HFMA CRCR LATEST UPDATED FINAL EXAM
2024 WITH DETAILED QUESTIONS AND
CORRECT ANSWERS ALREADY A+ GRADED
Through what document does a hospital establish
compliance standards? - ANSWER-code of conduct
What is the purpose OIG work plant? - ANSWER-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? - ANSWER-
Non-diagnostic service provided on Tuesday through
Friday
What does a modifier allow a provider to do? - ANSWER-
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 - ANSWER-They
must be billed separately to the part B Carrier
what is a recurring or series registration? - ANSWER-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? -
ANSWER-Unscheduled patients
Which of the following statement apply to the
observation patient type? - ANSWER-It is used to
evaluate the need for an inpatient admission
which services are hospice programs required to provide
around the clock patient - ANSWER-Physician, Nursing,
Pharmacy
,Scheduler instructions are used to prompt the scheduler
to do what? - ANSWER-Complete the scheduling process
correctly based on service request
The Time needed to prepare the patient before service is
the difference between the patients arrival time and
which of the following? - ANSWER-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: - ANSWER-Documentation of the
medical necessity for the test
What is the advantage of a pre-registration program -
ANSWER-It reduces processing times at the time of
service
What date are required to establish a new MPI(Master
patient Index) entry - ANSWER-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? - ANSWER-The payments are 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 - ANSWER-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? - ANSWER-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? -
ANSWER-Medical screening and stabilizing treatment
Which of the following is a step in the discharge process?
- ANSWER-Have a case management service complete
the discharge plan
2024 WITH DETAILED QUESTIONS AND
CORRECT ANSWERS ALREADY A+ GRADED
Through what document does a hospital establish
compliance standards? - ANSWER-code of conduct
What is the purpose OIG work plant? - ANSWER-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? - ANSWER-
Non-diagnostic service provided on Tuesday through
Friday
What does a modifier allow a provider to do? - ANSWER-
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 - ANSWER-They
must be billed separately to the part B Carrier
what is a recurring or series registration? - ANSWER-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? -
ANSWER-Unscheduled patients
Which of the following statement apply to the
observation patient type? - ANSWER-It is used to
evaluate the need for an inpatient admission
which services are hospice programs required to provide
around the clock patient - ANSWER-Physician, Nursing,
Pharmacy
,Scheduler instructions are used to prompt the scheduler
to do what? - ANSWER-Complete the scheduling process
correctly based on service request
The Time needed to prepare the patient before service is
the difference between the patients arrival time and
which of the following? - ANSWER-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: - ANSWER-Documentation of the
medical necessity for the test
What is the advantage of a pre-registration program -
ANSWER-It reduces processing times at the time of
service
What date are required to establish a new MPI(Master
patient Index) entry - ANSWER-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? - ANSWER-The payments are 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 - ANSWER-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? - ANSWER-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? -
ANSWER-Medical screening and stabilizing treatment
Which of the following is a step in the discharge process?
- ANSWER-Have a case management service complete
the discharge plan
