x
x
x
x
x
x
x
x
x
x
CRCR Multiple Choice questions and
x x x x
answers 100% guaranteed success.
x x x x x
x
x
x
x
x
x
x
x
x
x
The xdisadvantages xof xoutsourcing xinclude xall xof xthe xfollowing
xEXCEPT: xa) xThe ximpact xof xcustomer xservice xor xpatient xrelations x
b) The ximpact xof xloss xof xdirect xcontrol xof xaccounts xreceivable xservices x
c) Increased xcosts xdue xto xvendor xineffectiveness x
d) Reduced xinternal xstaffing xcosts xand xa xreliance xon xoutsourced xstaff x- x xcorrect
xanswer. x x x
Dx
x
The xMedicare xfee-for xservice xappeal xprocess xfor xboth xbeneficiaries xand
xproviders
x
includes xall xof xthe xfollowing xlevels
xEXCEPT:
x
x
a) xMedical xnecessity xreview xby xan xindependent xphysician's
xpanel
x
b) xJudicial xreview xby xa xfederal xdistrict
xcourt
x
c) xRedetermination xby xthe xcompany xthat xhandles xclaims
xfor
x
Medicare
d) xReview xby xthe xMedicare xAppeals xCouncil x(Appeals xCouncil) x- x xcorrect xanswer.
x x xB
x
Business xethics, xor xorganizational xethics xrepresent: x
x
a) The xprinciples xand xstandards xby xwhich xorganizations xoperate x
b) Regulations xthat xmust xbe xfollowed xby xlaw x
c) Definitions xof xappropriate xcustomer xservice x
d) The xcode xof xacceptable xconduct x- x xcorrect xanswer. x x xA x
x
A xportion xof xthe xaccounts xreceivable xinventory xwhich xhas xNOT xqualified xfor
xbilling
, x
includes:
x
x
a) xCharitable
xpledges
x
b) xAccounts xcreated xduring xpre-registration xbut xnot
xactivated
x
c) xAccounts xcoded xbut xheld xwithin xthe xsuspense
xperiod
d) xAccounts xassigned xto xa xpre-collection xagency x- x xcorrect xanswer.
x x xA
x
Local xCoverage xDeterminations x(LCD) xand xNational xCoverage xDeterminations
x(NCD) x
x
are
x
Medicare xestablished xguideline(s) xused xto
xdetermine:
x
a) Medicare xand xMedicaid xprovider xeligibility x
b) Medicare xoutpatient xreimbursement xrates x
c) Which xdiagnoses, xsigns, xor xsymptoms xare xreimbursable x
d) What xMedicare xreimburses xand xwhat xshould xbe xreferred xto x
Medicaid x- x xcorrect xanswer. x x xC x
x
Days xin xA/R xis xcalculated xbased xon xthe xvalue xof: x
x
a) The xtotal xaccounts xreceivable xon xa xspecific xdate x
b) Total xanticipated xrevenue xminus xexpenses x
c) The xtime xit xtakes xto xcollect xanticipated xrevenue x
x
d) xTotal xcash xreceived xto xdate x- x xcorrect xanswer. x x xC x
x
Patients xare xcontacting xhospitals xto xproactively xinquire xabout xcosts xand xfees
xprior xto xagreeing xto xservice. xThe xproblem xfor xhospitals xin xproviding xsuch
xinformation xis: xa) xThat xhospitals xdon't xwant xto xestablish xa xprice xwithout
xknowing xif xthe xpatient xhas xinsurance xand xhow xmuch xreimbursement xcan xbe
xexpected x
b) xThe xfact xthat xcharge xmaster xlists xthe xtotal xcharge, xnot xnet
xcharges xthat xreflect xcharges xafter xa xpayer's xcontractual
xadjustment xc) xThat xhospitals xdon't xwant xto xbe xput xin xthe xposition
xof x"guaranteeing" xprice xwithout xhaving xroom xfor xadditional
xcharges xthat xmay xarise xin xthe xcourse xof xtreatment x
d) xTheir xreluctance xto xshare xproprietary xinformation x- x xcorrect xanswer. x x xB x
x
Across xall xcare xsettings, xif xa xpatient xconsents xto xa xfinancial xdiscussion xduring xa
xmedical
x
encounter xto xexpedite xdischarge, xthe xHFMA xbest xpractice xis
xto:
x
,a) Make xsure xthat xthe xattending xstaff xcan xanswer xquestions xand
xassist xin xobtaining xrequired xpatient xfinancial xdata x
b) Have xa xpatient xfinancial xresponsibilities xkit xready xfor xthe
xpatient, xcontaining xall xof xthe xrequired xregistration xforms xand
xinstructions x
c) Support xthat xchoice, xproviding xthat xthe xdiscussion xdoes xnot
