HFMA - CERTIFIED REVENUE CYCLE
REPRESENTATIVE PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
According to best prac�ces, when should you make a reasonable atempt to have a financial discussion
with a pa�ent? - ansBefore a financial obliga�on is incurred (before care is provided).
Also, providers should:
A. have both elec�ve and non-elec�ve procedures clearly defined for the public
B. only elec�ve procedures clearly defined, and non-elec�ve are mandatory
C. only non-elec�ve, as they are mandatory. - ansA.
Balance Resolu�on: how should you discuss prior balances for resolu�on? - ansI may discuss prior
balances that are currently being pursued for collec�on by the provider, a collec�on agency, or other
organiza�ons. I may also write a list of the prior services delivered, dates of service, and the resul�ng
prior balance.
Compliance Framework 1/5: What is the Execu�ve Level Metrics Repor�ng? - ansReports of
organiza�onal performance evalua�ons should be developed, compiled into an overall compliance
report and presented to the organiza�on's execu�ve leadership team on an annual basis.
Compliance Framework 1/5: What is the Feedback and Response? - ansThis evalua�on is designed to
ensure that processes are in place to regularly solicit input and receive key stakeholders'' feedback,
measure and respond to input and feedback, and ensure that pa�ent complaints are resolved.
Compliance Framework 1/5: What is the Technology segment? - ansThe compliance framework ensures
that technology is in place to support verifica�on of insurance eligibility for current services, verifica�on
of exis�ng prior balance for current services, and es�mated cost of the current services and the pa�ent
responsibility por�on.
Compliance Framework 1/5: What's Process Observa�on? - ansAnnual observa�on, monitoring, and
tracking of results make up the process of compliance evalua�on required to document compliance with
, HFMA - CERTIFIED REVENUE CYCLE
REPRESENTATIVE PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
the best prac�ces. The evalua�on should be comprehensive and should cover all scenarios addressed by
the prac�ces that are relevant to a par�cular organiza�on.
Compliance Framework 1/5: What's the Training Program? - ansHFMA's best prac�ces call for annual
training on the organiza�on's financial assistance policies for all staff who engage in pa�ent financial
discussions, including pa�ent access, financial counseling, and customer service representa�ves.
Compliance Framework: Training Program: What are the topics that must be covered? - ans- pa�ent
financial communica�ons best prac�ces specific to staff role
-Financial Assistance Policies
-Available pa�ent financing op�ons
-Alterna�ve solu�ons for the uninsured
-laws/regula�ons, such as EMTALA, the Fair Debt Collec�ons Prac�ce Act, and the Telephone Consumer
Protec�on Act - specific to the staff role.
For Complex Scenarios: for pa�ents with non-rou�ne or complex scenarios, such as uninsured or
underinsured pa�ents, who should be involved in the financial discussions? - ansthe pa�ent and financial
counselor or supervisor.
For Rou�ne Scenarios: for pa�ents with insurance coverage or a know ability to pay, who should be
involved in the financial discussions? - ansthe pa�ent or guarantor and properly trained provider
representa�ves.
Healthcare Dollars & Sense is the name given to what 3 HFMA revenue cycle ini�a�ves? - ans- Pa�ent
financial communica�ons best prac�ces
- Best prac�ces for price transparency
- Medical account resolu�on
REPRESENTATIVE PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
According to best prac�ces, when should you make a reasonable atempt to have a financial discussion
with a pa�ent? - ansBefore a financial obliga�on is incurred (before care is provided).
Also, providers should:
A. have both elec�ve and non-elec�ve procedures clearly defined for the public
B. only elec�ve procedures clearly defined, and non-elec�ve are mandatory
C. only non-elec�ve, as they are mandatory. - ansA.
Balance Resolu�on: how should you discuss prior balances for resolu�on? - ansI may discuss prior
balances that are currently being pursued for collec�on by the provider, a collec�on agency, or other
organiza�ons. I may also write a list of the prior services delivered, dates of service, and the resul�ng
prior balance.
Compliance Framework 1/5: What is the Execu�ve Level Metrics Repor�ng? - ansReports of
organiza�onal performance evalua�ons should be developed, compiled into an overall compliance
report and presented to the organiza�on's execu�ve leadership team on an annual basis.
Compliance Framework 1/5: What is the Feedback and Response? - ansThis evalua�on is designed to
ensure that processes are in place to regularly solicit input and receive key stakeholders'' feedback,
measure and respond to input and feedback, and ensure that pa�ent complaints are resolved.
Compliance Framework 1/5: What is the Technology segment? - ansThe compliance framework ensures
that technology is in place to support verifica�on of insurance eligibility for current services, verifica�on
of exis�ng prior balance for current services, and es�mated cost of the current services and the pa�ent
responsibility por�on.
Compliance Framework 1/5: What's Process Observa�on? - ansAnnual observa�on, monitoring, and
tracking of results make up the process of compliance evalua�on required to document compliance with
, HFMA - CERTIFIED REVENUE CYCLE
REPRESENTATIVE PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
the best prac�ces. The evalua�on should be comprehensive and should cover all scenarios addressed by
the prac�ces that are relevant to a par�cular organiza�on.
Compliance Framework 1/5: What's the Training Program? - ansHFMA's best prac�ces call for annual
training on the organiza�on's financial assistance policies for all staff who engage in pa�ent financial
discussions, including pa�ent access, financial counseling, and customer service representa�ves.
Compliance Framework: Training Program: What are the topics that must be covered? - ans- pa�ent
financial communica�ons best prac�ces specific to staff role
-Financial Assistance Policies
-Available pa�ent financing op�ons
-Alterna�ve solu�ons for the uninsured
-laws/regula�ons, such as EMTALA, the Fair Debt Collec�ons Prac�ce Act, and the Telephone Consumer
Protec�on Act - specific to the staff role.
For Complex Scenarios: for pa�ents with non-rou�ne or complex scenarios, such as uninsured or
underinsured pa�ents, who should be involved in the financial discussions? - ansthe pa�ent and financial
counselor or supervisor.
For Rou�ne Scenarios: for pa�ents with insurance coverage or a know ability to pay, who should be
involved in the financial discussions? - ansthe pa�ent or guarantor and properly trained provider
representa�ves.
Healthcare Dollars & Sense is the name given to what 3 HFMA revenue cycle ini�a�ves? - ans- Pa�ent
financial communica�ons best prac�ces
- Best prac�ces for price transparency
- Medical account resolu�on
