CRCR Certification exam study test
guide with latest updated questions
The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of the following
activities?
A. Complete a community needs assessment and develop a discount program for patient
balances after insurance payment.
B. Pursue extraordinary collection activities with all patients eligible for financial assistance.
C. Implement a financial assistance program for uninsured and underinsured patients.
D. Discount all charges to self-pay patients to an amount generally billed to all other patients. -
ANSA. Complete a community needs assessment and develop a discount program for patient
balances after insurance payment
The accurate capture of charges remains critically important because:
A. Of the potential of fraud and abuse charges from erroneous billing.
B. Charges remain one of the few consistent indicators available to monitor resource use.
C. Charges are means of measuring physician productivity.
D. Charges provide the data used in activity based costing. - ANSB. Charges remain one of
the few consistent indicators available to monitor resource use
The ACO investment model will test the use of pre-paid shared savings to:
A. Invest in treatment protocols that reduce costs to Medicare
B. Attract physicians to participate in the ACO payment system.
C. Raise quality ratings in designated hospitals.
D. Encourage new ACOs to form in rural and underserved areas. - ANSD. Encourage new
ACOs to form in rural and underserved areas
Across all care settings, if a patient consents to a financial discussion during a medical
encounter to expedite discharge, the HFMA best practice is to:
A. Have a patient financial responsibilities kit ready for the patient, containing all of the required
registration forms and instructions.
B. Make sure that the attending staff can answer questions and assist in obtaining required
patient financial data.
C. Support that choice, providing that the discussion does not interfere with patient care or
disrupt patient flow.
D. Decline such request as finance discussions can disrupt patient care and patient flow. -
ANSC. Support that choice, providing that the discussion does not interfere with patient care or
disrupt patient flow
,Activities completed when the scheduled, pre-registered patient arrives for service includes:
A. Verifying insurance, activating the record and directing the patient to the service area.
B. Scanning the driver's license or other phot identification and directing the patient to the
financial counselor.
C. Activating the record, obtaining signatures and finalizing financial issues.
D. Registering the patient and directing the patient to the service area. - ANSC. Activating the
record, obtaining signatures and
The activity which results in the accurate recording of patient bed and level of care assessment,
patient transfer and patient discharge status on a real-time basis is known as:
A. Utilization review
B. Case Management
C. Census Management
D. Patient through-put - ANSA. Utilization review
or
B. Case Management
An advantage of a pre-registration program is:
A. The markets value of such a program
B. The ability to eliminate no-show appointments.
C. The opportunity to reduce processing times at the time of service.
D. The opportunity to reduce corporate compliance failures within the registration process. -
ANSC. The opportunity to reduce processing times at the time of service.
The Affordable Care Act legislated the development of Health Insurance Exchanges, where
individuals and small businesses can:
A. Obtain price estimates for medical services
B. Negotiate the price of medical services with providers
C. Purchase qualified health benefit plans regardless of insured's health status
D. Meet federal mandates for insurance coverage and obtain the corresponding tax deduction -
ANSC. Purchase qualified health benefit plans regardless of insured's health status.
All of the following are conditions that disqualify a procedure or service from being paid for by
Medicare EXCEPT:
A. Offered in an outpatient setting
B. Medically unnecessary
C. Not delivered in a Medicare licensed care setting.
D. Services and procedures that are custodial in nature - ANSC. Not delivered in a Medicare
licensed care setting
All of the following are reference resources used to help guide in the application for business
ethics EXCEPT:
A. Consumer satisfaction reports
,B. Mission & Value Statements
C. Code of Ethics / Code of Conduct
D. Compliance Office & Policies - ANSA. Consumer satisfaction reports
All of the following are steps in safeguarding collections EXCEPT:
A. Placing collections in a lock-box for posting review the next business day.
B. Posting the payment to the patient's account
C. Completing balancing activities
D. Issuing receipts - ANSA. Placing collections in a lock-box for posting review the next
business day
All of the following are steps in verifying insurance EXCEPT:
A. Sequencing plans involved in a coordination of benefits (COB) situation.
B. The patient signing the statement of financial responsibility.
C. Identifying and documenting the patient's health plan benefits
D. Confirming the patient's eligibility for benefits - ANSB. The patient signing the statement of
financial responsibility
All of the following information is used to identify a patient EXCEPT:
A. Date of Birth
B. Gender
C. Social Security Number
D. Address - ANSD. Address
All of the following information should be reviewed as part of schedule finalization EXCEPT:
A. The estimated patient financial obligations
B. The service to be provided
C. The arrival time and procedure time
D. The patient's preparation instructions - ANSA. The estimated patient financial obligations
Ambulance services are billed directly to the health plan for :
A. All pre-admission emergency transports
B. Transport deemed medically necessary by the attending paramedic-ambulance crew
C. Services provided before a patient is admitted and for ambulance rides arranged to pick up
the patient from the hospital after discharge to take him/her home or to another facility
D. The portion of the bill outside of the patient's self-pay - ANSC. Services provided before a
patient is admitted and for ambulance rides arranged to pick up the patient from the hospital
after discharge to take him/her home or the another facility
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and
treatment services for an enrolled group of persons on a monthly fee is known as a:
A. HMO
B. PPO
C. MSO
, D. GPO - ANSA. HMO
Any provider that has filed a timely cost report may appeal an adverse final decision received
from the Medicare Administrative Contractor (MAC). This appeal may be filed with:
A. The Provider Reimbursement Review Board
B. The Department of Health and Human Services Provider Relations Division
C. A court appointed federal mediator
D. The Office of the Inspector General - ANSA. The Provider Reimbursement Review Board
Applying the contracted payment methodology to the total charges yields:
A. An estimated price
B. An anticipated health plan payment
C. A price justified revenue accrual
D. A pricing agreement - ANSA. An estimated price
Appropriate training for the patient financial counselling staff must cover all of the following
EXCEPT:
A. Patient financial communications best practices specific to staff role
B. Financial assistance policies
C. Documenting the conversation in the medical record
D. Available patient financing options - ANSC. Documenting the conversation in the medical
record
The basis for qualification in Medicaid is typically:
A. The Federal Poverty Guidelines
B. Financial need as demonstrated by the prior two-years federal income tax fillings
C. The patient's score on the Internal Revenue Service's Personal Wealth and Spending
indicator
D. Bank statements for the previous 18 months - ANSA. The Federal Poverty Guidelines
Because 501(r) regulations focus on identifying potentially eligible financial assistance patients,
hospitals must:
A. Capture their experience with such patients to properly budget
B. Hold financial conversations with patients as soon as possible
C. Build the necessary processes to handle the potentially lengthy payment schedules
D. Expedite payment processing of normal accounts receivables to protect cash flow - ANSB.
Hold financial conversations with patients as soon as possible
Before classifying and subsequently writing off an account to financial assistance or bad debt,
the hospital must establish policy, define appropriate criteria, implementation, identifying and
processing accounts and:
A. Obtain the patients income tax statements from the prior 2 years
B. Having the account triaged for any partial payment possibilities
C. Monitor compliance
guide with latest updated questions
The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of the following
activities?
A. Complete a community needs assessment and develop a discount program for patient
balances after insurance payment.
B. Pursue extraordinary collection activities with all patients eligible for financial assistance.
C. Implement a financial assistance program for uninsured and underinsured patients.
D. Discount all charges to self-pay patients to an amount generally billed to all other patients. -
ANSA. Complete a community needs assessment and develop a discount program for patient
balances after insurance payment
The accurate capture of charges remains critically important because:
A. Of the potential of fraud and abuse charges from erroneous billing.
B. Charges remain one of the few consistent indicators available to monitor resource use.
C. Charges are means of measuring physician productivity.
D. Charges provide the data used in activity based costing. - ANSB. Charges remain one of
the few consistent indicators available to monitor resource use
The ACO investment model will test the use of pre-paid shared savings to:
A. Invest in treatment protocols that reduce costs to Medicare
B. Attract physicians to participate in the ACO payment system.
C. Raise quality ratings in designated hospitals.
D. Encourage new ACOs to form in rural and underserved areas. - ANSD. Encourage new
ACOs to form in rural and underserved areas
Across all care settings, if a patient consents to a financial discussion during a medical
encounter to expedite discharge, the HFMA best practice is to:
A. Have a patient financial responsibilities kit ready for the patient, containing all of the required
registration forms and instructions.
B. Make sure that the attending staff can answer questions and assist in obtaining required
patient financial data.
C. Support that choice, providing that the discussion does not interfere with patient care or
disrupt patient flow.
D. Decline such request as finance discussions can disrupt patient care and patient flow. -
ANSC. Support that choice, providing that the discussion does not interfere with patient care or
disrupt patient flow
,Activities completed when the scheduled, pre-registered patient arrives for service includes:
A. Verifying insurance, activating the record and directing the patient to the service area.
B. Scanning the driver's license or other phot identification and directing the patient to the
financial counselor.
C. Activating the record, obtaining signatures and finalizing financial issues.
D. Registering the patient and directing the patient to the service area. - ANSC. Activating the
record, obtaining signatures and
The activity which results in the accurate recording of patient bed and level of care assessment,
patient transfer and patient discharge status on a real-time basis is known as:
A. Utilization review
B. Case Management
C. Census Management
D. Patient through-put - ANSA. Utilization review
or
B. Case Management
An advantage of a pre-registration program is:
A. The markets value of such a program
B. The ability to eliminate no-show appointments.
C. The opportunity to reduce processing times at the time of service.
D. The opportunity to reduce corporate compliance failures within the registration process. -
ANSC. The opportunity to reduce processing times at the time of service.
