CHAM ARRIVAL – REVENUE CYCLE EXAM QUESTIONS
WITH FULLY 100% VERIFIED ANSWERS LATEST UPDATED
250 QUESTIONS AND ANSWERS
1. Q: What information is required during the initial patient
registration?
A: Patient's full name, date of birth, address, phone number, email,
insurance information, guarantor information, photo ID, and reason for
visit.
2. Q: How do we verify insurance eligibility?
A: Insurance eligibility is verified through the electronic verification
system, by calling the insurance company directly, or by using the payer's
web portal.
3. Q: What is the process for collecting patient copayments?
A: Copayments should be collected at the time of service before the
patient sees the provider. The amount is verified through insurance
eligibility verification and can be paid by credit card, check, or cash.
4. Q: How do we handle patients without insurance?
A: Uninsured patients should be informed about self-pay rates, potential
financial assistance programs, and payment plan options. They should
also be referred to financial counseling.
5. Q: What is the procedure for obtaining insurance authorization for
services?
A: Check if the service requires pre-authorization, contact the insurance
provider with the CPT codes, diagnosis, and provider information,
document the authorization number, and enter it into the system.
6. Q: How long before an appointment should insurance verification be
completed?
A: Insurance verification should be completed at least 72 hours (3
business days) before a scheduled appointment.
,7. Q: What is the policy for accepting referrals?
A: Referrals must have a valid authorization number, date range, number
of approved visits, referring provider information, and be entered into the
system before the patient's appointment.
8. Q: How do we handle insurance changes reported during check-in?
A: Collect the new insurance card, update the system, verify eligibility
immediately, determine if authorization is needed, and inform the patient
of any changes in coverage or responsibility.
9. Q: What is the process for updating patient demographics?
A: Ask patients to verify their information at each visit, update any
changes in the system immediately, and have the patient sign a form
confirming the accuracy of information.
10.Q: How do we register emergency patients?
A: Use quick registration protocols to capture essential information, then
complete the full registration after the patient has been stabilized or when
family members are available.
11.Q: What documents must be signed during registration?
A: Consent for treatment, HIPAA acknowledgment, financial
responsibility agreement, and assignment of benefits form.
12.Q: How do we handle minors arriving without parents/guardians?
A: Check for existing consent forms on file. If none exist, attempt to
contact the parent/guardian for verbal consent and documentation. For
emergency situations, follow EMTALA protocols.
13.Q: What is the procedure for collecting past-due balances during
check-in?
A: Verify outstanding balances, inform the patient of the amount due,
request payment, and offer payment plan options if the patient cannot pay
in full.
14.Q: How do we determine patient financial responsibility before
service?
A: Verify insurance benefits, calculate the patient responsibility based on
deductible, co-insurance and copay information, and provide a cost
estimate to the patient.
15.Q: What information should be included in a patient estimate?
A: Expected services with CPT codes, charges for each service, estimated
insurance coverage, and the patient's expected out-of-pocket cost.
, 16.Q: How do we handle insurance cards that appear altered or
fraudulent?
A: Document concerns, verify coverage directly with the insurance
company, notify supervisor, and follow facility protocol for suspected
fraud.
17.Q: What is the procedure for scheduling follow-up appointments
during checkout?
A: Confirm provider recommendations, check provider availability,
schedule the appointment, provide written confirmation to the patient,
and send reminders according to protocol.
18.Q: How do we process referrals to specialists?
A: Verify the referral in the system, check insurance requirements, obtain
necessary authorizations, provide the patient with referral information,
and forward required clinical documentation.
19.Q: What is the time frame for obtaining prior authorizations for
procedures?
A: Start the authorization process at least 7-10 business days before the
scheduled procedure date.
20.Q: How do we handle patients who cannot pay their copay at time of
service?
A: Inform the patient of the requirement, offer payment plan options,
provide financial assistance application if appropriate, document the
situation, and reschedule non-urgent appointments if needed.
Charge Capture and Coding
21.Q: What is the standard timeframe for completing charge entry after
service?
