CRCR 4 - Post-Service Financial Care – Exam with || || || || || || || || ||
verified detailed answers || ||
Credit balances may be created by any of the following activities except:
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(Pre-Test 4) ||
Credits to pharmacy charges posted before the claim final bills.
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Which of the following statements represent common reasons for inpatient claim denials?
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(Pre-Test 4) ||
Failure to obtain a required pre-authorization; failure to complete a continued stay
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authorization and services provided which were not medically necessary. || || || || || || || ||
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A 68-year-old patient, a Medicare beneficiary, was in a car accident. A medical insurance
|| || || || || || || || || || || || || ||
claim was filed with the auto insurance carrier. Six months later this claim remains unpaid.
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How can the provider pursue payment from Medicare?
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(Pre-Test 4) ||
The provider must first bill the auto insurer; however, after a period of 120 days, if the claim
|| || || || || || || || || || || || || || || || ||
remains unpaid, the provider may cancel the liability claim and bill Medicare.
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The difference between bad debt and financial assistance (charity) is:
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(Pre-Test 4) ||
Bad debt represents a refusal to pay; charity represents an inability to pay.
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In order to qualify for financial assistance, a patient or guarantor should:
|| || || || || || || || || || ||
(Pre-Test 4) ||
Provide the following documents: prior year tax return, employment check stubs from the
|| || || || || || || || || || || || ||
prior three months and bank statements from the prior three months.
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, To comply with the requirements of Section 501(r) for tax-exempt hospitals chartered as
|| || || || || || || || || || || || ||
510(c)3 providers, the hospital must complete with of the following activities:
|| || || || || || || || || ||
(Pre-Test 4) ||
A community needs assessment.
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The three types of bankruptcy as defined in the 1979 Bankruptcy Act are:
|| || || || || || || || || || || ||
(Pre-Test 4) ||
Chapter 7 - Straight Bankruptcy, Chapter 11 - Debtor Reorganization, and Chapter 13 -
|| || || || || || || || || || || || || ||
Debtor Rehabilitation ||
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Which of the following medical debt collection practices are recommended as part of
|| || || || || || || || || || || || ||
HFMA's Best Practices for medical account resolution: || || || || || ||
(Pre-Test 4) ||
Establish policies and ensure that they are followed. || || || || || || ||
|| || ||
Organizations may opt to contract with or outsource to specific vendors for some or all || || || || || || || || || || || || || || ||
components of revenue cycle processing. This practice has both advantages and || || || || || || || || || || ||
disadvantages.
Which of the following statements is not an advantage of utilizing an outsourcing vendor?
|| || || || || || || || || || || || ||
(Pre-Test 4) ||
The need for legal review if the outside vendor's staff represents themselves as employees of
|| || || || || || || || || || || || || || ||
the healthcare facility.
|| ||
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Each hospital covered by the 501(r) regulations is required to develop a financial assistance
|| || || || || || || || || || || || || ||
policy. Which of the following elements is not a required element of the policy?
|| || || || || || || || || || || || ||
(Pre-Test 4) ||
The notice that individuals eligible for financial assistance under this policy may be charged
|| || || || || || || || || || || || ||
more than the amount generally billed (AGB) to insured patients.
|| || || || || || || || || ||
|| || ||
There are 9 daily reconciliation process steps.
|| || || || || || ||
Select the proper order of the first four steps.
|| || || || || || || ||
verified detailed answers || ||
Credit balances may be created by any of the following activities except:
|| || || || || || || || || || ||
(Pre-Test 4) ||
Credits to pharmacy charges posted before the claim final bills.
|| || || || || || || || ||
|| || ||
Which of the following statements represent common reasons for inpatient claim denials?
|| || || || || || || || || || ||
(Pre-Test 4) ||
Failure to obtain a required pre-authorization; failure to complete a continued stay
|| || || || || || || || || || || ||
authorization and services provided which were not medically necessary. || || || || || || || ||
|| || ||
A 68-year-old patient, a Medicare beneficiary, was in a car accident. A medical insurance
|| || || || || || || || || || || || || ||
claim was filed with the auto insurance carrier. Six months later this claim remains unpaid.
|| || || || || || || || || || || || || ||
How can the provider pursue payment from Medicare?
|| || || || || || ||
(Pre-Test 4) ||
The provider must first bill the auto insurer; however, after a period of 120 days, if the claim
|| || || || || || || || || || || || || || || || ||
remains unpaid, the provider may cancel the liability claim and bill Medicare.
|| || || || || || || || || || || ||
|| || ||
The difference between bad debt and financial assistance (charity) is:
|| || || || || || || || ||
(Pre-Test 4) ||
Bad debt represents a refusal to pay; charity represents an inability to pay.
|| || || || || || || || || || || ||
|| || ||
In order to qualify for financial assistance, a patient or guarantor should:
|| || || || || || || || || || ||
(Pre-Test 4) ||
Provide the following documents: prior year tax return, employment check stubs from the
|| || || || || || || || || || || || ||
prior three months and bank statements from the prior three months.
|| || || || || || || || || ||
|| || ||
, To comply with the requirements of Section 501(r) for tax-exempt hospitals chartered as
|| || || || || || || || || || || || ||
510(c)3 providers, the hospital must complete with of the following activities:
|| || || || || || || || || ||
(Pre-Test 4) ||
A community needs assessment.
|| || ||
|| || ||
The three types of bankruptcy as defined in the 1979 Bankruptcy Act are:
|| || || || || || || || || || || ||
(Pre-Test 4) ||
Chapter 7 - Straight Bankruptcy, Chapter 11 - Debtor Reorganization, and Chapter 13 -
|| || || || || || || || || || || || || ||
Debtor Rehabilitation ||
|| || ||
Which of the following medical debt collection practices are recommended as part of
|| || || || || || || || || || || || ||
HFMA's Best Practices for medical account resolution: || || || || || ||
(Pre-Test 4) ||
Establish policies and ensure that they are followed. || || || || || || ||
|| || ||
Organizations may opt to contract with or outsource to specific vendors for some or all || || || || || || || || || || || || || || ||
components of revenue cycle processing. This practice has both advantages and || || || || || || || || || || ||
disadvantages.
Which of the following statements is not an advantage of utilizing an outsourcing vendor?
|| || || || || || || || || || || || ||
(Pre-Test 4) ||
The need for legal review if the outside vendor's staff represents themselves as employees of
|| || || || || || || || || || || || || || ||
the healthcare facility.
|| ||
|| || ||
Each hospital covered by the 501(r) regulations is required to develop a financial assistance
|| || || || || || || || || || || || || ||
policy. Which of the following elements is not a required element of the policy?
|| || || || || || || || || || || || ||
(Pre-Test 4) ||
The notice that individuals eligible for financial assistance under this policy may be charged
|| || || || || || || || || || || || ||
more than the amount generally billed (AGB) to insured patients.
|| || || || || || || || || ||
|| || ||
There are 9 daily reconciliation process steps.
|| || || || || || ||
Select the proper order of the first four steps.
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