CRCR PRACTICE QUESTIONS AND
ACCURATE SOLUTIONS
The 501(r) regulations require not-for-
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profit providers 501(c) (3) to do which of the following activities?
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A. Complete a community needs assessment and develop a discount program for patient balance
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s after insurance payment.
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B. Pursue extraordinary collection activities with all patients eligible for financial assistance.
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C. Implement a financial assistance program for uninsured and underinsured patients.
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D. Discount all charges to self-pay patients to an amount generally billed to all other patients. -
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answersA. Complete a community needs assessment and develop a discount program for patient
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balances after insurance payment rh rh rh
The accurate capture of charges remains critically important because:
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A. Of the potential of fraud and abuse charges from erroneous billing.
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B. Charges remain one of the few consistent indicators available to monitor resource use.
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C. Charges are means of measuring physician productivity.
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D. Charges provide the data used in activity based costing. -
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answersB. Charges remain one of the few consistent indicators available to monitor resource use
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The ACO investment model will test the use of pre-paid shared savings to:
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A. Invest in treatment protocols that reduce costs to Medicare
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B. Attract physicians to participate in the ACO payment system.
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C. Raise quality ratings in designated hospitals.
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D. Encourage new ACOs to form in rural and underserved areas. -
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answersD. Encourage new ACOs to form in rural and underserved areas
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,Across all care settings, if a patient consents to a financial discussion during a medical encounter to
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expedite discharge, the HFMA best practice is to:
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A. Have a patient financial responsibilities kit ready for the patient, containing all of the required re
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gistration forms and instructions. rh rh rh
B. Make sure that the attending staff can answer questions and assist in obtaining required patient
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financial data. rh
C. Support that choice, providing that the discussion does not interfere with patient care or disrup
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t patient flow.
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D. Decline such request as finance discussions can disrupt patient care and patient flow. -
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answersC. Support that choice, providing that the discussion does not interfere with patient care
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or disrupt patient flow
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Activities completed when the scheduled, pre-registered patient arrives for service includes:
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A. Verifying insurance, activating the record and directing the patient to the service area.
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B. Scanning the driver's license or other phot identification and directing the patient to the financi
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al counselor.
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C. Activating the record, obtaining signatures and finalizing financial issues.
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D. Registering the patient and directing the patient to the service area. -
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answersC. Activating the record, obtaining signatures and
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The activity which results in the accurate recording of patient bed and level of care assessment, pa
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tient transfer and patient discharge status on a real-time basis is known as:
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A. Utilization review
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B. Case Management
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C. Census Management
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D. Patient through-put - answersA. Utilization review
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or rh
B. Case Management
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An advantage of a pre-registration program is:
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A. The markets value of such a program
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,B. The ability to eliminate no-show appointments.
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C. The opportunity to reduce processing times at the time of service.
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D. The opportunity to reduce corporate compliance failures within the registration process. -
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answersC. The opportunity to reduce processing times at the time of service.
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The Affordable Care Act legislated the development of Health Insurance Exchanges, where indivi
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duals and small businesses can:rh rh rh rh
A. Obtain price estimates for medical services
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B. Negotiate the price of medical services with providers
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C. Purchase qualified health benefit plans regardless of insured's health status
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D. Meet federal mandates for insurance coverage and obtain the corresponding tax deduction -
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answersC. Purchase qualified health benefit plans regardless of insured's health status.
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All of the following are conditions that disqualify a procedure or service from being paid for by Me
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dicare EXCEPT: rh
A. Offered in an outpatient setting
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B. Medically unnecessary
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C. Not delivered in a Medicare licensed care setting.
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D. Services and procedures that are custodial in nature -
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answersC. Not delivered in a Medicare licensed care setting
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All of the following are reference resources used to help guide in the application for business ethic
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s EXCEPT:
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A. Consumer satisfaction reports
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B. Mission & Value Statements
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C. Code of Ethics / Code of Conduct
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D. Compliance Office & Policies - answersA. Consumer satisfaction reports
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All of the following are steps in safeguarding collections EXCEPT:
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A. Placing collections in a lock-box for posting review the next business day.
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, B. Posting the payment to the patient's account
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C. Completing balancing activities
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D. Issuing receipts - answersA. Placing collections in a lock-
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box for posting review the next business day
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All of the following are steps in verifying insurance EXCEPT:
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A. Sequencing plans involved in a coordination of benefits (COB) situation.
