HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE
EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED |ALREADY QUESTIONS AND CORRECT DETAILED |ALREADY
GRADED A+ GRADED A+
A scheduled inpatient represents an opportunity for the provider to do
which of the following? - ANSWER--Complete registration and insurance
Hospital can only convert an inpatient case to observation if: - ANSWER--
approval before service
The hospital utilization review committee determines before the patient is
discharged and prior to billing that an observation setting would be more
appropriate.
The Medicare Bundled Payments for Care Initiative (BCP) is designed to: -
ANSWER--Align incentives between hospitals, physicians, and non-
physician providers in-order to better coordinate patient care.
Hospital need which of the following information sets to assess a patient's
financial status? - ANSWER--Demographic, Income, Assets and Expenses.
To maximize the value derived from customer complaints, all consumer
complaints should be: - ANSWER--Tracked and shared to improve
HIPAA privacy rules require covered entities to take all, of the following
customer experience
actions EXCEPT: - ANSWER--Use only designated software platforms to
secure patient date.
The soft cost of a dissatisfied customer is: - ANSWER--The customer
passing on information about their negative experience to potential patients
When Recovery Audit Contractors (RAC) identify improper payments as
or through social media channels.
overpayment. the claims processing contractor must: - ANSWER--Send a
demand letter to the provider to recover the over payment amount.
Applying the contracted payment methodology to the total charges yields: -
ANSWER--An estimate price
Which HIPPA transaction set provides electronic processing of 8insurance
verification requests and responses? - ANSWER--The 270-271 set
The importance of medical records maintained by HIM is that the patient
records: - ANSWER--Are the primary source for clinical data required for
Across all care settings, if a patient consents to a financial discussion
reimbursement by health plans and liability payers
during a medical encounter to expedite discharge, the HFMA best practice
is to: - ANSWER--Support that choice, providing that the discussion does
not interfere with patient care or disrupt patient flow.
Important Revenue Cycle Activities in the pre-service stage include: -
ANSWER--Obtaining or updating patient and guarantor information
, HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE
EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED |ALREADY QUESTIONS AND CORRECT DETAILED |ALREADY
GRADED A+ GRADED A+
In the pre-service stage, the cost of the schedule services is identified and ANSWER--What serviced or healthcare items are covered under
the patient's health plan and benefits are used to calculate: - ANSWER-- Medicare?
The amount the patient may be expected to pay after insurance.
A decision on whether a patient should be admitted as an inpatient or
The disadvantage of outsourcing includes all, of the following Except - become an outpatient observation patient requires medical judgement
ANSWER--Reduces internal staffing costs and a reliance on outsourced based on all of the following EXCEPT: - ANSWER--The patient's home
staff. care coverage
Marinating routine contact with health plan or liability payer, making sure all What is the first step of the daily cash reconciliation process? - ANSWER--
required information is provided and all needed approvals are obtained is Obtaining cash, check, credit card and debit card payment from that day
the responsibility of who: - ANSWER--Case Management
The healthcare industry is vulnerable to compliance issues, in large part
A claim is denied for the following reasons EXCEPT: - ANSWER--The due to the complexity of the statutes and regulations pertaining to: -
submitted claim does not have the physician signature ANSWER--Medicare and Medicaid payments
All Hospitals are required to establish a written financial assistance policy The correct coding initiative program consist of: - ANSWER--Edits that are
that applies to: - ANSWER--All emergency and medically necessary care implemented within provider's claim processing system
Examples of ethics violation that impact the revenue cycle include all of the The Affordable Health Care Act legislated the development of Health
following EXCEPT: - ANSWER--Seeking payment options for self-pay Insurance Exchange, where individuals and small businesses can: -
ANSWER--Purchase health benefits plans regardless of insured's health
status
Verbal orders from a physician for a service(s) are: - ANSWER--Acceptable
if given to "qualified" staff as defined in a hospitals policies and procedures
Before classifying and subsequently writing off an account to financial
assistance or bad debit, the hospital must establish policy define
Medicare has established guidelines called Local Coverage Determination appropriate criteria, implement procedures for identifying accounts and: -
(LCD) and National Coverage Determination (NCD) that establish: - ANSWER--Monitor compliance
, HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE
EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED |ALREADY QUESTIONS AND CORRECT DETAILED |ALREADY
GRADED A+ GRADED A+
To maximize the value derived from customer complaints, all consumer
complaints should be: - ANSWER--Tracked and shared to improve the
The Electronic Remittance Advice (ERA) data sets are: - ANSWER--A
customer experience
standardized for that provides 3rd party payment details to providers
The Business ethics, or organizational ethics represent: - ANSWER--The
The first and most critical step in registering a patient, whether scheduled
principles and standards by which organizations operate
or unscheduled is: - ANSWER--Verifying the patient's identification
Providers are advised that it is best to establish patient financial
The standard claim form used for the billing by hospitals, nursing facilities,
responsibility and assistance policies and make sure they are followed
and other inpatient services is called the: - ANSWER--UB-04
internally and by: - ANSWER--Third-party payers
A four-digit number code established by the National Uniform Billing
The advantage to using a third-part, collection agency includes all of the
Committee (NUBC) that categorizes/classifies a line in the charge master is
following EXCEPT: - ANSWER--Providers pay pennies on each dollar
known as: - ANSWER--Revenue codes
collected.
Internal controls addressing coding and reimbursement charges are put in
Local Coverage Determination (LCD) and National Coverage
place to guard against: - ANSWER--Compliance fraud by "upcoding"
Determinations (NCD) are Medicare established guidelines used to
determine: - ANSWER--Which diagnosis, signs, or symptoms are
The 501(R) regulations require non-for-profit providers (501) ©(3) reimbursable
organizations to do which of the following activities: - ANSWER--Complete
a community needs assessment and develop a discount program for
Claims with the dates of service received later than one calendar year
patient's balances after insurance payment
beyond the date of service will be: - ANSWER--Denied by Medicare
During pre-registration, a search for the patient's MRI number is initiated
in the pre-service stage, the requested service is screened for medical
using which of the following data sets: - ANSWER--Patient's full legal name
necessity, health plan coverage and benefits are verified and: - ANSWER--
and date of birth or the patient's Social Security number
Pre-authorization are obtained
, HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE
EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED |ALREADY QUESTIONS AND CORRECT DETAILED |ALREADY
GRADED A+ GRADED A+
For scheduled patients, important revenue cycle activities in the time-of -
service stage DO NOT include: - ANSWER--Final bill is presented for
he HCCAHPS (Hospital Consumer Assessment of Healthcare Provider's
payment
and Systems) initiative was launched to: - ANSWER--Provide a
standardized method for evaluation patients' perspective on hospital care
If a medical service authorization, who is typically responsible for obtaining
the authorization: - ANSWER--The provider scheduling
All of the following are potential causes of credit balances EXCEPT: -
ANSWER--A patient's choice to build up a credit against future medical bills
Concurrent review and discharge planning - ANSWER--Occurs during
service
Medicare will only pay for tests and services that: - ANSWER--Can be
demonstrated as necessary
The fundamental approach in managing denials is: - ANSWER--To analyze
the type and sources of denials and consider process changes to eliminate
This was developed to promote and ensure healthcare quality and value
further denials
and also to protect consumers and workers in the healthcare system. This
directive is called: - ANSWER--Joint Commission for Acceleration of
Healthcare Organizations (JCAHO) safety standards
The first thing a health plan does when processing a claim is: - ANSWER--
Check if the patient is a health plan beneficiary and what is the coverage
It is important to calculate reserves to ensure: - ANSWER--A stable
financial operations and accurate financial reporting
Outsourcing options should be evaluated as - ANSWER--Any other
business service purchase
An advantage of a pre-registration program in - ANSWER--The opportunity
to reduce processing times at the time of service
Insurance verification results in which of the following: - ANSWER--The
accurate identification of the patient's eligibility and benefits
To be eligible for Medicaid, an individual must: - ANSWER--Meet income
and asset requirements
EMTLA and HFMA best practices specify that in an Emergency
Department setting: - ANSWER--No patient financial discussions should
occur before a patient is screened and stabilized
EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED |ALREADY QUESTIONS AND CORRECT DETAILED |ALREADY
GRADED A+ GRADED A+
A scheduled inpatient represents an opportunity for the provider to do
which of the following? - ANSWER--Complete registration and insurance
Hospital can only convert an inpatient case to observation if: - ANSWER--
approval before service
The hospital utilization review committee determines before the patient is
discharged and prior to billing that an observation setting would be more
appropriate.