A: Charges should be entered within 24-48 hours of service provision.
22.Q: How do we ensure all billable supplies are captured?
A: Use supply charge sheets, barcode scanning for inventory
management, and regular audits to compare supplies used versus supplies
charged.
23.Q: What documentation is required to support a level 5 E/M code?
A: Comprehensive history, comprehensive examination, and high-
complexity medical decision making must be documented.
24.Q: How do we handle missed charges identified after the patient has
left?
, A: Document the missed charge with supporting information, enter it into
the system as soon as identified, and flag for review if it's past timely
filing guidelines.
25.Q: What is the process for coding complex procedures?
A: Review complete documentation, consult CPT guidelines, determine
primary and secondary codes, apply appropriate modifiers, and review for
medical necessity.
26.Q: How do we manage charge capture for procedures performed in
the operating room?
A: Use OR logs, procedure notes, and charge sheets completed by the
surgeon, cross-reference with nursing documentation, and reconcile any
discrepancies.
27.Q: What steps are taken to prevent duplicate charges?
A: Verify previous charges in the system before entry, use automated
duplicate checking features, and conduct daily charge reconciliation.
28.Q: How do we code for multiple procedures performed during the
same session?
A: Identify the primary procedure, apply multiple procedure modifiers for
secondary procedures, and follow CCI edits and bundling rules.
29.Q: What documentation is required for infusion service coding?
A: Start and stop times, medication administered, route of administration,
and nurse documentation of the infusion process.
30.Q: How are medication charges calculated and captured?
A: Based on dosage administered, using the NDC number, with charges
entered either through the pharmacy system or clinical documentation
system.
31.Q: What is the process for charge reconciliation?
A: Compare scheduled appointments with service documentation and
entered charges, identify and research discrepancies, and make
corrections before billing.
32.Q: How do we ensure correct modifier usage?
A: Review clinical documentation, follow CPT guidelines, use decision
support tools, and implement secondary coding review for complex cases.
33.Q: What is the procedure for charging for services provided by
residents?
A: Document attending physician supervision, ensure proper attestation is
WITH FULLY 100% VERIFIED ANSWERS LATEST UPDATED
250 QUESTIONS AND ANSWERS
1. Q: What information is required during the initial patient
registration?
A: Patient's full name, date of birth, address, phone number, email,
insurance information, guarantor information, photo ID, and reason for
visit.
2. Q: How do we verify insurance eligibility?
A: Insurance eligibility is verified through the electronic verification
system, by calling the insurance company directly, or by using the payer's
web portal.
3. Q: What is the process for collecting patient copayments?
A: Copayments should be collected at the time of service before the
patient sees the provider. The amount is verified through insurance
eligibility verification and can be paid by credit card, check, or cash.
4. Q: How do we handle patients without insurance?
A: Uninsured patients should be informed about self-pay rates, potential
financial assistance programs, and payment plan options. They should
also be referred to financial counseling.
5. Q: What is the procedure for obtaining insurance authorization for
services?
A: Check if the service requires pre-authorization, contact the insurance
provider with the CPT codes, diagnosis, and provider information,
document the authorization number, and enter it into the system.
6. Q: How long before an appointment should insurance verification be
completed?
A: Insurance verification should be completed at least 72 hours (3
business days) before a scheduled appointment.
,7. Q: What is the policy for accepting referrals?
A: Referrals must have a valid authorization number, date range, number
of approved visits, referring provider information, and be entered into the
system before the patient's appointment.
8. Q: How do we handle insurance changes reported during check-in?
A: Collect the new insurance card, update the system, verify eligibility
immediately, determine if authorization is needed, and inform the patient
of any changes in coverage or responsibility.
9. Q: What is the process for updating patient demographics?
A: Ask patients to verify their information at each visit, update any
changes in the system immediately, and have the patient sign a form
confirming the accuracy of information.
10.Q: How do we register emergency patients?
A: Use quick registration protocols to capture essential information, then
complete the full registration after the patient has been stabilized or when
family members are available.
11.Q: What documents must be signed during registration?
