CRCR Exam Prep
1. What are collection agency fees based on?: A percentage of dollars collected
2. Self-funded benefit plans may choose to coordinate benefits using the gen-
der rule or what other rule?: Birthday
3. In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers?: Case rates
4. What customer service improvements might improve the patient accounts
department?: Holding statt accountable for customer service during performance reviews
5. What is an ABN (Advance Beneficiary Notice of Non-coverage) required to
do?: Inform a Medicare beneficiary that Medicare may not pay for the order or service
6. What type of account adjustment results from the patient's unwillingness to
pay for a self-pay balance?: Bad debt adjustment
7. What is the initial hospice benefit?: Two 90-day periods and an unlimited number of subsequent
periods
8. When does a hospital add ambulance charges to the Medicare inpatient
claim?: If the patient requires ambulance transportation to a skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an account
is billed?: Post a late-charge adjustment to the account
10. an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts: They are not being processed in a timely manner
11. What is an advantage of a preregistration program?: It reduces processing times at
the time of service
12. What are the two statutory exclusions from hospice coverage?: Medically unnec-
,essary services and custodial care
13. What core financial activities are resolved within patient access?: Scheduling,
insurance verification, discharge processing, and payment of point-of-service receipts
14. What statement applies to the scheduled outpatient?: The services do not involve an
overnight stay
15. How is a mis-posted contractual allowance resolved?: Comparing the contract reim-
bursement rates with the contract on the admittance advice to identify the correct amount
16. What type of patient status is used to evaluate the patient's need for
inpatient care?: Observation
, 17. Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what?: Medically necessary inpatient hospital
services for at least 3 consecutive days before the skilled nursing care admission
18. When is the word "SAME" entered on the CMS 1500 billing form in Field
0$?: When the patient is the insured
19. What are non-emergency patients who come for service without prior
notification to the provider called?: Unscheduled patients
20. If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse?: Neither enrolled not entitled to
benefits
21. Regulation Z of the Consumer Credit Protection Act, also known as the Truth
in Lending Act, establishes what?: Disclosure rules for consumer credit sales and consumer loans
22. What is a principal diagnosis?: Primary reason for the patient's admission
23. Collecting patient liability dollars after service leads to what?: Lower accounts
receivable levels
24. What is the daily out-of-pocket amount for each lifetime reserve day used?-
: 50% of the current deductible amount
25. What service provided to a Medicare beneficiary in a rural health clinic (RHC)
is not billable as an RHC services?: Inpatient care
26. What code indicates the disposition of the patient at the conclusion of
service?: Patient discharge status code
27. What are hospitals required to do for Medicare credit balance accounts?: -
They result in lost reimbursement and additional cost to collect
28. When an undue delay of payment results from a dispute between the
1. What are collection agency fees based on?: A percentage of dollars collected
2. Self-funded benefit plans may choose to coordinate benefits using the gen-
der rule or what other rule?: Birthday
3. In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers?: Case rates
4. What customer service improvements might improve the patient accounts
department?: Holding statt accountable for customer service during performance reviews
5. What is an ABN (Advance Beneficiary Notice of Non-coverage) required to
do?: Inform a Medicare beneficiary that Medicare may not pay for the order or service
6. What type of account adjustment results from the patient's unwillingness to
pay for a self-pay balance?: Bad debt adjustment
7. What is the initial hospice benefit?: Two 90-day periods and an unlimited number of subsequent
periods
8. When does a hospital add ambulance charges to the Medicare inpatient
claim?: If the patient requires ambulance transportation to a skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an account
is billed?: Post a late-charge adjustment to the account
10. an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts: They are not being processed in a timely manner
11. What is an advantage of a preregistration program?: It reduces processing times at
the time of service
12. What are the two statutory exclusions from hospice coverage?: Medically unnec-
,essary services and custodial care
13. What core financial activities are resolved within patient access?: Scheduling,
insurance verification, discharge processing, and payment of point-of-service receipts
14. What statement applies to the scheduled outpatient?: The services do not involve an
overnight stay
15. How is a mis-posted contractual allowance resolved?: Comparing the contract reim-
bursement rates with the contract on the admittance advice to identify the correct amount
16. What type of patient status is used to evaluate the patient's need for
inpatient care?: Observation
, 17. Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what?: Medically necessary inpatient hospital
services for at least 3 consecutive days before the skilled nursing care admission
18. When is the word "SAME" entered on the CMS 1500 billing form in Field
0$?: When the patient is the insured
19. What are non-emergency patients who come for service without prior
notification to the provider called?: Unscheduled patients
20. If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse?: Neither enrolled not entitled to
benefits
21. Regulation Z of the Consumer Credit Protection Act, also known as the Truth
in Lending Act, establishes what?: Disclosure rules for consumer credit sales and consumer loans
22. What is a principal diagnosis?: Primary reason for the patient's admission
23. Collecting patient liability dollars after service leads to what?: Lower accounts
receivable levels
24. What is the daily out-of-pocket amount for each lifetime reserve day used?-
: 50% of the current deductible amount
25. What service provided to a Medicare beneficiary in a rural health clinic (RHC)
is not billable as an RHC services?: Inpatient care
26. What code indicates the disposition of the patient at the conclusion of
service?: Patient discharge status code
27. What are hospitals required to do for Medicare credit balance accounts?: -
They result in lost reimbursement and additional cost to collect
28. When an undue delay of payment results from a dispute between the