The Medicare Bundled Payments for Care Initiative (BCP) is designed to: -
ANSWER--Align incentives between hospitals, physicians, and non-
physician providers in-order to better coordinate patient care.
Hospital need which of the following information sets to assess a patient's
financial status? - ANSWER--Demographic, Income, Assets and Expenses.
To maximize the value derived from customer complaints, all consumer
complaints should be: - ANSWER--Tracked and shared to improve
HIPAA privacy rules require covered entities to take all, of the following
customer experience
actions EXCEPT: - ANSWER--Use only designated software platforms to
secure patient date.
The soft cost of a dissatisfied customer is: - ANSWER--The customer
passing on information about their negative experience to potential patients
When Recovery Audit Contractors (RAC) identify improper payments as
or through social media channels.
overpayment. the claims processing contractor must: - ANSWER--Send a
demand letter to the provider to recover the over payment amount.
Applying the contracted payment methodology to the total charges yields: -
ANSWER--An estimate price
Which HIPPA transaction set provides electronic processing of 8insurance
verification requests and responses? - ANSWER--The 270-271 set
The importance of medical records maintained by HIM is that the patient
records: - ANSWER--Are the primary source for clinical data required for
Across all care settings, if a patient consents to a financial discussion
reimbursement by health plans and liability payers
during a medical encounter to expedite discharge, the HFMA best practice
is to: - ANSWER--Support that choice, providing that the discussion does
not interfere with patient care or disrupt patient flow.
Important Revenue Cycle Activities in the pre-service stage include: -
ANSWER--Obtaining or updating patient and guarantor information
, HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE
EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED |ALREADY QUESTIONS AND CORRECT DETAILED |ALREADY
GRADED A+ GRADED A+
In the pre-service stage, the cost of the schedule services is identified and ANSWER--What serviced or healthcare items are covered under
the patient's health plan and benefits are used to calculate: - ANSWER-- Medicare?
The amount the patient may be expected to pay after insurance.
A decision on whether a patient should be admitted as an inpatient or
The disadvantage of outsourcing includes all, of the following Except - become an outpatient observation patient requires medical judgement
ANSWER--Reduces internal staffing costs and a reliance on outsourced based on all of the following EXCEPT: - ANSWER--The patient's home
staff. care coverage
Marinating routine contact with health plan or liability payer, making sure all What is the first step of the daily cash reconciliation process? - ANSWER--
required information is provided and all needed approvals are obtained is Obtaining cash, check, credit card and debit card payment from that day
the responsibility of who: - ANSWER--Case Management
The healthcare industry is vulnerable to compliance issues, in large part
A claim is denied for the following reasons EXCEPT: - ANSWER--The due to the complexity of the statutes and regulations pertaining to: -
submitted claim does not have the physician signature ANSWER--Medicare and Medicaid payments
All Hospitals are required to establish a written financial assistance policy The correct coding initiative program consist of: - ANSWER--Edits that are
that applies to: - ANSWER--All emergency and medically necessary care implemented within provider's claim processing system
Examples of ethics violation that impact the revenue cycle include all of the The Affordable Health Care Act legislated the development of Health
following EXCEPT: - ANSWER--Seeking payment options for self-pay Insurance Exchange, where individuals and small businesses can: -
ANSWER--Purchase health benefits plans regardless of insured's health
status
Verbal orders from a physician for a service(s) are: - ANSWER--Acceptable
if given to "qualified" staff as defined in a hospitals policies and procedures
Before classifying and subsequently writing off an account to financial
assistance or bad debit, the hospital must establish policy define
Medicare has established guidelines called Local Coverage Determination appropriate criteria, implement procedures for identifying accounts and: -
(LCD) and National Coverage Determination (NCD) that establish: - ANSWER--Monitor compliance
, HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE
EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED |ALREADY QUESTIONS AND CORRECT DETAILED |ALREADY