The Affordable Care Act legislated the development of Health Insurance Exchanges, where
individuals and small businesses can:
A. Obtain price estimates for medical services
B. Negotiate the price of medical services with providers
C. Purchase qualified health benefit plans regardless of insured's health status
D. Meet federal mandates for insurance coverage and obtain the corresponding tax deduction -
ANSC. Purchase qualified health benefit plans regardless of insured's health status.
All of the following are conditions that disqualify a procedure or service from being paid for by
Medicare EXCEPT:
A. Offered in an outpatient setting
B. Medically unnecessary
C. Not delivered in a Medicare licensed care setting.
D. Services and procedures that are custodial in nature - ANSC. Not delivered in a Medicare
licensed care setting
All of the following are reference resources used to help guide in the application for business
ethics EXCEPT:
A. Consumer satisfaction reports
,B. Mission & Value Statements
C. Code of Ethics / Code of Conduct
D. Compliance Office & Policies - ANSA. Consumer satisfaction reports
All of the following are steps in safeguarding collections EXCEPT:
A. Placing collections in a lock-box for posting review the next business day.
B. Posting the payment to the patient's account
C. Completing balancing activities
D. Issuing receipts - ANSA. Placing collections in a lock-box for posting review the next
business day
All of the following are steps in verifying insurance EXCEPT:
A. Sequencing plans involved in a coordination of benefits (COB) situation.
B. The patient signing the statement of financial responsibility.
C. Identifying and documenting the patient's health plan benefits
D. Confirming the patient's eligibility for benefits - ANSB. The patient signing the statement of
financial responsibility
All of the following information is used to identify a patient EXCEPT:
A. Date of Birth
B. Gender
C. Social Security Number
D. Address - ANSD. Address
All of the following information should be reviewed as part of schedule finalization EXCEPT:
A. The estimated patient financial obligations
B. The service to be provided
C. The arrival time and procedure time
D. The patient's preparation instructions - ANSA. The estimated patient financial obligations
Ambulance services are billed directly to the health plan for :
A. All pre-admission emergency transports
B. Transport deemed medically necessary by the attending paramedic-ambulance crew
C. Services provided before a patient is admitted and for ambulance rides arranged to pick up
the patient from the hospital after discharge to take him/her home or to another facility
D. The portion of the bill outside of the patient's self-pay - ANSC. Services provided before a
patient is admitted and for ambulance rides arranged to pick up the patient from the hospital
after discharge to take him/her home or the another facility
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and
treatment services for an enrolled group of persons on a monthly fee is known as a:
A. HMO
B. PPO
C. MSO
, D. GPO - ANSA. HMO
Any provider that has filed a timely cost report may appeal an adverse final decision received
from the Medicare Administrative Contractor (MAC). This appeal may be filed with:
A. The Provider Reimbursement Review Board
B. The Department of Health and Human Services Provider Relations Division
C. A court appointed federal mediator
D. The Office of the Inspector General - ANSA. The Provider Reimbursement Review Board
Applying the contracted payment methodology to the total charges yields:
A. An estimated price
B. An anticipated health plan payment
C. A price justified revenue accrual
D. A pricing agreement - ANSA. An estimated price
Appropriate training for the patient financial counselling staff must cover all of the following
EXCEPT:
A. Patient financial communications best practices specific to staff role
B. Financial assistance policies
C. Documenting the conversation in the medical record
D. Available patient financing options - ANSC. Documenting the conversation in the medical
record
The basis for qualification in Medicaid is typically:
A. The Federal Poverty Guidelines
B. Financial need as demonstrated by the prior two-years federal income tax fillings
C. The patient's score on the Internal Revenue Service's Personal Wealth and Spending
indicator
D. Bank statements for the previous 18 months - ANSA. The Federal Poverty Guidelines
Because 501(r) regulations focus on identifying potentially eligible financial assistance patients,
hospitals must:
A. Capture their experience with such patients to properly budget
B. Hold financial conversations with patients as soon as possible
C. Build the necessary processes to handle the potentially lengthy payment schedules
D. Expedite payment processing of normal accounts receivables to protect cash flow - ANSB.
Hold financial conversations with patients as soon as possible
Before classifying and subsequently writing off an account to financial assistance or bad debt,
the hospital must establish policy, define appropriate criteria, implementation, identifying and
processing accounts and:
A. Obtain the patients income tax statements from the prior 2 years
B. Having the account triaged for any partial payment possibilities
C. Monitor compliance
