HFMA CRCR EXAM 172 Questions with Answers HFMA CRCR EXAM 172 Questions with Answers
2024,100% CORRECT 2024,100% CORRECT
Which of the following statement apply to the observation patient type? -
ANSWER--It is used to evaluate the need for an inpatient admission
Through what document does a hospital establish compliance standards? -
ANSWER--code of conduct
which services are hospice programs required to provide around the clock
patient - ANSWER--Physician, Nursing, Pharmacy
What is the purpose OIG work plant? - ANSWER--Identify Acceptable
compliance programs in various provider setting
Scheduler instructions are used to prompt the scheduler to do what? -
ANSWER--Complete the scheduling process correctly based on service
If a Medicare patient is admitted on Friday, what services fall within the
requeste
three-day DRG window rule? - ANSWER--Non-diagnostic service provided
on Tuesday through Friday
The Time needed to prepare the patient before service is the difference
between the patients arrival time and which of the following? - ANSWER--
What does a modifier allow a provider to do? - ANSWER--Report a specific
Procedure time
circumstance that affected a procedure or service without changing the
code or its definition
Medicare guidelines require that when a test is ordered for a LCD or NCD
exists, the information provided on the order must include: - ANSWER--
IF outpatient diagnostic services are provided within three days of the
Documentation of the medical necessity for the test
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective
Payment System) hospital, what must happen to these charges -
ANSWER--They must be billed separately to the part B Carrier
What is the advantage of a pre-registration program - ANSWER--It reduces
processing times at the time of service
what is a recurring or series registration? - ANSWER--One registration
record is created for multiple days of service
What date are required to establish a new MPI(Master patient Index) entry -
ANSWER--The responsible party's full legal name, date of birth, and social
security number
What are nonemergency patients who come for service without prior
notification to the provider called? - ANSWER--Unscheduled patients
Which of the following statements is true about third-party payments? -
ANSWER--The payments are received by the provider from the payer
responsible for reimbursing the provider for the patient's covered services.
, HFMA CRCR EXAM 172 Questions with Answers HFMA CRCR EXAM 172 Questions with Answers
2024,100% CORRECT 2024,100% CORRECT
When is a patient considered to be medically indigent? - ANSWER--The
patient's outstanding medical bills exceed a defined dollar amount or
Which provision protects the patient from medical expenses that exceed
percentage of assets.
the pre-set level - ANSWER--stop loss
What patient assets are considered in the financial assistance application?
what documentation must a primary care physician send to HMO patient to
- ANSWER--Sources of readily available funds , vehicles, campers, boats
authorize a visit to a specialist for additional testing or care? - ANSWER--
and saving accounts
Referral
If the patient cannot agree to payment arrangements, What is the next
Under EMTALA (Emergency Medical Treatment and Labor Act)
option? - ANSWER--Warn the patient that unpaid accounts are placed with
regulations, the provider may not ask about a patient's insurance
collection agencies for further processing
information if it would delay what? - ANSWER--Medical screening and
stabilizing treatment
What core financial activities are resolved within patient access? -
ANSWER--scheduling , pre-registration, insurance verification and
Which of the following is a step in the discharge process? - ANSWER--
managed care processing
Have a case management service complete the discharge plan
What is an unscheduled direct admission? - ANSWER--A patient who
The hospital has a APC based contract for the payment of outpatient
arrives at the hospital via ambulance for treatment in the emergency
services. Total anticipated charges for the visit are $2,380. The approved
department
APC payment rate is $780. Where will the patients benefit package be
applied? - ANSWER--To the approved APC payment rate
When is it not appropriate to use observation status? - ANSWER--As a
substitute for an inpatient admission
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
Patients who require periodic skilled nursing or therapeutic care receive
due from the patient? - ANSWER--$100.00
services from what type of program? - ANSWER--Home health agency
Every patient who is new to the healthcare provider must be offered what?
- ANSWER--A printed copy of the provider privacy notice
2024,100% CORRECT 2024,100% CORRECT
Which of the following statement apply to the observation patient type? -
ANSWER--It is used to evaluate the need for an inpatient admission
Through what document does a hospital establish compliance standards? -
ANSWER--code of conduct
which services are hospice programs required to provide around the clock
patient - ANSWER--Physician, Nursing, Pharmacy
What is the purpose OIG work plant? - ANSWER--Identify Acceptable
compliance programs in various provider setting
Scheduler instructions are used to prompt the scheduler to do what? -
ANSWER--Complete the scheduling process correctly based on service
If a Medicare patient is admitted on Friday, what services fall within the
requeste
three-day DRG window rule? - ANSWER--Non-diagnostic service provided
on Tuesday through Friday
The Time needed to prepare the patient before service is the difference
between the patients arrival time and which of the following? - ANSWER--
What does a modifier allow a provider to do? - ANSWER--Report a specific
Procedure time
circumstance that affected a procedure or service without changing the
code or its definition
Medicare guidelines require that when a test is ordered for a LCD or NCD
exists, the information provided on the order must include: - ANSWER--
IF outpatient diagnostic services are provided within three days of the
Documentation of the medical necessity for the test
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective
Payment System) hospital, what must happen to these charges -
ANSWER--They must be billed separately to the part B Carrier
What is the advantage of a pre-registration program - ANSWER--It reduces
processing times at the time of service
what is a recurring or series registration? - ANSWER--One registration
record is created for multiple days of service
What date are required to establish a new MPI(Master patient Index) entry -
ANSWER--The responsible party's full legal name, date of birth, and social
security number
What are nonemergency patients who come for service without prior
notification to the provider called? - ANSWER--Unscheduled patients
Which of the following statements is true about third-party payments? -
ANSWER--The payments are received by the provider from the payer
responsible for reimbursing the provider for the patient's covered services.
, HFMA CRCR EXAM 172 Questions with Answers HFMA CRCR EXAM 172 Questions with Answers
2024,100% CORRECT 2024,100% CORRECT
When is a patient considered to be medically indigent? - ANSWER--The
patient's outstanding medical bills exceed a defined dollar amount or
Which provision protects the patient from medical expenses that exceed
percentage of assets.
the pre-set level - ANSWER--stop loss
What patient assets are considered in the financial assistance application?
what documentation must a primary care physician send to HMO patient to
- ANSWER--Sources of readily available funds , vehicles, campers, boats
authorize a visit to a specialist for additional testing or care? - ANSWER--
and saving accounts
Referral
If the patient cannot agree to payment arrangements, What is the next
Under EMTALA (Emergency Medical Treatment and Labor Act)
option? - ANSWER--Warn the patient that unpaid accounts are placed with
regulations, the provider may not ask about a patient's insurance
collection agencies for further processing
information if it would delay what? - ANSWER--Medical screening and
stabilizing treatment
What core financial activities are resolved within patient access? -
ANSWER--scheduling , pre-registration, insurance verification and
Which of the following is a step in the discharge process? - ANSWER--
managed care processing
Have a case management service complete the discharge plan
What is an unscheduled direct admission? - ANSWER--A patient who
The hospital has a APC based contract for the payment of outpatient
arrives at the hospital via ambulance for treatment in the emergency
services. Total anticipated charges for the visit are $2,380. The approved
department
APC payment rate is $780. Where will the patients benefit package be
applied? - ANSWER--To the approved APC payment rate
When is it not appropriate to use observation status? - ANSWER--As a
substitute for an inpatient admission
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
Patients who require periodic skilled nursing or therapeutic care receive
due from the patient? - ANSWER--$100.00
services from what type of program? - ANSWER--Home health agency
Every patient who is new to the healthcare provider must be offered what?
- ANSWER--A printed copy of the provider privacy notice
