CRCR Unit 4 (4.1 - 4.9) Post-Service - Financial Care.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CRCR%20Unit
CRCR Unit 4 (4.1 - 4.9) Post-Service - Financial
Care Questions & Answers
1. A.The separation of cash handling procedures whereby the same person
who opens and endorses the checks is not responsible for the deposit
B. The establishment of internal audits by personnel outside the involved
department.
C. The routine use of outside auditors to track cash flow
D. The routine reconciliation of daily cash against deposits, postings, and
write-offs
E.The use of multiple levels of authorization for refund checks, write-offs, and
disbursements
Answer Identify internal controls for cash handling
2. EFT is the electronic transfer of funds from payer to payee through the
banking system. It is considered the fastest way to move money because itis
possible to transfer funds between banks on the same day.
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,CRCR Unit 4 (4.1 - 4.9) Post-Service - Financial Care.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CRCR%20Unit
EFT Balancing & Control - EFT simplifies cash balancing & control require-
ments since the cash is deposited directly into the healthcare provider's bank
account.
1. Bank informs healthcare provider of the amount received and issues a
deposit.
2. Healthcare provider balances this deposit to the electronic remittance ad-
vice (ERA) received.
Answer Recognize the general concepts of electronic funds transfer(EFT)
3. Electronic Remittance Advice (ERA) 835 Data Set - A standardized health-
care claim payment remittance advice known as the 835 format is used to
electronically send third-party payment details to healthcare providers.There
are 4 levels of automation that can be used.
A. Level 1 - electronic receipt of data only.
a. Electronic remittance advice is received
b. The information is printed
c. The printout is then processed the same as a paper remittance advice.
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,CRCR Unit 4 (4.1 - 4.9) Post-Service - Financial Care.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CRCR%20Unit
d. Advantages include
1. Saving mail time for remittance
2. Standardized format for data entry
B. Level 2 - electronic receipt & electronic data entry
a. With this level, the electronic remittance is received
b. Entered into the computer electronically.
c. Viewed on a terminal
1. Data entry tasks are eliminated through automated entry of the information,
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,CRCR Unit 4 (4.1 - 4.9) Post-Service - Financial Care.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CRCR%20Unit
but usually there continues to be a manual matching of remittance informa-
tion to an individual account and reconciliation of charges submitted to the
amount paid.
C. Level 3 - electronic receipt, data entry, reconciliation, posting, and closing.
a. Electronic remittance advice is received and entered into a computer
electronically.
b. The remittance data is electronically posted by the patient accounting
software, simultaneously updating the patient's account.
1. Standard adjustment codes must be established to automate entries for
payments, i.e. contractual allowances and other write-offs. Manual interven-
tion is only needed if there is a disagreement or an error.
D. Level 4 - total automation of receipt, data entry, payment posting, and
adjustment processing.
a, In addition to everything included at level 3, this level links with banking in-
formation to allow reconciliation of payments received electronically througha
non-bank network, with funds received electronically.
1. Medicare logs and the secondary billing process are automated using the
ERA. An electronic explanation of benefits received from the primary health
plan is transmitted electronically with the secondary claims. Manual
4 of 124 10/30/2024, 9:41
CRCR Unit 4 (4.1 - 4.9) Post-Service - Financial
Care Questions & Answers
1. A.The separation of cash handling procedures whereby the same person
who opens and endorses the checks is not responsible for the deposit
B. The establishment of internal audits by personnel outside the involved
department.
C. The routine use of outside auditors to track cash flow
D. The routine reconciliation of daily cash against deposits, postings, and
write-offs
E.The use of multiple levels of authorization for refund checks, write-offs, and
disbursements
Answer Identify internal controls for cash handling
2. EFT is the electronic transfer of funds from payer to payee through the
banking system. It is considered the fastest way to move money because itis
possible to transfer funds between banks on the same day.
1 of 124 10/30/2024, 9:41
,CRCR Unit 4 (4.1 - 4.9) Post-Service - Financial Care.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CRCR%20Unit
EFT Balancing & Control - EFT simplifies cash balancing & control require-
ments since the cash is deposited directly into the healthcare provider's bank
account.
1. Bank informs healthcare provider of the amount received and issues a
deposit.
2. Healthcare provider balances this deposit to the electronic remittance ad-
vice (ERA) received.
Answer Recognize the general concepts of electronic funds transfer(EFT)
3. Electronic Remittance Advice (ERA) 835 Data Set - A standardized health-
care claim payment remittance advice known as the 835 format is used to
electronically send third-party payment details to healthcare providers.There
are 4 levels of automation that can be used.
A. Level 1 - electronic receipt of data only.
a. Electronic remittance advice is received
b. The information is printed
c. The printout is then processed the same as a paper remittance advice.
2 of 124 10/30/2024, 9:41
,CRCR Unit 4 (4.1 - 4.9) Post-Service - Financial Care.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CRCR%20Unit
d. Advantages include
1. Saving mail time for remittance
2. Standardized format for data entry
B. Level 2 - electronic receipt & electronic data entry
a. With this level, the electronic remittance is received
b. Entered into the computer electronically.
c. Viewed on a terminal
1. Data entry tasks are eliminated through automated entry of the information,
3 of 124 10/30/2024, 9:41
,CRCR Unit 4 (4.1 - 4.9) Post-Service - Financial Care.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CRCR%20Unit
but usually there continues to be a manual matching of remittance informa-
tion to an individual account and reconciliation of charges submitted to the
amount paid.
C. Level 3 - electronic receipt, data entry, reconciliation, posting, and closing.
a. Electronic remittance advice is received and entered into a computer
electronically.
b. The remittance data is electronically posted by the patient accounting
software, simultaneously updating the patient's account.
1. Standard adjustment codes must be established to automate entries for
payments, i.e. contractual allowances and other write-offs. Manual interven-
tion is only needed if there is a disagreement or an error.
D. Level 4 - total automation of receipt, data entry, payment posting, and
adjustment processing.
a, In addition to everything included at level 3, this level links with banking in-
formation to allow reconciliation of payments received electronically througha
non-bank network, with funds received electronically.
1. Medicare logs and the secondary billing process are automated using the
ERA. An electronic explanation of benefits received from the primary health
plan is transmitted electronically with the secondary claims. Manual
4 of 124 10/30/2024, 9:41
