CERTIFIED REVENUE CYCLE
REPRESENTATIVE (CRCR)
Pricing,transparency,is,defined,as,readily,available,information,on,the,price,of,healthcare,s
ervices,,that,together,with,other,information,,help,define,the,value,of,those,services,and,en
able,consumers,to,-,ans-
✔✔Identify,,compare,,and,choose,providers,that,offer,the,desired,level,of,value.
Because,case,managers,document,the,clinical,reasons,for,treatment,,they,are,-,ans-
✔✔A,good,resource,when,developing,written,appeals,and,denials.
All,of,the,following,information,describe,claim,edits,EXCEPT,-,ans-
✔✔The,claim,editing,process,slowed,down,the,receipt,of,payments,,increases,account,rec
eivable,outstanding,,and,decreases,cash,flow.
What,types,of,services,are,classified,as,non-acute?,-,ans-
✔✔Hospice,Care,,Clinic,Services,&,Skilled,Nursing
The,unscheduled,"direct",admission,represents,a,patient,who:,-,ans-
✔✔Is,admitted,from,a,physician's,office,on,an,urgent,basis.
The,process,of,creating,the,pre-registration,record,ensures,-,ans-
✔✔That,access,staff,will,have,complete,and,valid,information,needed,to,finalize,any,remai
ning,pre-access,activities.
An,advantage,of,a,pre-registration,program,is,-,ans-
✔✔The,opportunity,to,reduce,processing,times,at,the,time,of,service.
Claim,edits,are,-,ans-
✔✔Rules,developed,to,verify,the,accuracy,of,claims,based,on,each,health,plan's,policies.
Examples,of,ethic,violations,that,impact,the,revenue,cycle,include,all,of,the,following,EXC
EPT,-,ans-✔✔Seeking,payment,options,for,patient,self-pay
EMTALA,and,HFMA,best,practices,specify,that,,in,an,Emergency,Department,setting,-,ans
-
✔✔No,patient,financial,discussions,should,occur,before,a,patient,is,screened,and,stabilize
d.
, Which,of,the,following,is,usually,covered,on,a,Conditions,of,Admission,form,-,ans-
✔✔Release,of,information
The,nuanced,data,resulting,from,detailed,ICD-
10,coding,allows,senior,leadership,to,work,with,physicians,to,do,all,of,the,following,EXCEP
T,-,ans-✔✔Obtain,higher,compensation,for,physicians
Selecting,the,wrong,insurance,plan,code,can,lead,to,the,following,problems,or,denials,,exc
ept,-,ans-✔✔Estimating,the,wrong,reimbursement
Eliminating,mail,time,and,reducing,data,entry,time,,electronically,monitoring,the,receipt,of,
claims,and,online,claim,adjudication;,more,prompt,payment,are,all,benefits,achieved,by,-,a
ns-✔✔The,electronic,submission,of,claims,using,electronic,transactions
Process,observation,is,a,part,of,what,framework,of,Revenue,Cycle?,-,ans-✔✔Compliance
ICD-10-CM,and,ICD-10-PCS,code,sets,are,modifications,of,-,ans-
✔✔The,international,ICD-10,codes,as,developed,by,the,WHO,
(World,Health,Organization)
In,the,balance,resolution,process,,providers,should:,-,ans-
✔✔Ask,the,patient,if,he,or,she,would,like,to,receive,information,about,payment,options,an
d,supportive,financial,assistance,programs
A,claim,is,denied,for,the,following,reasons,,EXCEPT,-,ans-
✔✔The,submitted,claim,does,not,have,the,physicians,signature
What,is,a,component,of,HFMA's,"Healthcare,Dollars,&,Sense",initiative?,-,ans-
✔✔Medical,Account,Resolution
Charges,,as,the,most,appropriate,measurement,of,utilization,enables,-,ans-
✔✔Accuracy,of,expense,and,cost,capture,in,the,revenue,cycle
Net,Accounts,Receivable,is,-,ans-
✔✔The,amount,an,entity,is,reasonably,confident,of,collection,from,overall,accounts,receiv
ables
The,soft,cost,of,a,dissatisfied,customer,is,-,ans-
✔✔The,customer,passing,on,information,about,their,negative,experience,to,potential,patie
nts,or,through,social,media,channels.
A,Medicare,Part,A,benefit,period,begins,-,ans-
✔✔The,first,day,in,which,an,individual,has,not,been,a,hospital,inpatient,nor,in,a,skilled,nurs
ing,facility,for,the,previous,60,days.
