CRCR EXAM PREP WITH ACTUAL
QUESTIONS & VERIFIED ANSWERS
GRADED A+
What do EMTALA regulations require on-call physicians to do? - ANS✔✔--Personally
appear in the emergency department and attend to the patient within a reasonable time
At the end of each shift, what must happen to cash, checks, and credit card transaction
documents? - ANS✔✔--They must be balanced
What will cause a CMS 1500 claim to be rejected? - ANS✔✔--The provider is billing
with a future date of service
Under Medicare regulations, which of the following is not included on a valid physician's
order for services? - ANS✔✔--The cost of the test
What are collection agency fees based on? - ANS✔✔--A percentage of dollars
collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule? - ANS✔✔--Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers? - ANS✔✔--Case rates
What customer service improvements might improve the patient accounts department?
- ANS✔✔--Holding staff accountable for customer service during performance
reviews
How should a provider resolve a late-charge credit posted after an account is billed? -
ANS✔✔--Post a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service indicate what
about accounts - ANS✔✔--They are not being processed in a timely manner
What is an advantage of a preregistration program? - ANS✔✔--It reduces processing
times at the time of service
, What are the two statutory exclusions from hospice coverage? - ANS✔✔--Medically
unnecessary services and custodial care
What core financial activities are resolved within patient access? - ANS✔✔--
Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
What statement applies to the scheduled outpatient? - ANS✔✔--The services do not
involve an overnight stay
How is a mis-posted contractual allowance resolved? - ANS✔✔--Comparing the
contract reimbursement rates with the contract on the admittance advice to identify the
correct amount
What type of patient status is used to evaluate the patient's need for inpatient care? -
ANS✔✔--Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what? - ANS✔✔--Medically necessary inpatient hospital
services for at least 3 consecutive days before the skilled nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? -
ANS✔✔--When the patient is the insured
What are non-emergency patients who come for service without prior notification to the
provider called? - ANS✔✔--Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what
is the status of the subscriber's spouse? - ANS✔✔--Neither enrolled not entitled to
benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending
Act, establishes what? - ANS✔✔--Disclosure rules for consumer credit sales and
consumer loans
What is a principal diagnosis? - ANS✔✔--Primary reason for the patient's admission
Collecting patient liability dollars after service leads to what? - ANS✔✔--Lower
accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? - ANS✔✔-
-50% of the current deductible amount
QUESTIONS & VERIFIED ANSWERS
GRADED A+
What do EMTALA regulations require on-call physicians to do? - ANS✔✔--Personally
appear in the emergency department and attend to the patient within a reasonable time
At the end of each shift, what must happen to cash, checks, and credit card transaction
documents? - ANS✔✔--They must be balanced
What will cause a CMS 1500 claim to be rejected? - ANS✔✔--The provider is billing
with a future date of service
Under Medicare regulations, which of the following is not included on a valid physician's
order for services? - ANS✔✔--The cost of the test
What are collection agency fees based on? - ANS✔✔--A percentage of dollars
collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule? - ANS✔✔--Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers? - ANS✔✔--Case rates
What customer service improvements might improve the patient accounts department?
- ANS✔✔--Holding staff accountable for customer service during performance
reviews
How should a provider resolve a late-charge credit posted after an account is billed? -
ANS✔✔--Post a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service indicate what
about accounts - ANS✔✔--They are not being processed in a timely manner
What is an advantage of a preregistration program? - ANS✔✔--It reduces processing
times at the time of service
, What are the two statutory exclusions from hospice coverage? - ANS✔✔--Medically
unnecessary services and custodial care
What core financial activities are resolved within patient access? - ANS✔✔--
Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
What statement applies to the scheduled outpatient? - ANS✔✔--The services do not
involve an overnight stay
How is a mis-posted contractual allowance resolved? - ANS✔✔--Comparing the
contract reimbursement rates with the contract on the admittance advice to identify the
correct amount
What type of patient status is used to evaluate the patient's need for inpatient care? -
ANS✔✔--Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what? - ANS✔✔--Medically necessary inpatient hospital
services for at least 3 consecutive days before the skilled nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? -
ANS✔✔--When the patient is the insured
What are non-emergency patients who come for service without prior notification to the
provider called? - ANS✔✔--Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what
is the status of the subscriber's spouse? - ANS✔✔--Neither enrolled not entitled to
benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending
Act, establishes what? - ANS✔✔--Disclosure rules for consumer credit sales and
consumer loans
What is a principal diagnosis? - ANS✔✔--Primary reason for the patient's admission
Collecting patient liability dollars after service leads to what? - ANS✔✔--Lower
accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? - ANS✔✔-
-50% of the current deductible amount
