CRCR Exam Unit 1
1. 3 Critical Elements of the Healthcare Revenue Cycle - ANS-Pre-Service, Time of
Service, Post Service
2. A/R Aging - ANS-Reports divide the AR into 30, 60, 90, and 120 day categories,
based on discharge.
3. Accountable Care Organizations (ACO) - ANS-Delivery system of physicians,
hospitals, and other healthcare providers, working collaboratively to manage and
coordinate the care of a patient population. The point is to ensure appropriateness of
care, elimination of duplicate services, and prevention of medical errors for a
population of patients.
4. Accrual Accounting - ANS-Revenue is recorded when it is earned to permit the
alignment of revenue with the associated expenses. Healthcare providers usually use
this method.
5. Advanced Beneficiary Notification Requirements (ABN) - ANS-As soon as a provider
determines that Medicare will most likely not pay, it must advise the beneficiary that,
in the provider's opinion, he/she will be personally responsible for the payment. This
involves the timely and effective delivery of the approved CMS form to the individual
beneficiary or to the beneficiary's authorized representative.
6. Affordable Care Act (ACA) - ANS-Federal legislation passed in 2010 designed to
reform the healthcare system into one that rewards greater value, improves quality of
care, and increases efficiency in delivery of services.
7. Balance Sheet - ANS-A summary of the organization's wealth as of the date of the
statement. It represents the summary of the organization's assets, liabilities, and
accumulated excesses from operations less any accumulated losses. The net value
of excesses and losses may be known as net assets.
8. Cash Flow Statement - ANS-Summary of how cash was used and where it was
obtained.
9. Continuum of Care - ANS-Involves healthcare providers in multiple settings and
multiple levels coming together with the overall goal of coordinating patients'
healthcare
10. Contra-Account Amounts - ANS-Adjustments posted at the time of billing. this
increases the accuracy of the receivable and minimizes the need to estimate
contractual reserves.
11. Correct Coding Initiative (CCI) - ANS-Created to promote the use of correct coding
methods on a national basis. Purpose is to ensure that the most comprehensive
groups of codes, rather than component parts, are billed. Consists of edits that are
implemented within providers' claim processing systems.
12. Credit Balances - Days Outstanding - ANS-The dollars in credit balance at the
account level divided by the three month daily average of total net patient service
revenue. Credit balances should be resolved timely and should be benchmarked at
<1% of the days outstanding in the AR.
13. Emergency Medical Treatment and Active Labor Act (EMTALA) - ANS-Says that no
patient financial discussions should occur before a patient is screened and stabilized.
1. 3 Critical Elements of the Healthcare Revenue Cycle - ANS-Pre-Service, Time of
Service, Post Service
2. A/R Aging - ANS-Reports divide the AR into 30, 60, 90, and 120 day categories,
based on discharge.
3. Accountable Care Organizations (ACO) - ANS-Delivery system of physicians,
hospitals, and other healthcare providers, working collaboratively to manage and
coordinate the care of a patient population. The point is to ensure appropriateness of
care, elimination of duplicate services, and prevention of medical errors for a
population of patients.
4. Accrual Accounting - ANS-Revenue is recorded when it is earned to permit the
alignment of revenue with the associated expenses. Healthcare providers usually use
this method.
5. Advanced Beneficiary Notification Requirements (ABN) - ANS-As soon as a provider
determines that Medicare will most likely not pay, it must advise the beneficiary that,
in the provider's opinion, he/she will be personally responsible for the payment. This
involves the timely and effective delivery of the approved CMS form to the individual
beneficiary or to the beneficiary's authorized representative.
6. Affordable Care Act (ACA) - ANS-Federal legislation passed in 2010 designed to
reform the healthcare system into one that rewards greater value, improves quality of
care, and increases efficiency in delivery of services.
7. Balance Sheet - ANS-A summary of the organization's wealth as of the date of the
statement. It represents the summary of the organization's assets, liabilities, and
accumulated excesses from operations less any accumulated losses. The net value
of excesses and losses may be known as net assets.
8. Cash Flow Statement - ANS-Summary of how cash was used and where it was
obtained.
9. Continuum of Care - ANS-Involves healthcare providers in multiple settings and
multiple levels coming together with the overall goal of coordinating patients'
healthcare
10. Contra-Account Amounts - ANS-Adjustments posted at the time of billing. this
increases the accuracy of the receivable and minimizes the need to estimate
contractual reserves.
11. Correct Coding Initiative (CCI) - ANS-Created to promote the use of correct coding
methods on a national basis. Purpose is to ensure that the most comprehensive
groups of codes, rather than component parts, are billed. Consists of edits that are
implemented within providers' claim processing systems.
12. Credit Balances - Days Outstanding - ANS-The dollars in credit balance at the
account level divided by the three month daily average of total net patient service
revenue. Credit balances should be resolved timely and should be benchmarked at
<1% of the days outstanding in the AR.
13. Emergency Medical Treatment and Active Labor Act (EMTALA) - ANS-Says that no
patient financial discussions should occur before a patient is screened and stabilized.
