Certified Revenue Cycle Representative –
CRCR Study Guide Questions And Answers
Verified 100% Correct
Which option is NOT a department that supports and collaborates with the
revenue cycle? - ANSWER -A. Information Technology
B. Clinical Services
C. Finance
**D. Assisted Living Services
Which option is NOT a continuum of care provider? - ANSWER -A. Physician
**B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
Which of the following are essential elements of an effective compliance
program? - ANSWER -**Reasonable methods to achieve compliance with
standards, including monitoring systems and hotlines
**Established compliance standards and procedures
Automatic dismissal of any employee excluded from participation in a federal
healthcare program
**Designation of a compliance officer employed within the Billing Department
**Oversight of personnel by high-level personnel.
Annually, the OIG publishes a work plan of compliance issues and objectives that
will be focused on throughout the following year. Identify which option is NOT a
work plan task mentioned in this course. - ANSWER -A. Payments to Physicians
for Co-Surgery Procedures
B. Denials and Appeals in Medicare Part D
,C. Medicare Hospital Payments for Claims Involving the Acute- and Post-Acute-
Care Transfer Policies
**D. Standard Unique Employer Identifier
In order to promote the use of correct coding methods on a national basis and
prevent payment errors due to improper coding, CMS developed what? -
ANSWER -**A. The Correct Coding Initiative (CCI)
B. The Advance Beneficiary Notice of Noncoverage (ABN)
C. The Medicare Secondary Payer (MSP)
D. Modifiers
Indicate if the activity is described by the appropriate description of the violation
involved: - ANSWER -True - A staff member receives cash in the mail and does
not immediately report the case to the manager for special handling. This is an
example of financial misconduct
False - A mother sees a charge on her hospital bill for a circumcision for a
newborn girl. This is an example of falsifying medical records to boost
reimbursement.
True - A patient access staff member takes several file folders and highlighters
home for personal use. This is an example of theft of property.
False - A physician documents a fictitious epidural in a patient's medical record in
an effort to receive additional payment. This is an example of miscoding claims
True - Several unauthorized claims are sent to a health plan with the wrong
procedure code. This is an example of overcharging.
What do business/organizational ethics represent? - ANSWER -**A. Principles
and standards by which organizations operate
B. A healthcare provider's practices and principles
C. An employee's actions influenced by experiences and value system
D. The patient privacy standard within healthcare
, What is the intended outcome of collaborations made through an ACO delivery
system? - ANSWER -**A. To ensure appropriateness of care, elimination of
duplicate services, and prevention of medical errors for a population of patients.
B. To create cost-containment provisions to reform the healthcare delivery system.
C. To reform the healthcare system into a system that rewards greater value,
improves the quality of care and increases efficiency in the delivery of services.
D. To provide financial incentives to physicians for reporting quality data to CMS.
Which of these statements describes the new methodology for the determination
of net patient service revenue: - ANSWER -A. Net patient service revenue is
defined as the average payment amount for the payer but not recorded until the end
of the month processing is completed.
B. Gross patient service revenue is recorded as net patient service revenue until
such time as all payments are received.
**C. Net patient service revenue is defined as the total incurred charges, less the
explicit price concession, less any applicable implicit price concession(s) as
applied to the specific portfolio of accounts.
D. Net patient service revenue is gross revenue minus any contractual adjustments
applicable to the account. Any additional adjustments are not recorded until the
account reaches a zero balance.
E. Net patient service revenue is the sum of the balances of all charges and
payments recorded in the accounting period.
What are KPIs? - ANSWER -A. Benchmarks which are used to compare Key
Performance Indicators in an organization to an agreed upon average or expected
standard within the same industry.
**B. Key performance indicators, which set standards for accounts receivable
(A/R) and provide a method of measuring the collection and control of A/R.
C. Days in A/R is calculated based on the value of the total accounts receivable on
a specific date.