A: Consent for treatment, HIPAA acknowledgment, financial
responsibility agreement, and assignment of benefits form.
12.Q: How do we handle minors arriving without parents/guardians?
A: Check for existing consent forms on file. If none exist, attempt to
contact the parent/guardian for verbal consent and documentation. For
emergency situations, follow EMTALA protocols.
13.Q: What is the procedure for collecting past-due balances during
check-in?
A: Verify outstanding balances, inform the patient of the amount due,
request payment, and offer payment plan options if the patient cannot pay
in full.
14.Q: How do we determine patient financial responsibility before
service?
A: Verify insurance benefits, calculate the patient responsibility based on
deductible, co-insurance and copay information, and provide a cost
estimate to the patient.
15.Q: What information should be included in a patient estimate?
A: Expected services with CPT codes, charges for each service, estimated
insurance coverage, and the patient's expected out-of-pocket cost.
, 16.Q: How do we handle insurance cards that appear altered or
fraudulent?
A: Document concerns, verify coverage directly with the insurance
company, notify supervisor, and follow facility protocol for suspected
fraud.
17.Q: What is the procedure for scheduling follow-up appointments
during checkout?
A: Confirm provider recommendations, check provider availability,
schedule the appointment, provide written confirmation to the patient,
and send reminders according to protocol.
18.Q: How do we process referrals to specialists?
A: Verify the referral in the system, check insurance requirements, obtain
necessary authorizations, provide the patient with referral information,
and forward required clinical documentation.
19.Q: What is the time frame for obtaining prior authorizations for
procedures?
A: Start the authorization process at least 7-10 business days before the
scheduled procedure date.
20.Q: How do we handle patients who cannot pay their copay at time of
service?
A: Inform the patient of the requirement, offer payment plan options,
provide financial assistance application if appropriate, document the
situation, and reschedule non-urgent appointments if needed.
Charge Capture and Coding
21.Q: What is the standard timeframe for completing charge entry after
service?
A: Charges should be entered within 24-48 hours of service provision.
22.Q: How do we ensure all billable supplies are captured?
A: Use supply charge sheets, barcode scanning for inventory
management, and regular audits to compare supplies used versus supplies
charged.
23.Q: What documentation is required to support a level 5 E/M code?
A: Comprehensive history, comprehensive examination, and high-
complexity medical decision making must be documented.
24.Q: How do we handle missed charges identified after the patient has
left?
, A: Document the missed charge with supporting information, enter it into
the system as soon as identified, and flag for review if it's past timely
filing guidelines.
25.Q: What is the process for coding complex procedures?
A: Review complete documentation, consult CPT guidelines, determine
primary and secondary codes, apply appropriate modifiers, and review for
medical necessity.
26.Q: How do we manage charge capture for procedures performed in
the operating room?
A: Use OR logs, procedure notes, and charge sheets completed by the
surgeon, cross-reference with nursing documentation, and reconcile any
discrepancies.
27.Q: What steps are taken to prevent duplicate charges?
A: Verify previous charges in the system before entry, use automated
duplicate checking features, and conduct daily charge reconciliation.
28.Q: How do we code for multiple procedures performed during the
same session?
A: Identify the primary procedure, apply multiple procedure modifiers for
secondary procedures, and follow CCI edits and bundling rules.
29.Q: What documentation is required for infusion service coding?
A: Start and stop times, medication administered, route of administration,
and nurse documentation of the infusion process.
30.Q: How are medication charges calculated and captured?
A: Based on dosage administered, using the NDC number, with charges
entered either through the pharmacy system or clinical documentation
system.
31.Q: What is the process for charge reconciliation?
A: Compare scheduled appointments with service documentation and
entered charges, identify and research discrepancies, and make
corrections before billing.
32.Q: How do we ensure correct modifier usage?
A: Review clinical documentation, follow CPT guidelines, use decision
support tools, and implement secondary coding review for complex cases.
33.Q: What is the procedure for charging for services provided by
residents?
A: Document attending physician supervision, ensure proper attestation is
