Certified Revenue Cycle Representative Study guides, Class notes & Summaries

CRCR EXAM MULTIPLE CHOICE, CRCR Exam Prep, Certified Revenue Cycle Representative - CRCR (2021) Questions with Complete Rationales What are collection agency fees based on? - ANS: A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - ANS: Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - ANS: Case rates What customer...

Certified Revenue Cycle Specialist (CRCS) Questions with Right Rationales 1-Day Rule - ANS: requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within on day prior to the hospital admission are bundled with the inpatient services for Medicare billing 3-Day Rule - ANS: requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within three days prior to the hospital a...

CRCR Exam Questions with Complete Answers What insurances is for military personnel and their families - ANS: Tricare Account receivable A/R aging reports - ANS: Divide accounts receivable into 30, 60, 90 ,120 days past due categories Which of the following is a violation of the EMTALA - ANS: Registration staff members routinely contact managed care plans for prior authorizations before the patients is seen by the on duty physician To maximize the value derived from customer complain...

CRCR 1 Exam Questions with Complete Solutions 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 acute and non-acute setting. Which patient types are typically considered acute care patient types? - ANS: Observation, newborn, Emergency (ED) Accurate identification of the patient is the first step in the scheduling process. Identifiers used in various combination to achieve ac...

CRCR Exam Questions with Complete Solutions Through what document does a hospital establish compliance standards? - ANS: code of conduct What is the purpose of OIG work plan - ANS: Identify acceptable compliance programs in various provider settings If a Medicare patient is admitted on Friday, what service falls within the three day DRG window rule? - ANS: Non-diagnostic services provided on Thursday through Friday What does a modifier allow a provider to do? - ANS: Report a specific...

Certified Revenue Cycle Specialist (CRCS) Questions with Complete Solutions 1-Day Rule - ANS: requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within on day prior to the hospital admission are bundled with the inpatient services for Medicare billing 3-Day Rule - ANS: requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within three days prior to the hospital...

CRCR Quiz Questions with Correct Rationales Which of the following statements are true of HFMA's Patient Financial Communications Best Practices? - ANS: The best practices were developed specifically to help patients understand the cost of services, their individual insurance benefits, and their responsibility for balances after insurance, if any. The patient experience includes all of the following except: - ANS: Recognition that revenue cycle processes must be patient-centric and effici...

HFMA CRCR Exam Questions with Complete Solutions Through what document does a hospital establish compliance standards? - ANS: code of conduct What is the purpose OIG work plant? - ANS: Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? - ANS: Non-diagnostic service provided on Tuesday through Friday What does a modifier allow a provider to do? - ANS: Report a specifi...

CRCR Test Review Questions with Complete Rationales Important revenue cycle activities in the pre-service stage include; - ANS: Obtaining or updating patient and guarantor information In the pre-service stage, the cost of the scheduled service is identified and the patient's health plan and benefits are used to calculate; - ANS: The amount the patient may be expected to pay after insurance. Demographic and health plan edit failures are identified and resolved within the Patient Access ...

CRCR STUDY QUESTIONS with Complete Solutions code of conduct - ANS: hospital establish compliance standards Purpose of OIG work plan? - ANS: communicate issues that will be reviewed during the year for compliance with Medicare regulations Medicare pt. admitted on Friday, what services fall within the three day window rule? - ANS: Dx services and related charges provided on the W,R, and F before adm. What does modifier allow a provider to do? - ANS: Report a specific circumstance that...