D. A component that can divide the accounts receivable into 30, 60, 90, 120 days,
and over 120 days categories, based on the date of service/discharge
While the highest level of differentiation among patients is scheduled patient vs
unscheduled patient, a variety of patient types are routinely identified in both the
CRCR Study Guide Questions And Answers
Verified 100% Correct
Which option is NOT a department that supports and collaborates with the
revenue cycle? - ANSWER -A. Information Technology
B. Clinical Services
C. Finance
**D. Assisted Living Services
Which option is NOT a continuum of care provider? - ANSWER -A. Physician
**B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
Which of the following are essential elements of an effective compliance
program? - ANSWER -**Reasonable methods to achieve compliance with
standards, including monitoring systems and hotlines
**Established compliance standards and procedures
Automatic dismissal of any employee excluded from participation in a federal
healthcare program
**Designation of a compliance officer employed within the Billing Department
**Oversight of personnel by high-level personnel.
Annually, the OIG publishes a work plan of compliance issues and objectives that
will be focused on throughout the following year. Identify which option is NOT a
work plan task mentioned in this course. - ANSWER -A. Payments to Physicians
for Co-Surgery Procedures
B. Denials and Appeals in Medicare Part D
,C. Medicare Hospital Payments for Claims Involving the Acute- and Post-Acute-
Care Transfer Policies
**D. Standard Unique Employer Identifier
In order to promote the use of correct coding methods on a national basis and
prevent payment errors due to improper coding, CMS developed what? -
ANSWER -**A. The Correct Coding Initiative (CCI)
B. The Advance Beneficiary Notice of Noncoverage (ABN)
C. The Medicare Secondary Payer (MSP)
D. Modifiers
Indicate if the activity is described by the appropriate description of the violation
involved: - ANSWER -True - A staff member receives cash in the mail and does
not immediately report the case to the manager for special handling. This is an
example of financial misconduct
False - A mother sees a charge on her hospital bill for a circumcision for a
newborn girl. This is an example of falsifying medical records to boost
reimbursement.
True - A patient access staff member takes several file folders and highlighters
home for personal use. This is an example of theft of property.
False - A physician documents a fictitious epidural in a patient's medical record in
an effort to receive additional payment. This is an example of miscoding claims
True - Several unauthorized claims are sent to a health plan with the wrong
procedure code. This is an example of overcharging.
What do business/organizational ethics represent? - ANSWER -**A. Principles
and standards by which organizations operate
B. A healthcare provider's practices and principles
C. An employee's actions influenced by experiences and value system
D. The patient privacy standard within healthcare
, What is the intended outcome of collaborations made through an ACO delivery
system? - ANSWER -**A. To ensure appropriateness of care, elimination of
duplicate services, and prevention of medical errors for a population of patients.
B. To create cost-containment provisions to reform the healthcare delivery system.
C. To reform the healthcare system into a system that rewards greater value,
improves the quality of care and increases efficiency in the delivery of services.
D. To provide financial incentives to physicians for reporting quality data to CMS.
Which of these statements describes the new methodology for the determination
of net patient service revenue: - ANSWER -A. Net patient service revenue is
defined as the average payment amount for the payer but not recorded until the end
of the month processing is completed.
B. Gross patient service revenue is recorded as net patient service revenue until
such time as all payments are received.
**C. Net patient service revenue is defined as the total incurred charges, less the
explicit price concession, less any applicable implicit price concession(s) as
applied to the specific portfolio of accounts.
D. Net patient service revenue is gross revenue minus any contractual adjustments
applicable to the account. Any additional adjustments are not recorded until the
account reaches a zero balance.
E. Net patient service revenue is the sum of the balances of all charges and
payments recorded in the accounting period.
What are KPIs? - ANSWER -A. Benchmarks which are used to compare Key
Performance Indicators in an organization to an agreed upon average or expected
standard within the same industry.
**B. Key performance indicators, which set standards for accounts receivable
(A/R) and provide a method of measuring the collection and control of A/R.
C. Days in A/R is calculated based on the value of the total accounts receivable on
a specific date.
D. A component that can divide the accounts receivable into 30, 60, 90, 120 days,
and over 120 days categories, based on the date of service/discharge
While the highest level of differentiation among patients is scheduled patient vs
unscheduled patient, a variety of patient types are routinely identified in both the
