CRCR Certification questions and answers well illustrated.

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CRCR Certification questions and answers
x x x x

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well illustrated. x

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Overall xaggregate xpayments xmade xto xa xhospice xare xsubject xto xa xcomputed x"cap
xamount" xcalculated xby x- x xcorrect xanswer. x x xThe xMedicare xAdministrative xContractor

x(MAC) xat xthe xend xof xthe xhospice xcap xperiod x
x

Which xof xthe xfollowing xis xrequired xfor xparticipation xin xMedicaid x- x xcorrect xanswer. x x
xMeet x
x
Income xand xAssets

xRequirements
x

In xchoosing xa xsetting xfor xpatient xfinancial xdiscussions, xorganizations xshould xfirst
xand x
x
foremost x- x xcorrect xanswer. x x xRespect xthe xpatients
xprivacy
x

A xnightly xroom xcharge xwill xbe xincorrect xif xthe xpatient's x- x xcorrect xanswer. x x xTransfer
xfrom x
x
ICU x(intensive xcare xunit) xto xthe

xMedical/Surgical
x
floor xis xnot xreflected xin xthe xregistration
xsystem
x

The xAffordable xCare xAct xlegislated xthe xdevelopment xof xHealth xInsurance
xExchanges, xwhere xindividuals xand xsmall xbusinesses xcan x- x xcorrect xanswer. x x

xPurchase xqualified xhealth xbenefit xplans xregardless xof xinsured's xhealth xstatus x
x

A xportion xof xthe xaccounts xreceivable xinventory xwhich xhas xNOT xqualified xfor
xbilling x
x
includes: x- x xcorrect xanswer. x x xCharitable
xpledges
x

What xis xrequired xfor xthe xUB-04/837-I, xused xby xRural xHealth xClinics xto xgenerate
xpayment x
x
from xMedicare? x- x xcorrect xanswer. x x xRevenue
xcodes
x

,This xdirective xwas xdeveloped xto xpromote xand xensure xhealthcare xquality xand xvalue
xand xalso xto xprotect xconsumers xand xworkers xin xthe xhealthcare xsystem. xThis xdirective

xis xcalled x- x xcorrect xanswer. x x xPatient xbill xof xrights x
x

The xactivity xwhich xresults xin xthe xaccurate xrecording xof xpatient xbed xand xlevel xof xcare
xassessment, xpatient xtransfer xand xpatient xdischarge xstatus xon xa xreal-time xbasis xis

xknown xas x- x xcorrect xanswer. x x xCase xmanagement x
x

Which xstatement xis xan xEMTALA x(Emergency xMedical xTreatment xand xActive xLabor
xAct) x
x
violation? x- x xcorrect xanswer. x x xRegistration xstaff xmay xroutinely xcontact xmanaged
xare
x
plans xfor xprior xauthorizations xbefore xthe xpatient xis xseen xby xthe xon-duty
xphysician
x

HIPAA xhad xadopted xEmployer xIdentification xNumbers x(EIN) xto xbe xused xin xstandard
xtransactions xto xidentify xthe xemployer xof xan xindividual xdescribed xin xa xtransaction

xEIN's xare xassigned xby x- x xcorrect xanswer. x x xThe xInternal xRevenue xService x
x

Checks xreceived xthrough xmail, xcash xreceived xthrough xmail, xand xlock xbox xare
xall x
x
examples xof x- x xcorrect xanswer. x x xControl xpoints xfor xcash
xposting
x

What xare xsome xcore xelements xif xa xboard-approved xfinancial xassistance xpolicy? x- x

xcorrect x
x
answer. x x xEligibility, xapplication xprocess, xand xnonpayment xcollection
xactivities
x

A xrecurring/series xregistration xis xcharacterized xby x- x x correct xanswer. x x x The
xcreation xof x
x
one xregistration xrecord xfor xmultiple xdays xof
xservice
x

With xthe xadvent xof xthe xAffordable xCare xAct xHealth xInsurance xMarketplaces xand xthe
xexpansion xof xMedicaid xin xsome xstates, xit xis xmore ximportant xthan xever xfor xhospitals

xto x- x xcorrect xanswer. x x xAssist xpatients xin xunderstanding xtheir xinsurance xcoverage

xand xtheir xfinancial xobligation x
x

The xpurpose xof xa xfinancial xreport xis xto: x- x x correct xanswer. x x x Present xfinancial
xinformation x
x
to xdecision

xmakers
x

Patient xfinancial xcommunications xbest xpractices xproduce xcommunications xthat
xare x-
x
correct xanswer. x x xConsistent, xclear xand
xtransparent

, x

Medicare xhas xestablished xguidelines xcalled xthe xLocal xCoverage xDeterminations
x(LCD) x

and xNational xCoverage xDeterminations x(NCD) xthat xestablish x- x xcorrect xanswer. x x
xWhat
x
services xor xhealthcare xitems xare xcovered xunder
xMedicare
x

Any xprovider xthat xhas xfiled xa xtimely xcost xreport xmay xappeal xan xadverse xfinal
xdecision xreceived xfrom xthe xMedicare xAdministrative xContractor x(MAC). xThis xappeal

xmay xbe xfiled xwith x- x xcorrect xanswer. x x xThe xProvider xReimbursement xReview xBoard x
x

Concurrent xreview xand xdischarge xplanning x- x xcorrect xanswer. x x xOccurs xduring xservice
x
x

Duplicate xpayments xoccur: x- x xcorrect xanswer. x x xWhen xproviders xre-bill xclaims xbased
xon x
x
nonpayment xfrom xthe xinitial xbill
xsubmission
x

An xindividual xenrolled xin xMedicare xwho xis xdissatisfied xwith xthe xgovernment's xclaim
xdetermination xis xentitled xto xreconsideration xof xthe xdecision. xThis xtype xof xappeal xis

xknown xas x- x xcorrect xanswer. x x xA xbeneficiary xappeal x
x

Insurance xverification xresults xin xwhich xof xthe xfollowing x- x x correct xanswer. The
x x x

xaccurate x
x
identification xof xthe xpatient's xeligibility xand
xbenefits
x

The xMedicare xfee-for xservice xappeal xprocess xfor xboth xbeneficiaries xand xproviders
xincludes xall xof xthe xfollowing xlevels xEXCEPT: x- x xcorrect xanswer. x x xJudicial xreview xby

xa xfederal xdistrict xcourt x
x

Under xEMTALA x(Emergency xMedical xTreatment xand xLabor xAct) xregulations, xthe
xprovidermay xnot xask xabout xa xpatient's xinsurance xinformation xif xit xwould xdelay xwhat?

x- x xcorrect xanswer. x x xMedical xscreening xand xstabilizing xtreatment x
x

Ambulance xservices xare xbilled xdirectly xto xthe xhealth xplan xfor x- x xcorrect xanswer. x x

xServices x
x
provided xbefore xa xpatient xis xadmitted xand xfor xambulance xrides xarranged xto xpick xup
xthe
x
patient xfrom xthe xhospital xafter xdischarge xto xtake xhim/her xhome xor xto xanother
xfacility
x

Key xperformance xindicators x(KPIs) xset xstandards xfor xaccounts xreceivables x(A/R)
xand x-
x
correct xanswer. x x xProvide xa xmethod xof xmeasuring xthe xcollection xand xcontrol xof
xA/R
x