xinterfere xwith xpatient xcare xor xdisrupt xpatient xflow x
d) Decline xsuch xrequest xas xfinance xdiscussions xcan xdisrupt
xpatient xcare xand xpatient xflow x- x xcorrect xanswer. x x xC x
x
A xcomprehensive x"Compliance xProgram" xis xdefined xas x
x
a) Annual xlegal xaudit xand xreview xfor xadherence xto xregulations x
b) Educating xstaff xon xregulations x
c) Systematic xprocedures xto xensure xthat xthe xprovisions xof xregulations
ximposed xby xa xgovernment xagency xare xbeing xmet x
d) The xdevelopment xof xoperational xpolicies xthat xcorrespond xto xregulations x- x
xcorrect xanswer. x x xC x
x
Case xManagement xrequires xthat xa xcase xmanager xbe xassigned x
x
a) To xpatients xof xany xphysician xrequesting xcase xmanagement x
b) To xa xselect xpatient xgroup x
c) To xevery xpatient x
d) To xspecific xcases xdesignated xby xthird xparty xcontractual xagreement x- x xcorrect
xanswer. x x x
Bx
x
Pricing xtransparency xis xdefined xas xreadily xavailable xinformation xon xthe xprice xof
xhealthcare xservices, xthat xtogether xwith xother xinformation, xhelp xdefine xthe xvalue xof
xthose xservices xand xenable xconsumers xto x
x
a) Identify, xcompare, xand xchoose xproviders xthat xoffer xthe xdesired xlevel xof xvalue x
b) Customize xhealth xcare xwith xa xpersonally xchosen xmix xof xproviders x
c) Negotiate xthe xcost xof xhealth xplan xpremiums x
x
d) xVerify xthe xcost xof xindividual xclinicians x- x xcorrect xanswer. x x xA x
x
Any xhealthcare xinsurance xplan xthat xprovides xor xensures xcomprehensive
xhealth xmaintenance xand xtreatment xservices xfor xan xenrolled xgroup xof xpersons
xbased xon xa xmonthly xfee xis xknown xas xa xa) xMSO x
b) HMO x
c) PPO x
d) GPO x- x xcorrect xanswer. x x xB x
x
In xa xChapter x7 xStraight xBankruptcy xfiling x
x
a) xThe xcourt xliquidates xthe xdebtor's xnonexempt xproperty,
xpays
, x
creditors, xand xdischarges xthe xdebtor xfrom xthe
xdebt
b) xThe xcourt xliquidates xthe xdebtor's xnonexempt xproperty,
xpays
creditors, xand xbegins xto xpay xoff xthe xlargest xclaims xfirst. xAll xclaims
xare xpaid xsome xportion xof xthe xamount xowed x
c) The xcourt xvacates xall xclaims xagainst xa xdebtor xwith xthe
xunderstanding xthat xthe xdebtor xmay xnot xapply xfor xcredit xwithout
xcourt xsupervision x
d) The xcourt xestablishes xa xcreditor xpayment xschedule xwith
xthe xlongest xoutstanding xclaims xpaid xfirst x- x xcorrect xanswer. x x xA x
x
The xcore xfinancial xactivities xresolved xwithin xpatient xaccess xinclude: x
x
a) Scheduling, xpre-registration, xinsurance xverification xand
xmanaged xcare xprocessing x
b) Scheduling, xinsurance xverification, xclinical xdischarge
xprocessing xand xpayment xposting xof xpoint xof xservice xreceipts x
c) Scheduling, xregistration, xcharge xentry xand xmanaged xcare
xprocessing x
d) Scheduling, xpre-registration, xregistration, xmedical xnecessity
xscreening xand xpatient xrefunds x- x xcorrect xanswer. x x x A x
x
Which xof xthe xfollowing xis xNOT xcontained xin xa xcollection xagency xagreement? x
x
a) xA xclear xunderstanding xthat xthe xprovider xretains xownership xof
xany
x
outsourced
xactivities
x
b) xSpecific xlanguage xas xto xwho xwill xpay xlegal xfees, xif
xneeded
x
c) xAn xannual xrenewal
xclause
x
d) xA xmutual xhold-harmless xclause x- x xcorrect xanswer. x
x xD
x
Maintaining xroutine xcontact xwith xthe xhealth xplan xor xliability xpayer, xmaking xsure
xall
x
required xinformation xis xprovided xand xall xneeded xapprovals xare xobtained xis
xthe
x
responsibility
xof:
x
x
a) x Patient
xAccounts
x
x
x
x
x
x
x
x
x
CRCR Multiple Choice questions and
x x x x
answers 100% guaranteed success.
