HFMA CRCR EXAM LATEST EXAM 170+
QUESTIONS AND CORRECT
ANSWERS(VERIFIED ANSWERS)
It reduces processing times at the time of service
What is an advantage of a preregistration program?
Medically unnecessary services and custodial care
What are the two statutory exclusions from hospice coverage?
Scheduling, insurance verification, discharge processing, and payment of point-
of-service receipts
What core financial activities are resolved within patient access?
The services do not involve an overnight stay
What statement applies to the scheduled outpatient?
Comparing the contract reimbursement rates with the contract on the
admittance advice to identify the correct amount
How is a mis-posted contractual allowance resolved?
Observation
What type of patient status is used to evaluate the patient's need for inpatient
care?
,Medically necessary inpatient hospital services for at least 3 consecutive days
before the skilled nursing care admission
Coverage rules for Medicare beneficiaries receiving skilled nursing care require
that the beneficiary has received what?
When the patient is the insured
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
Unscheduled patients
What are non-emergency patients who come for service without prior notification
to the provider called?
Neither enrolled not entitled to benefits
If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse?
Disclosure rules for consumer credit sales and consumer loans
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what?
Primary reason for the patient's admission
What is a principal diagnosis?
Lower accounts receivable levels
Collecting patient liability dollars after service leads to what?
50% of the current deductible amount
, What is the daily out-of-pocket amount for each lifetime reserve day used?
Inpatient care
What service provided to a Medicare beneficiary in a rural health clinic (RHC) is
not billable as an RHC services?
Patient discharge status code
What code indicates the disposition of the patient at the conclusion of service?
They result in lost reimbursement and additional cost to collect
What are hospitals required to do for Medicare credit balance accounts?
Patient
When an undue delay of payment results from a dispute between the patient and
the third party payer, who is responsible for payment?
A valid CPT or HCPCS code
Medicare guidelines require that when a test is ordered for a LCD or NCD exists,
the information provided on the order must include:
Access their information and perform functions on-line
With advances in internet security and encryption, revenue-cycle processes are
expanding to allow patients to do what?
onset date of current illness
What date is required on all CMS 1500 claim forms?
Review appropriateness of the service request
QUESTIONS AND CORRECT
ANSWERS(VERIFIED ANSWERS)
It reduces processing times at the time of service
What is an advantage of a preregistration program?
Medically unnecessary services and custodial care
What are the two statutory exclusions from hospice coverage?
Scheduling, insurance verification, discharge processing, and payment of point-
of-service receipts
What core financial activities are resolved within patient access?
The services do not involve an overnight stay
What statement applies to the scheduled outpatient?
Comparing the contract reimbursement rates with the contract on the
admittance advice to identify the correct amount
How is a mis-posted contractual allowance resolved?
Observation
What type of patient status is used to evaluate the patient's need for inpatient
care?
,Medically necessary inpatient hospital services for at least 3 consecutive days
before the skilled nursing care admission
Coverage rules for Medicare beneficiaries receiving skilled nursing care require
that the beneficiary has received what?
When the patient is the insured
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
Unscheduled patients
What are non-emergency patients who come for service without prior notification
to the provider called?
Neither enrolled not entitled to benefits
If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse?
Disclosure rules for consumer credit sales and consumer loans
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what?
Primary reason for the patient's admission
What is a principal diagnosis?
Lower accounts receivable levels
Collecting patient liability dollars after service leads to what?
50% of the current deductible amount
, What is the daily out-of-pocket amount for each lifetime reserve day used?
Inpatient care
What service provided to a Medicare beneficiary in a rural health clinic (RHC) is
not billable as an RHC services?
Patient discharge status code
What code indicates the disposition of the patient at the conclusion of service?
They result in lost reimbursement and additional cost to collect
What are hospitals required to do for Medicare credit balance accounts?
Patient
When an undue delay of payment results from a dispute between the patient and
the third party payer, who is responsible for payment?
A valid CPT or HCPCS code
Medicare guidelines require that when a test is ordered for a LCD or NCD exists,
the information provided on the order must include:
Access their information and perform functions on-line
With advances in internet security and encryption, revenue-cycle processes are
expanding to allow patients to do what?
onset date of current illness
What date is required on all CMS 1500 claim forms?
Review appropriateness of the service request
