HFMA CRCR Exam 2025. Complete Test With
100% Correct Answers |Already Graded A+
Through what document does a hospital establish compliance standards? - CORRECT
ANS>>code of conduct
what is a recurring or series registration? - CORRECT ANS>>One registration record is
created for multiple days of service
What are nonemergency patients who come for service without prior notification to the
provider called? - CORRECT ANS>>Unscheduled patients
Which of the following statement apply to the observation patient type? - CORRECT
ANS>>It is used to evaluate the need for an inpatient admission
which services are hospice programs required to provide around the clock patient --
CORRECT ANS>>Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what?
- CORRECT ANS>>Complete the scheduling process correctly based on service
requested
The Time needed to prepare the patient before service is the difference between the
patient’s arrival time and which of the following? - CORRECT ANS>>Procedure time
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the
information provided on the order must include: - - CORRECT ANS>>Documentation of
the medical necessity for the test
What is the advantage of a pre-registration program - CORRECT ANS>>It reduces
processing times at the time of service
What date are required to establish a new MPI (Master patient Index) entry - CORRECT
ANS>>The responsible party's full legal name, date of birth, and social security number
Which of the following statements is true about third-party payments? - CORRECT
ANS>>The payments are received by the provider from the payer responsible for
,reimbursing the provider for the patient's covered services.
Which provision protects the patient from medical expenses that exceed the pre-set
level - CORRECT ANS>>stop loss
what documentation must a primary care physician send to HMO patient to authorize a
visit to a specialist for additional testing or care? - CORRECT ANS>>Referral
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider
may not ask about a patient's insurance information if it would delay what? -- CORRECT
ANS>>Medical screening and stabilizing treatment
Which of the following is a step in the discharge process? - CORRECT ANS>>Have a
case management service complete the discharge plan
The hospital has an APC based contract for the payment of outpatient services. Total
anticipated charges for the visit are $2,380. The approved APC payment rate is $780.
Where will the patients benefit package be applied? - CORRECT ANS>>To the approved
APC payment rate
A patient has met the $200 individual deductible and $900 of the $1000 co-insurance
responsibility. The co-insurance rate is 20%. The estimated insurance plan
responsibility is $1975.00. What amount of coinsurance is due from the patient? -
CORRECT ANS>> $100.00
When is a patient considered to be medically indigent? - CORRECT ANS>>The patient’s
outstanding medical bills exceed a defined dollar amount or percentage of assets.
What patient assets are considered in the financial assistance application? - CORRECT
ANS>>Sources of readily available funds, vehicles, campers, boats and saving
accounts
If the patient cannot agree to payment arrangements, what is the next option? -
CORRECT ANS>>Warn the patient that unpaid accounts are placed with collection
agencies for further processing
What core financial activities are resolved within patient access? - CORRECT
ANS>>scheduling, pre-registration, insurance verification and managed care
, processing
What is an unscheduled direct admission? - CORRECT ANS>>A patient who arrives at
the hospital via ambulance for treatment in the emergency department
When is it not appropriate to use observation status? - CORRECT ANS>>As a substitute
for an inpatient admission
Patients who require periodic skilled nursing or therapeutic care receive services from
what type of program? - CORRECT ANS>>Home health agency
Every patient who is new to the healthcare provider must be offered what? - CORRECT
ANS>>A printed copy of the provider privacy notice
Which of the following statements apples to self-insured insurance plans? - CORRECT
ANS>>The employer provides a traditional HMO health plan
In addition to the member's identification number, what information is recorded in a
270transaction - CORRECT ANS>>Name
What process does a patient's health plan use to retroactively collect payments from
liability automobile or worker's compensation plan? - - CORRECT ANS>>Subrogation
In what type of payment methodology is a lump sum of bundled payment negotiated
between the payer and some or all providers? - - CORRECT ANS>>DRG/Case rate
What Restriction does a managed care plan place on locations that must be used if the
plan is to pay for the service provided? - CORRECT ANS>>Site of service limitation
Which of the following statements applies to private rooms? - CORRECT ANS>>If the
medical necessity for a private room is documented in the chart. The patient’s
insurance will be billed for the differential
Which of the following is true about screening a beneficiary of possible MSP (Medicare
secondary payer) situations? - CORRECT ANS>>It is necessary to ask the patient each
of the MSP questions
Which of the following is not true of Medicare Advantage Plans? - CORRECT ANS>>A
patient must have both Medicare Part A and B benefits to be eligible for a Medicare
100% Correct Answers |Already Graded A+
Through what document does a hospital establish compliance standards? - CORRECT
ANS>>code of conduct
what is a recurring or series registration? - CORRECT ANS>>One registration record is
created for multiple days of service
What are nonemergency patients who come for service without prior notification to the
provider called? - CORRECT ANS>>Unscheduled patients
Which of the following statement apply to the observation patient type? - CORRECT
ANS>>It is used to evaluate the need for an inpatient admission
which services are hospice programs required to provide around the clock patient --
CORRECT ANS>>Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what?
