HFMA CRCR Study question with verified detailed solutions
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Pre-Service patient experience - ✔✔Scheduling, Pre-reg, insurance verificaiton,
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pre-certification, price estimation, financial counseling, cashiering (scheduled patients) || || || || || || ||
Time of service patient experience - ✔✔Arrival, validation and activation, financial
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clearance, patient care delivery, clinical documentation and revenue recognition,
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case/referral management. (scheduled and unscheduled patients) || || || || ||
Post-service patient experience - ✔✔Claim processing, remittance processing, denial
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processing, payer payment analysis, third-[arty follow up, customer service, self-pay
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collection, collection agency. (after patient discharge)
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Healthcare dollars and sense - ✔✔Name given to ID 3 HFMA revenue cycle initiatives:
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Financial counseling, price transparency, and medical account resolution
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Price transparency best practice - ✔✔ACA allows for open market insurance with clear
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pricing info. Patient needs price transparency in healthcare and a consumer guide with
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pricing information (1.2)
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Consents are signed as part of the post-service process, true or false? - ✔✔False
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In what manner do case managers assist revenue cycle staff? - ✔✔By providing assistance
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with written appeals to health plans related to utilization and other care issues
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True or false? The patient is scheduled and registered for service is a time-of-service activity
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- ✔✔False-the patient is scheduled and registered prior to the time of service
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, Which option is NOT a HFMA best practice?
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A. Coordinate the resolution of bad debt accounts with a law firm
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B. Establish policies and ensure that they are followed
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C. Coordinate account resolution activities with business affiliates
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D. Report back to credit bureaus when an account is resolved - ✔✔A. Coordinate the
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resolution of bad debt accounts with a law firm
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Which option is NOT a specific managed care requirement?
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A. Referrals
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B. Notification
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C. Preferred Provider Organization
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D. Discharge Planning - ✔✔C. Preferred Provider Organization
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What is a PPO (Preferred Provider Organization)? - ✔✔It is a health plan where the
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employer and the health plan contract to purchase healthcare services for covered
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beneficiaries from a selected group of participating providers.
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Which option is NOT a lien type?
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A.Judicial
B.Subrogation
C.Statutory
D.Agreement (Consensus) - ✔✔B. Subrogation || || || ||
Collection rates are... || ||
A. Always guaranteed by the collection agency.
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B. Accurately calculated to demonstrate the actual recovery percentage rate.
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C. Calculated using agency's private formula.
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Pre-Service patient experience - ✔✔Scheduling, Pre-reg, insurance verificaiton,
|| || || || || || || ||
pre-certification, price estimation, financial counseling, cashiering (scheduled patients) || || || || || || ||
Time of service patient experience - ✔✔Arrival, validation and activation, financial
|| || || || || || || || || || ||
clearance, patient care delivery, clinical documentation and revenue recognition,
|| || || || || || || || ||
case/referral management. (scheduled and unscheduled patients) || || || || ||
Post-service patient experience - ✔✔Claim processing, remittance processing, denial
|| || || || || || || || ||
processing, payer payment analysis, third-[arty follow up, customer service, self-pay
|| || || || || || || || || ||
collection, collection agency. (after patient discharge)
|| || || || ||
Healthcare dollars and sense - ✔✔Name given to ID 3 HFMA revenue cycle initiatives:
|| || || || || || || || || || || || || ||
Financial counseling, price transparency, and medical account resolution
|| || || || || || ||
Price transparency best practice - ✔✔ACA allows for open market insurance with clear
|| || || || || || || || || || || || ||
pricing info. Patient needs price transparency in healthcare and a consumer guide with
|| || || || || || || || || || || || ||
pricing information (1.2)
|| ||
Consents are signed as part of the post-service process, true or false? - ✔✔False
|| || || || || || || || || || || || ||
In what manner do case managers assist revenue cycle staff? - ✔✔By providing assistance
|| || || || || || || || || || || || || ||
with written appeals to health plans related to utilization and other care issues
|| || || || || || || || || || || ||
True or false? The patient is scheduled and registered for service is a time-of-service activity
|| || || || || || || || || || || || || || ||
- ✔✔False-the patient is scheduled and registered prior to the time of service
|| || || || || || || || || || || ||
, Which option is NOT a HFMA best practice?
|| || || || || || ||
A. Coordinate the resolution of bad debt accounts with a law firm
|| || || || || || || || || || ||
B. Establish policies and ensure that they are followed
|| || || || || || || ||
C. Coordinate account resolution activities with business affiliates
|| || || || || || ||
D. Report back to credit bureaus when an account is resolved - ✔✔A. Coordinate the
|| || || || || || || || || || || || || || ||
resolution of bad debt accounts with a law firm
|| || || || || || || ||
Which option is NOT a specific managed care requirement?
|| || || || || || || ||
A. Referrals
||
B. Notification
||
C. Preferred Provider Organization
|| || ||
D. Discharge Planning - ✔✔C. Preferred Provider Organization
|| || || || || || ||
What is a PPO (Preferred Provider Organization)? - ✔✔It is a health plan where the
|| || || || || || || || || || || || || || ||
employer and the health plan contract to purchase healthcare services for covered
|| || || || || || || || || || || ||
beneficiaries from a selected group of participating providers.
|| || || || || || ||
Which option is NOT a lien type?
|| || || || || ||
A.Judicial
B.Subrogation
C.Statutory
D.Agreement (Consensus) - ✔✔B. Subrogation || || || ||
Collection rates are... || ||
A. Always guaranteed by the collection agency.
|| || || || || ||
B. Accurately calculated to demonstrate the actual recovery percentage rate.
|| || || || || || || || ||
C. Calculated using agency's private formula.
|| || || || ||