GRADED A+ GRADED A+
To maximize the value derived from customer complaints, all consumer
complaints should be: - ANSWER--Tracked and shared to improve the
The Electronic Remittance Advice (ERA) data sets are: - ANSWER--A
customer experience
standardized for that provides 3rd party payment details to providers
The Business ethics, or organizational ethics represent: - ANSWER--The
The first and most critical step in registering a patient, whether scheduled
principles and standards by which organizations operate
or unscheduled is: - ANSWER--Verifying the patient's identification
Providers are advised that it is best to establish patient financial
The standard claim form used for the billing by hospitals, nursing facilities,
responsibility and assistance policies and make sure they are followed
and other inpatient services is called the: - ANSWER--UB-04
internally and by: - ANSWER--Third-party payers
A four-digit number code established by the National Uniform Billing
The advantage to using a third-part, collection agency includes all of the
Committee (NUBC) that categorizes/classifies a line in the charge master is
following EXCEPT: - ANSWER--Providers pay pennies on each dollar
known as: - ANSWER--Revenue codes
collected.
Internal controls addressing coding and reimbursement charges are put in
Local Coverage Determination (LCD) and National Coverage
place to guard against: - ANSWER--Compliance fraud by "upcoding"
Determinations (NCD) are Medicare established guidelines used to
determine: - ANSWER--Which diagnosis, signs, or symptoms are
The 501(R) regulations require non-for-profit providers (501) ©(3) reimbursable
organizations to do which of the following activities: - ANSWER--Complete
a community needs assessment and develop a discount program for
Claims with the dates of service received later than one calendar year
patient's balances after insurance payment
beyond the date of service will be: - ANSWER--Denied by Medicare
During pre-registration, a search for the patient's MRI number is initiated
in the pre-service stage, the requested service is screened for medical
using which of the following data sets: - ANSWER--Patient's full legal name
necessity, health plan coverage and benefits are verified and: - ANSWER--
and date of birth or the patient's Social Security number
Pre-authorization are obtained
, HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE
EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED |ALREADY QUESTIONS AND CORRECT DETAILED |ALREADY
GRADED A+ GRADED A+
For scheduled patients, important revenue cycle activities in the time-of -
service stage DO NOT include: - ANSWER--Final bill is presented for
he HCCAHPS (Hospital Consumer Assessment of Healthcare Provider's
payment
and Systems) initiative was launched to: - ANSWER--Provide a
standardized method for evaluation patients' perspective on hospital care
If a medical service authorization, who is typically responsible for obtaining
the authorization: - ANSWER--The provider scheduling
All of the following are potential causes of credit balances EXCEPT: -
ANSWER--A patient's choice to build up a credit against future medical bills
Concurrent review and discharge planning - ANSWER--Occurs during
service
Medicare will only pay for tests and services that: - ANSWER--Can be
demonstrated as necessary
The fundamental approach in managing denials is: - ANSWER--To analyze
the type and sources of denials and consider process changes to eliminate
This was developed to promote and ensure healthcare quality and value
further denials
and also to protect consumers and workers in the healthcare system. This
directive is called: - ANSWER--Joint Commission for Acceleration of
Healthcare Organizations (JCAHO) safety standards
The first thing a health plan does when processing a claim is: - ANSWER--
Check if the patient is a health plan beneficiary and what is the coverage
It is important to calculate reserves to ensure: - ANSWER--A stable
financial operations and accurate financial reporting
Outsourcing options should be evaluated as - ANSWER--Any other
business service purchase
An advantage of a pre-registration program in - ANSWER--The opportunity
to reduce processing times at the time of service
Insurance verification results in which of the following: - ANSWER--The
accurate identification of the patient's eligibility and benefits
To be eligible for Medicaid, an individual must: - ANSWER--Meet income
and asset requirements
EMTLA and HFMA best practices specify that in an Emergency
Department setting: - ANSWER--No patient financial discussions should
occur before a patient is screened and stabilized