x x x x x
x
x
x
x
x
x
x
x
x
x
The xdisadvantages xof xoutsourcing xinclude xall xof xthe xfollowing
xEXCEPT: xa) xThe ximpact xof xcustomer xservice xor xpatient xrelations x
b) The ximpact xof xloss xof xdirect xcontrol xof xaccounts xreceivable xservices x
c) Increased xcosts xdue xto xvendor xineffectiveness x
d) Reduced xinternal xstaffing xcosts xand xa xreliance xon xoutsourced xstaff x- x xcorrect
xanswer. x x x
Dx
x
The xMedicare xfee-for xservice xappeal xprocess xfor xboth xbeneficiaries xand
xproviders
x
includes xall xof xthe xfollowing xlevels
xEXCEPT:
x
x
a) xMedical xnecessity xreview xby xan xindependent xphysician's
xpanel
x
b) xJudicial xreview xby xa xfederal xdistrict
xcourt
x
c) xRedetermination xby xthe xcompany xthat xhandles xclaims
xfor
x
Medicare
d) xReview xby xthe xMedicare xAppeals xCouncil x(Appeals xCouncil) x- x xcorrect xanswer.
x x xB
x
Business xethics, xor xorganizational xethics xrepresent: x
x
a) The xprinciples xand xstandards xby xwhich xorganizations xoperate x
b) Regulations xthat xmust xbe xfollowed xby xlaw x
c) Definitions xof xappropriate xcustomer xservice x
d) The xcode xof xacceptable xconduct x- x xcorrect xanswer. x x xA x
x
A xportion xof xthe xaccounts xreceivable xinventory xwhich xhas xNOT xqualified xfor
xbilling
, x
includes:
x
x
a) xCharitable
xpledges
x
b) xAccounts xcreated xduring xpre-registration xbut xnot
xactivated
x
c) xAccounts xcoded xbut xheld xwithin xthe xsuspense
xperiod
d) xAccounts xassigned xto xa xpre-collection xagency x- x xcorrect xanswer.
x x xA
x
Local xCoverage xDeterminations x(LCD) xand xNational xCoverage xDeterminations
x(NCD) x
x
are
x
Medicare xestablished xguideline(s) xused xto
xdetermine:
x
a) Medicare xand xMedicaid xprovider xeligibility x
b) Medicare xoutpatient xreimbursement xrates x
c) Which xdiagnoses, xsigns, xor xsymptoms xare xreimbursable x
d) What xMedicare xreimburses xand xwhat xshould xbe xreferred xto x
Medicaid x- x xcorrect xanswer. x x xC x
x
Days xin xA/R xis xcalculated xbased xon xthe xvalue xof: x
x
a) The xtotal xaccounts xreceivable xon xa xspecific xdate x
b) Total xanticipated xrevenue xminus xexpenses x
c) The xtime xit xtakes xto xcollect xanticipated xrevenue x
x
d) xTotal xcash xreceived xto xdate x- x xcorrect xanswer. x x xC x
x
Patients xare xcontacting xhospitals xto xproactively xinquire xabout xcosts xand xfees
xprior xto xagreeing xto xservice. xThe xproblem xfor xhospitals xin xproviding xsuch
xinformation xis: xa) xThat xhospitals xdon't xwant xto xestablish xa xprice xwithout
xknowing xif xthe xpatient xhas xinsurance xand xhow xmuch xreimbursement xcan xbe
xexpected x
b) xThe xfact xthat xcharge xmaster xlists xthe xtotal xcharge, xnot xnet
xcharges xthat xreflect xcharges xafter xa xpayer's xcontractual
xadjustment xc) xThat xhospitals xdon't xwant xto xbe xput xin xthe xposition
xof x"guaranteeing" xprice xwithout xhaving xroom xfor xadditional
xcharges xthat xmay xarise xin xthe xcourse xof xtreatment x
d) xTheir xreluctance xto xshare xproprietary xinformation x- x xcorrect xanswer. x x xB x
x
Across xall xcare xsettings, xif xa xpatient xconsents xto xa xfinancial xdiscussion xduring xa
xmedical
x
encounter xto xexpedite xdischarge, xthe xHFMA xbest xpractice xis
xto:
x
,a) Make xsure xthat xthe xattending xstaff xcan xanswer xquestions xand
xassist xin xobtaining xrequired xpatient xfinancial xdata x
b) Have xa xpatient xfinancial xresponsibilities xkit xready xfor xthe
xpatient, xcontaining xall xof xthe xrequired xregistration xforms xand
xinstructions x
c) Support xthat xchoice, xproviding xthat xthe xdiscussion xdoes xnot