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B. The patient signing the statement of financial responsibility.
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C. Identifying and documenting the patient's health plan benefits
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D. Confirming the patient's eligibility for benefits -
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answersB. The patient signing the statement of financial responsibility
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All of the following information is used to identify a patient EXCEPT:
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A. Date of Birth
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B. Gender
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C. Social Security Number
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D. Address - answersD. Address
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All of the following information should be reviewed as part of schedule finalization EXCEPT:
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A. The estimated patient financial obligations
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B. The service to be provided
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C. The arrival time and procedure time
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D. The patient's preparation instructions - answersA. The estimated patient financial obligations
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Ambulance services are billed directly to the health plan for : rh rh rh rh rh rh rh rh rh rh
A. All pre-admission emergency transports
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B. Transport deemed medically necessary by the attending paramedic-ambulance crew
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C. Services provided before a patient is admitted and for ambulance rides arranged to pick up the p
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atient from the hospital after discharge to take him/her home or to another facility
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ACCURATE SOLUTIONS
The 501(r) regulations require not-for-
rh rh rh rh
profit providers 501(c) (3) to do which of the following activities?
rh rh rh rh rh rh rh rh rh rh
A. Complete a community needs assessment and develop a discount program for patient balance
rh rh rh rh rh rh rh rh rh rh rh rh rh
s after insurance payment.
rh rh rh
B. Pursue extraordinary collection activities with all patients eligible for financial assistance.
rh rh rh rh rh rh rh rh rh rh rh
C. Implement a financial assistance program for uninsured and underinsured patients.
rh rh rh rh rh rh rh rh rh rh
D. Discount all charges to self-pay patients to an amount generally billed to all other patients. -
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
answersA. Complete a community needs assessment and develop a discount program for patient
rh rh rh rh rh rh rh rh rh rh rh rh rh rh
balances after insurance payment rh rh rh
The accurate capture of charges remains critically important because:
rh rh rh rh rh rh rh rh
A. Of the potential of fraud and abuse charges from erroneous billing.
rh rh rh rh rh rh rh rh rh rh rh
B. Charges remain one of the few consistent indicators available to monitor resource use.
rh rh rh rh rh rh rh rh rh rh rh rh rh
C. Charges are means of measuring physician productivity.
rh rh rh rh rh rh rh
D. Charges provide the data used in activity based costing. -
rh rh rh rh rh rh rh rh rh rh
answersB. Charges remain one of the few consistent indicators available to monitor resource use
rh rh rh rh rh rh rh rh rh rh rh rh rh rh
The ACO investment model will test the use of pre-paid shared savings to:
rh rh rh rh rh rh rh rh rh rh rh rh
A. Invest in treatment protocols that reduce costs to Medicare
rh rh rh rh rh rh rh rh rh
B. Attract physicians to participate in the ACO payment system.
rh rh rh rh rh rh rh rh rh
C. Raise quality ratings in designated hospitals.
rh rh rh rh rh rh
D. Encourage new ACOs to form in rural and underserved areas. -
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answersD. Encourage new ACOs to form in rural and underserved areas
rh rh rh rh rh rh rh rh rh rh rh
,Across all care settings, if a patient consents to a financial discussion during a medical encounter to
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
expedite discharge, the HFMA best practice is to:
rh rh rh rh rh rh rh rh
A. Have a patient financial responsibilities kit ready for the patient, containing all of the required re
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
gistration forms and instructions. rh rh rh
B. Make sure that the attending staff can answer questions and assist in obtaining required patient
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
financial data. rh
C. Support that choice, providing that the discussion does not interfere with patient care or disrup
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
t patient flow.
rh rh
D. Decline such request as finance discussions can disrupt patient care and patient flow. -
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answersC. Support that choice, providing that the discussion does not interfere with patient care
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
or disrupt patient flow
rh rh rh
Activities completed when the scheduled, pre-registered patient arrives for service includes:
rh rh rh rh rh rh rh rh rh rh
A. Verifying insurance, activating the record and directing the patient to the service area.
rh rh rh rh rh rh rh rh rh rh rh rh rh
B. Scanning the driver's license or other phot identification and directing the patient to the financi
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
al counselor.