- CORRECT ANS>>Complete the scheduling process correctly based on service
requested
The Time needed to prepare the patient before service is the difference between the
patient’s arrival time and which of the following? - CORRECT ANS>>Procedure time
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the
information provided on the order must include: - - CORRECT ANS>>Documentation of
the medical necessity for the test
What is the advantage of a pre-registration program - CORRECT ANS>>It reduces
processing times at the time of service
What date are required to establish a new MPI (Master patient Index) entry - CORRECT
ANS>>The responsible party's full legal name, date of birth, and social security number
Which of the following statements is true about third-party payments? - CORRECT
ANS>>The payments are received by the provider from the payer responsible for
,reimbursing the provider for the patient's covered services.
Which provision protects the patient from medical expenses that exceed the pre-set
level - CORRECT ANS>>stop loss
what documentation must a primary care physician send to HMO patient to authorize a
visit to a specialist for additional testing or care? - CORRECT ANS>>Referral
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider
may not ask about a patient's insurance information if it would delay what? -- CORRECT
ANS>>Medical screening and stabilizing treatment
Which of the following is a step in the discharge process? - CORRECT ANS>>Have a
case management service complete the discharge plan
The hospital has an APC based contract for the payment of outpatient services. Total
anticipated charges for the visit are $2,380. The approved APC payment rate is $780.
Where will the patients benefit package be applied? - CORRECT ANS>>To the approved
APC payment rate
A patient has met the $200 individual deductible and $900 of the $1000 co-insurance
responsibility. The co-insurance rate is 20%. The estimated insurance plan
responsibility is $1975.00. What amount of coinsurance is due from the patient? -
CORRECT ANS>> $100.00
When is a patient considered to be medically indigent? - CORRECT ANS>>The patient’s
outstanding medical bills exceed a defined dollar amount or percentage of assets.
What patient assets are considered in the financial assistance application? - CORRECT
ANS>>Sources of readily available funds, vehicles, campers, boats and saving
accounts
If the patient cannot agree to payment arrangements, what is the next option? -
CORRECT ANS>>Warn the patient that unpaid accounts are placed with collection
agencies for further processing
What core financial activities are resolved within patient access? - CORRECT
ANS>>scheduling, pre-registration, insurance verification and managed care
, processing
What is an unscheduled direct admission? - CORRECT ANS>>A patient who arrives at
the hospital via ambulance for treatment in the emergency department
When is it not appropriate to use observation status? - CORRECT ANS>>As a substitute
for an inpatient admission
Patients who require periodic skilled nursing or therapeutic care receive services from
what type of program? - CORRECT ANS>>Home health agency
Every patient who is new to the healthcare provider must be offered what? - CORRECT
ANS>>A printed copy of the provider privacy notice
Which of the following statements apples to self-insured insurance plans? - CORRECT
ANS>>The employer provides a traditional HMO health plan
In addition to the member's identification number, what information is recorded in a
270transaction - CORRECT ANS>>Name
What process does a patient's health plan use to retroactively collect payments from
liability automobile or worker's compensation plan? - - CORRECT ANS>>Subrogation
In what type of payment methodology is a lump sum of bundled payment negotiated
between the payer and some or all providers? - - CORRECT ANS>>DRG/Case rate
What Restriction does a managed care plan place on locations that must be used if the
plan is to pay for the service provided? - CORRECT ANS>>Site of service limitation
Which of the following statements applies to private rooms? - CORRECT ANS>>If the
medical necessity for a private room is documented in the chart. The patient’s
insurance will be billed for the differential
Which of the following is true about screening a beneficiary of possible MSP (Medicare
secondary payer) situations? - CORRECT ANS>>It is necessary to ask the patient each
of the MSP questions
Which of the following is not true of Medicare Advantage Plans? - CORRECT ANS>>A
patient must have both Medicare Part A and B benefits to be eligible for a Medicare