xinterfere xwith xpatient xcare xor xdisrupt xpatient xflow x
d) Decline xsuch xrequest xas xfinance xdiscussions xcan xdisrupt
xpatient xcare xand xpatient xflow x- x xcorrect xanswer. x x xC x
x
A xcomprehensive x"Compliance xProgram" xis xdefined xas x
x
a) Annual xlegal xaudit xand xreview xfor xadherence xto xregulations x
b) Educating xstaff xon xregulations x
c) Systematic xprocedures xto xensure xthat xthe xprovisions xof xregulations
ximposed xby xa xgovernment xagency xare xbeing xmet x
d) The xdevelopment xof xoperational xpolicies xthat xcorrespond xto xregulations x- x
xcorrect xanswer. x x xC x
x
Case xManagement xrequires xthat xa xcase xmanager xbe xassigned x
x
a) To xpatients xof xany xphysician xrequesting xcase xmanagement x
b) To xa xselect xpatient xgroup x
c) To xevery xpatient x
d) To xspecific xcases xdesignated xby xthird xparty xcontractual xagreement x- x xcorrect
xanswer. x x x
Bx
x
Pricing xtransparency xis xdefined xas xreadily xavailable xinformation xon xthe xprice xof
xhealthcare xservices, xthat xtogether xwith xother xinformation, xhelp xdefine xthe xvalue xof
xthose xservices xand xenable xconsumers xto x
x
a) Identify, xcompare, xand xchoose xproviders xthat xoffer xthe xdesired xlevel xof xvalue x
b) Customize xhealth xcare xwith xa xpersonally xchosen xmix xof xproviders x
c) Negotiate xthe xcost xof xhealth xplan xpremiums x
x
d) xVerify xthe xcost xof xindividual xclinicians x- x xcorrect xanswer. x x xA x
x
Any xhealthcare xinsurance xplan xthat xprovides xor xensures xcomprehensive
xhealth xmaintenance xand xtreatment xservices xfor xan xenrolled xgroup xof xpersons
xbased xon xa xmonthly xfee xis xknown xas xa xa) xMSO x
b) HMO x
c) PPO x
d) GPO x- x xcorrect xanswer. x x xB x
x
In xa xChapter x7 xStraight xBankruptcy xfiling x
x
a) xThe xcourt xliquidates xthe xdebtor's xnonexempt xproperty,
xpays
, x
creditors, xand xdischarges xthe xdebtor xfrom xthe
xdebt
b) xThe xcourt xliquidates xthe xdebtor's xnonexempt xproperty,
xpays
creditors, xand xbegins xto xpay xoff xthe xlargest xclaims xfirst. xAll xclaims
xare xpaid xsome xportion xof xthe xamount xowed x
c) The xcourt xvacates xall xclaims xagainst xa xdebtor xwith xthe
xunderstanding xthat xthe xdebtor xmay xnot xapply xfor xcredit xwithout
xcourt xsupervision x
d) The xcourt xestablishes xa xcreditor xpayment xschedule xwith
xthe xlongest xoutstanding xclaims xpaid xfirst x- x xcorrect xanswer. x x xA x
x
The xcore xfinancial xactivities xresolved xwithin xpatient xaccess xinclude: x
x
a) Scheduling, xpre-registration, xinsurance xverification xand
xmanaged xcare xprocessing x
b) Scheduling, xinsurance xverification, xclinical xdischarge
xprocessing xand xpayment xposting xof xpoint xof xservice xreceipts x
c) Scheduling, xregistration, xcharge xentry xand xmanaged xcare
xprocessing x
d) Scheduling, xpre-registration, xregistration, xmedical xnecessity
xscreening xand xpatient xrefunds x- x xcorrect xanswer. x x x A x
x
Which xof xthe xfollowing xis xNOT xcontained xin xa xcollection xagency xagreement? x
x
a) xA xclear xunderstanding xthat xthe xprovider xretains xownership xof
xany
x
outsourced
xactivities
x
b) xSpecific xlanguage xas xto xwho xwill xpay xlegal xfees, xif
xneeded
x
c) xAn xannual xrenewal
xclause
x
d) xA xmutual xhold-harmless xclause x- x xcorrect xanswer. x
x xD
x
Maintaining xroutine xcontact xwith xthe xhealth xplan xor xliability xpayer, xmaking xsure
xall
x
required xinformation xis xprovided xand xall xneeded xapprovals xare xobtained xis
xthe
x
responsibility
xof:
x
x
a) x Patient
xAccounts
