CRCR Certification Exam () Actual Questions
and Verified Answers, 100% Guarantee Pass
The jdisadvantages jof joutsourcing jinclude jall jof jthe jfollowing jEXCEPT:
a) jThe jimpact jof jcustomer jservice jor jpatient jrelations
b) jThe jimpact jof jloss jof jdirect jcontrol jof jaccounts jreceivable jservices
c) jIncreased jcosts jdue jto jvendor jineffectiveness
d) jReduced jinternal jstaffing jcosts jand ja jreliance jon joutsourced jstaff j- jANSWER-d) jReduced
internal jstaffing jcosts jand ja jreliance jon joutsourced jstaff
j
The jMedicare jfee-for jservice jappeal jprocess jfor jboth jbeneficiaries jand jproviders
includes jall jof jthe jfollowing jlevels jEXCEPT:
a) jMedical jnecessity jreview jby jan jindependent jphysician's jpanel
b) jJudicial jreview jby ja jfederal jdistrict jcourt
c) jRedetermination jby jthe jcompany jthat jhandles jclaims jfor jMedicare
d) jReview jby jthe jMedicare jAppeals jCouncil j(Appeals jCouncil) j- jANSWER-b) jJudicial jreview
by ja jfederal jdistrict jcourt
j
Business jethics, jor jorganizational jethics jrepresent:
a) jThe jprinciples jand jstandards jby jwhich jorganizations joperate
b) jRegulations jthat jmust jbe jfollowed jby jlaw
c) jDefinitions jof jappropriate jcustomer jservice
,d) jThe jcode jof jacceptable jconduct j- jANSWER-a) jThe jprinciples jand jstandards jby jwhich
organizations joperate
j
A jportion jof jthe jaccounts jreceivable jinventory jwhich jhas jNOT jqualified jfor jbilling
includes:
a) jCharitable jpledges
b) jAccounts jcreated jduring jpre-registration jbut jnot jactivated
c) jAccounts jcoded jbut jheld jwithin jthe jsuspense jperiod
d) jAccounts jassigned jto ja jpre-collection jagency j- jANSWER-a) jCharitable jpledges
Local jCoverage jDeterminations j(LCD) jand jNational jCoverage jDeterminations j(NCD) jare
Medicare jestablished jguideline(s) jused jto jdetermine:
a) jMedicare jand jMedicaid jprovider jeligibility
b) jMedicare joutpatient jreimbursement jrates
c) jWhich jdiagnoses, jsigns, jor jsymptoms jare jreimbursable
d) jWhat jMedicare jreimburses jand jwhat jshould jbe jreferred jto jMedicaid j- jANSWER-c) jWhich
diagnoses, jsigns, jor jsymptoms jare jreimbursable
j
Days jin jA/R jis jcalculated jbased jon jthe jvalue jof:
a) jThe jtotal jaccounts jreceivable jon ja jspecific jdate
b) jTotal janticipated jrevenue jminus jexpenses
c) jThe jtime jit jtakes jto jcollect janticipated jrevenue
d) jTotal jcash jreceived jto jdate j- jANSWER-c) jThe jtime jit jtakes jto jcollect janticipated jrevenue
,Patients jare jcontacting jhospitals jto jproactively jinquire jabout jcosts jand jfees jprior jto
agreeing jto jservice. jThe jproblem jfor jhospitals jin jproviding jsuch jinformation jis:
a) jThat jhospitals jdon't jwant jto jestablish ja jprice jwithout jknowing jif
the jpatient jhas jinsurance jand jhow jmuch jreimbursement jcan jbe
expected
b) jThe jfact jthat jcharge jmaster jlists jthe jtotal jcharge, jnot jnet jcharges
that jreflect jcharges jafter ja jpayer's jcontractual jadjustment
c) jThat jhospitals jdon't jwant jto jbe jput jin jthe jposition jof
"guaranteeing" jprice jwithout jhaving jroom jfor jadditional jcharges
that jmay jarise jin jthe jcourse jof jtreatment
d) jTheir jreluctance jto jshare jproprietary jinformation j- jANSWER-b) jThe jfact jthat jcharge
master jlists jthe jtotal jcharge, jnot jnet jcharges
j
that jreflect jcharges jafter ja jpayer's jcontractual jadjustment
Across jall jcare jsettings, jif ja jpatient jconsents jto ja jfinancial jdiscussion jduring ja jmedical