rh
C. Activating the record, obtaining signatures and finalizing financial issues.
rh rh rh rh rh rh rh rh rh
D. Registering the patient and directing the patient to the service area. -
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answersC. Activating the record, obtaining signatures and
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The activity which results in the accurate recording of patient bed and level of care assessment, pa
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
tient transfer and patient discharge status on a real-time basis is known as:
rh rh rh rh rh rh rh rh rh rh rh rh
A. Utilization review
rh rh
B. Case Management
rh rh rh
C. Census Management
rh rh
D. Patient through-put - answersA. Utilization review
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or rh
B. Case Management
rh rh
An advantage of a pre-registration program is:
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A. The markets value of such a program
rh rh rh rh rh rh rh
,B. The ability to eliminate no-show appointments.
rh rh rh rh rh rh
C. The opportunity to reduce processing times at the time of service.
rh rh rh rh rh rh rh rh rh rh rh
D. The opportunity to reduce corporate compliance failures within the registration process. -
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answersC. The opportunity to reduce processing times at the time of service.
rh rh rh rh rh rh rh rh rh rh rh rh
The Affordable Care Act legislated the development of Health Insurance Exchanges, where indivi
rh rh rh rh rh rh rh rh rh rh rh rh
duals and small businesses can:rh rh rh rh
A. Obtain price estimates for medical services
rh rh rh rh rh rh
B. Negotiate the price of medical services with providers
rh rh rh rh rh rh rh rh
C. Purchase qualified health benefit plans regardless of insured's health status
rh rh rh rh rh rh rh rh rh rh
D. Meet federal mandates for insurance coverage and obtain the corresponding tax deduction -
rh rh rh rh rh rh rh rh rh rh rh rh rh
answersC. Purchase qualified health benefit plans regardless of insured's health status.
rh rh rh rh rh rh rh rh rh rh rh
All of the following are conditions that disqualify a procedure or service from being paid for by Me
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
dicare EXCEPT: rh
A. Offered in an outpatient setting
rh rh rh rh rh
B. Medically unnecessary
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C. Not delivered in a Medicare licensed care setting.
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D. Services and procedures that are custodial in nature -
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answersC. Not delivered in a Medicare licensed care setting
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All of the following are reference resources used to help guide in the application for business ethic
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
s EXCEPT:
rh
A. Consumer satisfaction reports
rh rh rh
B. Mission & Value Statements
rh rh rh rh
C. Code of Ethics / Code of Conduct
rh rh rh rh rh rh rh
D. Compliance Office & Policies - answersA. Consumer satisfaction reports
rh rh rh rh rh rh rh rh rh
All of the following are steps in safeguarding collections EXCEPT:
rh rh rh rh rh rh rh rh rh
A. Placing collections in a lock-box for posting review the next business day.
rh rh rh rh rh rh rh rh rh rh rh rh
, B. Posting the payment to the patient's account
rh rh rh rh rh rh rh rh
C. Completing balancing activities
rh rh rh
D. Issuing receipts - answersA. Placing collections in a lock-
rh rh rh rh rh rh rh rh rh
box for posting review the next business day
rh rh rh rh rh rh rh
All of the following are steps in verifying insurance EXCEPT:
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A. Sequencing plans involved in a coordination of benefits (COB) situation.
rh rh rh rh rh rh rh rh rh rh
B. The patient signing the statement of financial responsibility.
rh rh rh rh rh rh rh rh
C. Identifying and documenting the patient's health plan benefits
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D. Confirming the patient's eligibility for benefits -
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answersB. The patient signing the statement of financial responsibility
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All of the following information is used to identify a patient EXCEPT:
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A. Date of Birth
rh rh rh
B. Gender
rh
C. Social Security Number
rh rh rh
D. Address - answersD. Address
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All of the following information should be reviewed as part of schedule finalization EXCEPT:
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A. The estimated patient financial obligations
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B. The service to be provided
rh rh rh rh rh
C. The arrival time and procedure time
rh rh rh rh rh rh
D. The patient's preparation instructions - answersA. The estimated patient financial obligations
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Ambulance services are billed directly to the health plan for : rh rh rh rh rh rh rh rh rh rh
A. All pre-admission emergency transports
rh rh rh rh
B. Transport deemed medically necessary by the attending paramedic-ambulance crew
rh rh rh rh rh rh rh rh rh
C. Services provided before a patient is admitted and for ambulance rides arranged to pick up the p
rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh rh
atient from the hospital after discharge to take him/her home or to another facility
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