CRCR; Q’s & A’s
received by the provider from the payer responsible for reimbursing the
provider for the patient's
covered services.
Which provision protects the patient from medical expenses that exceed the
pre-set level ✔✔stop
loss
what documentation must a primary care physician send to HMO patient to
authorize a visit to a
specialist for additional testing or care? ✔✔Referral
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the
provider may
not ask about a patient's insurance information if it would delay what?
✔✔Medical screening and
stabilizing treatment
Which of the following is a step in the discharge process? ✔✔Have a case
management service