encounter jto jexpedite jdischarge, jthe jHFMA jbest jpractice jis jto:
a) jMake jsure jthat jthe jattending jstaff jcan janswer jquestions jand
assist jin jobtaining jrequired jpatient jfinancial jdata
b) jHave ja jpatient jresponsibilities jkit jready jfor jthe jpatient,
containing jall jof jthe jrequired jregistration jforms jand jinstructions
c) jSupport jthat jchoice, jproviding jthat jthe jdiscussion jdoes jnot
interfere jwith jpatient jcare jor jdisrupt jpatient jflow
, d) jDecline jsuch jrequest jas jfinance jdiscussions jcan jdisrupt jpatient jcare jand jpatient jflow j-
ANSWER-c) jSupport jthat jchoice, jproviding jthat jthe jdiscussion jdoes jnot jinterfere jwith
j
patient jcare jor jdisrupt jpatient jflow
j
A jcomprehensive j"Compliance jProgram" jis jdefined jas
a) jAnnual jlegal jaudit jand jreview jfor jadherence jto jregulations
b) jEducating jstaff jon jregulations
c) jSystematic jprocedures jto jensure jthat jthe jprovisions jof jregulations jimposed jby ja
government
j
agency jare jbeing jmet
d) jThe jdevelopment jof joperational jpolicies jthat jcorrespond jto jregulations j- jANSWER-c)
Systematic jprocedures jto jensure jthat jthe jprovisions jof jregulations jimposed jby ja
j
government
j
10. jCase jManagement jrequires jthat ja jcase jmanager jbe jassigned
a) jTo jpatients jof jany jphysician jrequesting jcase jmanagement
b) jTo ja jselect jpatient jgroup
c) jTo jevery jpatient
d) jTo jspecific jcases jdesignated jby jthird jparty jcontractual jagreement j- jANSWER-b) jTo ja
select jpatient jgroup
j
Pricing jtransparency jis jdefined jas jreadily javailable jinformation jon jthe jprice jof jhealthcare
services, jthat jtogether jwith jother jinformation, jhelp jdefine jthe jvalue jof jthose jservices jand
and Verified Answers, 100% Guarantee Pass
The jdisadvantages jof joutsourcing jinclude jall jof jthe jfollowing jEXCEPT:
a) jThe jimpact jof jcustomer jservice jor jpatient jrelations
b) jThe jimpact jof jloss jof jdirect jcontrol jof jaccounts jreceivable jservices
c) jIncreased jcosts jdue jto jvendor jineffectiveness
d) jReduced jinternal jstaffing jcosts jand ja jreliance jon joutsourced jstaff j- jANSWER-d) jReduced
internal jstaffing jcosts jand ja jreliance jon joutsourced jstaff
j
The jMedicare jfee-for jservice jappeal jprocess jfor jboth jbeneficiaries jand jproviders
includes jall jof jthe jfollowing jlevels jEXCEPT:
a) jMedical jnecessity jreview jby jan jindependent jphysician's jpanel
b) jJudicial jreview jby ja jfederal jdistrict jcourt
c) jRedetermination jby jthe jcompany jthat jhandles jclaims jfor jMedicare
d) jReview jby jthe jMedicare jAppeals jCouncil j(Appeals jCouncil) j- jANSWER-b) jJudicial jreview
by ja jfederal jdistrict jcourt
j
Business jethics, jor jorganizational jethics jrepresent:
a) jThe jprinciples jand jstandards jby jwhich jorganizations joperate
b) jRegulations jthat jmust jbe jfollowed jby jlaw
c) jDefinitions jof jappropriate jcustomer jservice
,d) jThe jcode jof jacceptable jconduct j- jANSWER-a) jThe jprinciples jand jstandards jby jwhich
organizations joperate
j
A jportion jof jthe jaccounts jreceivable jinventory jwhich jhas jNOT jqualified jfor jbilling
includes:
a) jCharitable jpledges
b) jAccounts jcreated jduring jpre-registration jbut jnot jactivated
c) jAccounts jcoded jbut jheld jwithin jthe jsuspense jperiod
d) jAccounts jassigned jto ja jpre-collection jagency j- jANSWER-a) jCharitable jpledges
Local jCoverage jDeterminations j(LCD) jand jNational jCoverage jDeterminations j(NCD) jare
