CRCR Prep Exam UPDATED
QUESTIONS AND CORRECT ANSWERS
HFMA - CORRECT ANSWER Healthcare Financial Management Association
Revenue Cycle Overview: What are the 3 segments? - CORRECT ANSWER Pre-Service,
Time of Service, Post-Service
Scheduling is part of which segment of the Revenue Cycle? - CORRECT ANSWER Pre-
service
Patient-Centric Revenue Cycle - CORRECT ANSWER 1) Engaged Consumer
2) Engaged Patient
3) Satisfied Customer
Healthcare Dollars & Sense - CORRECT ANSWER 1) Price Transparency
2) Patient Financial Communications
3) Medical Account Resolution
Need for Price Transparency - CORRECT ANSWER 1) The type of service based on CPT or
MS-DRG code
2) The patients health plan
3) The patients benefit plan
Medical Account Resolution Best Practices - CORRECT ANSWER 1) Educate patients
2) Clear/Concise/Correct clear bills
3) Establish and follow policies
4) Be consistent in account resolution
5) Coordinate to avoid duplication
6) Use good judgement when communicating
7) Start account resolution when statement is sent
,8) Report back to credit bureau when account is resolved
HCAHPS - CORRECT ANSWER Hospital Consumer Assessment of Healthcare Providers and
Systems (Satisfaction Survey)
Patient Access Process - CORRECT ANSWER 1) Insurance verification, pre-certification, pre-
authorization processes should be completed prior to patients scheduled visit.
2) An incorrect estimate or incorrect application of the health plan and benefit rules resulting in debits
and credits on the patients account after the insurance company has processed the claim.
What is the objective of the HCAHPS Initiative? - CORRECT ANSWER To provide a
standardized method for evaluating patients perspective on hospital care.
Departments that support and collaborate with the revenue cycle - CORRECT ANSWER 1) IT
2) Clinical Services
3) Finance
4) Health Plan Contracting
Physician order should include - CORRECT ANSWER 1) Date
2) Valid diagnosis
3) Patients name
4) Physician name and signature
5) Description of test or test ordered
Continuum providers - CORRECT ANSWER 1) Physician
2) Skilled Nursing Facility
3) Home Health Agency
4) Durable Medical Equipment
5) Hospice
6) Assisted Living
, OIG stands for what? - CORRECT ANSWER Office of Inspector General
FCA stands for what? - CORRECT ANSWER False Claims Act
FERA stands for what? - CORRECT ANSWER Fraud Enforcement and Recovery Act 2009
What does FERA do for the Government? - CORRECT ANSWER Close loopholes , Enhance
the ability of the government, whistleblowers and reporting individuals to identify and successfully
pursue entities and individuals who improperly receive government funds.
Compliance Program is defined as - CORRECT ANSWER Systematic procedures instituted by
an organization to ensure that the provisions of the regulations imposed by a government agency are
being met." (2016)
Corporate Compliance Program Elements - CORRECT ANSWER 1) Self reporting
2) Corporate culture
3) Full support
4) Oversight
5) Written procedures
6) Training and education
7) Hotline
8) Employment of excluded individuals
9) Standards compliance
10) Established compliance standards and procedures.
11) Written communication standards and procedures.
12) An effective plan to communicate to employees and agents.
13) Discretionary authority vested in persons unlikely to engage in criminal conduct.
14) Mechanisms for monitoring compliance, including independent evaluations.
15) Appropriate and consistent disciplinary measures and mechanisms for employees violating
procedures/ethics.
16) Implementation of an audit plan with the following elements:
- Clearly defined goals that identify the specific company practices to be audited
QUESTIONS AND CORRECT ANSWERS
HFMA - CORRECT ANSWER Healthcare Financial Management Association
Revenue Cycle Overview: What are the 3 segments? - CORRECT ANSWER Pre-Service,
Time of Service, Post-Service
Scheduling is part of which segment of the Revenue Cycle? - CORRECT ANSWER Pre-
service
Patient-Centric Revenue Cycle - CORRECT ANSWER 1) Engaged Consumer
2) Engaged Patient
3) Satisfied Customer
Healthcare Dollars & Sense - CORRECT ANSWER 1) Price Transparency
2) Patient Financial Communications
3) Medical Account Resolution
Need for Price Transparency - CORRECT ANSWER 1) The type of service based on CPT or
MS-DRG code
2) The patients health plan
3) The patients benefit plan
Medical Account Resolution Best Practices - CORRECT ANSWER 1) Educate patients
2) Clear/Concise/Correct clear bills
3) Establish and follow policies
4) Be consistent in account resolution
5) Coordinate to avoid duplication
6) Use good judgement when communicating
7) Start account resolution when statement is sent
,8) Report back to credit bureau when account is resolved
HCAHPS - CORRECT ANSWER Hospital Consumer Assessment of Healthcare Providers and
Systems (Satisfaction Survey)
Patient Access Process - CORRECT ANSWER 1) Insurance verification, pre-certification, pre-
authorization processes should be completed prior to patients scheduled visit.
2) An incorrect estimate or incorrect application of the health plan and benefit rules resulting in debits
and credits on the patients account after the insurance company has processed the claim.
What is the objective of the HCAHPS Initiative? - CORRECT ANSWER To provide a
standardized method for evaluating patients perspective on hospital care.
Departments that support and collaborate with the revenue cycle - CORRECT ANSWER 1) IT
2) Clinical Services
3) Finance
4) Health Plan Contracting
Physician order should include - CORRECT ANSWER 1) Date
2) Valid diagnosis
3) Patients name
4) Physician name and signature
5) Description of test or test ordered
Continuum providers - CORRECT ANSWER 1) Physician
2) Skilled Nursing Facility
3) Home Health Agency
4) Durable Medical Equipment
5) Hospice
6) Assisted Living
, OIG stands for what? - CORRECT ANSWER Office of Inspector General
FCA stands for what? - CORRECT ANSWER False Claims Act
FERA stands for what? - CORRECT ANSWER Fraud Enforcement and Recovery Act 2009
What does FERA do for the Government? - CORRECT ANSWER Close loopholes , Enhance
the ability of the government, whistleblowers and reporting individuals to identify and successfully
pursue entities and individuals who improperly receive government funds.
Compliance Program is defined as - CORRECT ANSWER Systematic procedures instituted by
an organization to ensure that the provisions of the regulations imposed by a government agency are
being met." (2016)
Corporate Compliance Program Elements - CORRECT ANSWER 1) Self reporting
2) Corporate culture
3) Full support
4) Oversight
5) Written procedures
6) Training and education
7) Hotline
8) Employment of excluded individuals
9) Standards compliance
10) Established compliance standards and procedures.
11) Written communication standards and procedures.
12) An effective plan to communicate to employees and agents.
13) Discretionary authority vested in persons unlikely to engage in criminal conduct.
14) Mechanisms for monitoring compliance, including independent evaluations.
15) Appropriate and consistent disciplinary measures and mechanisms for employees violating
procedures/ethics.
16) Implementation of an audit plan with the following elements:
- Clearly defined goals that identify the specific company practices to be audited
