HFMA CRCR EXAM 2025. COMPLETE TEST BANK 600+ EXAM QUESTIONS WITH DETAILED VERIFIED ANSWERS (100% CORRECT) A+ GRADE ASSURED

HFMA CRCR EXAM 2025. COMPLETE TEST BANK 600+ EXAM QUESTIONS WITH DETAILED VERIFIED ANSWERS (100% CORRECT) A+ GRADE ASSURED It is important to have high registration quality standards because a) Inaccurate or incomplete pt data will delay payment or cause denials b) Incomplete registrations will trigger exclusion from Medicare participation c) Inaccurate registration may cause discharge before full treatment is obtained d) Incomplete registrations will raise satisfaction scores for the hospital - CORRECT ANSA When recovery audit contractors (RAC) identify improper payments as overpayments the claims processing contractor must a) Assume legal responsibility for repaying the overage amount b) Make recovery of the overpayment the top processing priority c) Send a demand letter to the provider to recover the over payment amount d) Conduct an audit of all the effected providers claims within the past 12 months - CORRECT ANSC Internal controls addressing coding and reimbursement changes are put I place to guard against a) Underpayments b) Denials c) Compliance fraud by upcoding d) Charge master error - CORRECT ANSC The pt discharge process begins when a) The physician writes the discharge orders b) Clinical services are completed and pt accounts have all the info necessary to bill c) The physician writes the discharge orders and the third-party payer sign-off on the necessity of the services provided d) Clinical services are completed, pt accounts can generated and accurate bill and there is agreement on the handling of pt financial responsibilities - - CORRECT ANSA Most major health plansincluding Medicare and Medicaid, offer a) Toll free verification hot lines,staffed around the clock b) Electronic and/or web portal verification c) Pt "verification of benefits" cards d) A grace period for obtaining verification within 72 hours of treatment - CORRECT ANSB The physician who wrote the order for an inpatient service and is in charge of the pts treatment during admission is a) The pts personal physician b) The primary care physician c) The attending physician d) The physician pt care director - CORRECT ANSC An originating site is a) The location where the pts bill is generated b) The location of the pt at the time the service is provided c) The site that generates reimbursement of a claim d) The location of the medical treatment provider - CORRECT ANSB HFMA best practices stipulate that a reasonable attempt should be made to have the financial responsibilities discussion a) As early as possible, before a financial obligation isincurred b) During the registration process c) Before scheduling of services d) No later than the evening of the day of admission - - CORRECT ANSA HFMA's pt financial communications best practices specify that pts should be told about The types of services provided and a) An explanation of why a specific service is not provided b) The service providers that typically participate in the service, e.g. radiologists, pathologists, etc. c) A satisfaction survey regarding clinicalservice providers d) The price of service to their covering health plan - CORRECT ANSB Telemed seeksto improve a pt's health by a) Permitting 2-way real time interactive communication between the pt and the clinical professional b) Using high-compression fiber opticsto transmit medical data c) Providing relevant, on-demand consumer medical education d) Providing physician accessto the most current medical research - - CORRECT ANSA A large number of credit balances are not the result of overpayments but of a) Posting errors in the pt accounting system b) Incorrect claim submissions c) Inadequate staff training d) Banking transaction errors - CORRECT ANSA Across all care settings, if a pt consents to a financial discussion during a medical encounter to expedite discharge, the HFMA best practice isto a) Have a pt financial responsibilities kit ready for the pt containing all of the required registration forms and instructions b) Make sure that the attending staff can answer questions and assist in obtaining required pt financial data c) Support that choice, providing that the discussion does not interfere with pt care or disrupt pt flow d) Decline such request as finance discussions can disrupt pt care and pt flow - CORRECT ANSC The office of inspector general (OIG) publishes a compliance work plan a) Monthly b) Quarterly c) Semi-annually d) Annually - CORRECT ANSD What are collection agency fees based on? - CORRECT ANSA percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what another rule? - CORRECT ANSBirthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - - CORRECT ANSCase rates What customer service improvements might improve the patient accounts department? - CORRECT ANSHolding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - CORRECT ANSInform a Medicare beneficiary that Medicare may not pay for the order or service What type of account adjustment results from the patient's unwillingness to pay for a selfpay balance? - CORRECT ANSBad debt adjustment What is the initial hospice benefit? - CORRECT ANSTwo 90-day periods and an unlimited number of subsequent periods When does a hospital add ambulance charges to the Medicare inpatient claim? - CORRECT ANSIf the patient requires ambulance transportation to a skilled nursing facility How should a provider resolve a late-charge credit posted after an account is billed? - CORRECT ANSPost a late-charge adjustment to the account an increase in the dollars aged greater than 90 days from date of service indicate what about accounts - CORRECT ANSThey are not being processed in a timely manner What is an advantage of a preregistration program? - CORRECT ANSIt reduces processing times at the time of service What are the two statutory exclusionsfrom hospice coverage? - - CORRECT ANSMedically unnecessary services and custodial care What core financial activities are resolved within patient access? - - CORRECT ANSScheduling, insurance verification, discharge processing, and payment of point-of-service receipts Whatstatement appliesto the scheduled outpatient? - - CORRECT ANSThe services do not involve an overnightstay How is a mis-posted contractual allowance resolved? - - CORRECT ANSComparing the contract reimbursement rates with the contract on the admittance advice to identify the correct amount What type of patient status is used to evaluate the patient's need for inpatient care? - CORRECT ANSObservation What are collection agency fees based on? - CORRECT ANSA percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - CORRECT ANSBirthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - - CORRECT ANSCase rates What customer service improvements might improve the patient accounts department? - CORRECT ANSHolding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - CORRECT ANSInform a Medicare beneficiary that Medicare may not pay for the order or service What type of account adjustment results from the patient's unwillingness to pay for a self