Medicare jestablished jguideline(s) jused jto jdetermine:
a) jMedicare jand jMedicaid jprovider jeligibility
b) jMedicare joutpatient jreimbursement jrates
c) jWhich jdiagnoses, jsigns, jor jsymptoms jare jreimbursable
d) jWhat jMedicare jreimburses jand jwhat jshould jbe jreferred jto jMedicaid j- jANSWER-c) jWhich
diagnoses, jsigns, jor jsymptoms jare jreimbursable
j
Days jin jA/R jis jcalculated jbased jon jthe jvalue jof:
a) jThe jtotal jaccounts jreceivable jon ja jspecific jdate
b) jTotal janticipated jrevenue jminus jexpenses
c) jThe jtime jit jtakes jto jcollect janticipated jrevenue
d) jTotal jcash jreceived jto jdate j- jANSWER-c) jThe jtime jit jtakes jto jcollect janticipated jrevenue
,Patients jare jcontacting jhospitals jto jproactively jinquire jabout jcosts jand jfees jprior jto
agreeing jto jservice. jThe jproblem jfor jhospitals jin jproviding jsuch jinformation jis:
a) jThat jhospitals jdon't jwant jto jestablish ja jprice jwithout jknowing jif
the jpatient jhas jinsurance jand jhow jmuch jreimbursement jcan jbe
expected
b) jThe jfact jthat jcharge jmaster jlists jthe jtotal jcharge, jnot jnet jcharges
that jreflect jcharges jafter ja jpayer's jcontractual jadjustment
c) jThat jhospitals jdon't jwant jto jbe jput jin jthe jposition jof
"guaranteeing" jprice jwithout jhaving jroom jfor jadditional jcharges
that jmay jarise jin jthe jcourse jof jtreatment
d) jTheir jreluctance jto jshare jproprietary jinformation j- jANSWER-b) jThe jfact jthat jcharge
master jlists jthe jtotal jcharge, jnot jnet jcharges
j
that jreflect jcharges jafter ja jpayer's jcontractual jadjustment
Across jall jcare jsettings, jif ja jpatient jconsents jto ja jfinancial jdiscussion jduring ja jmedical
encounter jto jexpedite jdischarge, jthe jHFMA jbest jpractice jis jto:
a) jMake jsure jthat jthe jattending jstaff jcan janswer jquestions jand
assist jin jobtaining jrequired jpatient jfinancial jdata
b) jHave ja jpatient jresponsibilities jkit jready jfor jthe jpatient,
containing jall jof jthe jrequired jregistration jforms jand jinstructions
c) jSupport jthat jchoice, jproviding jthat jthe jdiscussion jdoes jnot
interfere jwith jpatient jcare jor jdisrupt jpatient jflow
, d) jDecline jsuch jrequest jas jfinance jdiscussions jcan jdisrupt jpatient jcare jand jpatient jflow j-
ANSWER-c) jSupport jthat jchoice, jproviding jthat jthe jdiscussion jdoes jnot jinterfere jwith
j
patient jcare jor jdisrupt jpatient jflow
j
A jcomprehensive j"Compliance jProgram" jis jdefined jas
a) jAnnual jlegal jaudit jand jreview jfor jadherence jto jregulations
b) jEducating jstaff jon jregulations
c) jSystematic jprocedures jto jensure jthat jthe jprovisions jof jregulations jimposed jby ja
government
j
agency jare jbeing jmet
d) jThe jdevelopment jof joperational jpolicies jthat jcorrespond jto jregulations j- jANSWER-c)
Systematic jprocedures jto jensure jthat jthe jprovisions jof jregulations jimposed jby ja
j
government
j
10. jCase jManagement jrequires jthat ja jcase jmanager jbe jassigned
a) jTo jpatients jof jany jphysician jrequesting jcase jmanagement
b) jTo ja jselect jpatient jgroup
c) jTo jevery jpatient
d) jTo jspecific jcases jdesignated jby jthird jparty jcontractual jagreement j- jANSWER-b) jTo ja
select jpatient jgroup
j
Pricing jtransparency jis jdefined jas jreadily javailable jinformation jon jthe jprice jof jhealthcare
services, jthat jtogether jwith jother jinformation, jhelp jdefine jthe jvalue jof jthose jservices jand