REPRESENTATIVE (CRCR)
Pricing,transparency,is,defined,as,readily,available,information,on,the,price,of,healthcare,s
ervices,,that,together,with,other,information,,help,define,the,value,of,those,services,and,en
able,consumers,to,-,ans-
✔✔Identify,,compare,,and,choose,providers,that,offer,the,desired,level,of,value.
Because,case,managers,document,the,clinical,reasons,for,treatment,,they,are,-,ans-
✔✔A,good,resource,when,developing,written,appeals,and,denials.
All,of,the,following,information,describe,claim,edits,EXCEPT,-,ans-
✔✔The,claim,editing,process,slowed,down,the,receipt,of,payments,,increases,account,rec
eivable,outstanding,,and,decreases,cash,flow.
What,types,of,services,are,classified,as,non-acute?,-,ans-
✔✔Hospice,Care,,Clinic,Services,&,Skilled,Nursing
The,unscheduled,"direct",admission,represents,a,patient,who:,-,ans-
✔✔Is,admitted,from,a,physician's,office,on,an,urgent,basis.
The,process,of,creating,the,pre-registration,record,ensures,-,ans-
✔✔That,access,staff,will,have,complete,and,valid,information,needed,to,finalize,any,remai
ning,pre-access,activities.
An,advantage,of,a,pre-registration,program,is,-,ans-
✔✔The,opportunity,to,reduce,processing,times,at,the,time,of,service.
Claim,edits,are,-,ans-
✔✔Rules,developed,to,verify,the,accuracy,of,claims,based,on,each,health,plan's,policies.
Examples,of,ethic,violations,that,impact,the,revenue,cycle,include,all,of,the,following,EXC
EPT,-,ans-✔✔Seeking,payment,options,for,patient,self-pay
EMTALA,and,HFMA,best,practices,specify,that,,in,an,Emergency,Department,setting,-,ans
-
✔✔No,patient,financial,discussions,should,occur,before,a,patient,is,screened,and,stabilize
d.
, Which,of,the,following,is,usually,covered,on,a,Conditions,of,Admission,form,-,ans-
✔✔Release,of,information
The,nuanced,data,resulting,from,detailed,ICD-
10,coding,allows,senior,leadership,to,work,with,physicians,to,do,all,of,the,following,EXCEP
T,-,ans-✔✔Obtain,higher,compensation,for,physicians
Selecting,the,wrong,insurance,plan,code,can,lead,to,the,following,problems,or,denials,,exc
ept,-,ans-✔✔Estimating,the,wrong,reimbursement
Eliminating,mail,time,and,reducing,data,entry,time,,electronically,monitoring,the,receipt,of,
claims,and,online,claim,adjudication;,more,prompt,payment,are,all,benefits,achieved,by,-,a
ns-✔✔The,electronic,submission,of,claims,using,electronic,transactions
Process,observation,is,a,part,of,what,framework,of,Revenue,Cycle?,-,ans-✔✔Compliance
ICD-10-CM,and,ICD-10-PCS,code,sets,are,modifications,of,-,ans-
✔✔The,international,ICD-10,codes,as,developed,by,the,WHO,
(World,Health,Organization)
In,the,balance,resolution,process,,providers,should:,-,ans-
✔✔Ask,the,patient,if,he,or,she,would,like,to,receive,information,about,payment,options,an
d,supportive,financial,assistance,programs
A,claim,is,denied,for,the,following,reasons,,EXCEPT,-,ans-
✔✔The,submitted,claim,does,not,have,the,physicians,signature
What,is,a,component,of,HFMA's,"Healthcare,Dollars,&,Sense",initiative?,-,ans-
✔✔Medical,Account,Resolution
Charges,,as,the,most,appropriate,measurement,of,utilization,enables,-,ans-
✔✔Accuracy,of,expense,and,cost,capture,in,the,revenue,cycle
Net,Accounts,Receivable,is,-,ans-
✔✔The,amount,an,entity,is,reasonably,confident,of,collection,from,overall,accounts,receiv
ables
The,soft,cost,of,a,dissatisfied,customer,is,-,ans-
✔✔The,customer,passing,on,information,about,their,negative,experience,to,potential,patie
nts,or,through,social,media,channels.
A,Medicare,Part,A,benefit,period,begins,-,ans-
✔✔The,first,day,in,which,an,individual,has,not,been,a,hospital,inpatient,nor,in,a,skilled,nurs
ing,facility,for,the,previous,60,days.
