CRCR Certification (graded A)2023 LATEST UPDATE

Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid Meet Income and Assets Requirements In choosing a setting for patient financial discussions, organizations should first and foremost Respect the patients privacy A nightly room charge will be incorrect if the patient's Transfer from ICU (intensive care unit) to the Medical/Surgical floor is not reflected in the registration system The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals and small businesses can Purchase qualified health benefit plans regardless of insured's health status A portion of the accounts receivable inventory which has NOT qualified for billing includes: Charitable pledges What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare? Revenue codes This directive was developed to promote and ensure healthcare quality and value and also to protect consumers and workers in the healthcare system. This directive is called Patient bill of rights The activity which results in the accurate recording of patient bed and level of care assessment, patient transfer and patient discharge status on a real-time basis is known as Case management Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? Registration staff may routinely contact managed are plans for prior authorizations before the patient is seen by the on-duty physician HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to identify the employer of an individual described in a transaction EIN's are assigned by The Internal Revenue Service Checks received through mail, cash received through mail, and lock box are all examples of Control points for cash posting What are some core elements if a board-approved financial assistance policy? Eligibility, application process, and nonpayment collection activities A recurring/series registration is characterized by The creation of one registration record for multiple days of service With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of Medicaid in some states, it is more important than ever for hospitals to Assist patients in understanding their insurance coverage and their financial obligation The purpose of a financial report is to: Present financial information to decision makers Patient financial communications best practices produce communications that are Consistent, clear and transparent Medicare has established guidelines called the Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) that establish What services or healthcare items are covered under Medicare Any provider that has filed a timely cost report may appeal an adverse final decision received from the Medicare Administrative Contractor (MAC). This appeal may be filed with The Provider Reimbursement Review Board Concurrent review and discharge planning Occurs during service Duplicate payments occur: When providers re-bill claims based on nonpayment from the initial bill submission An individual enrolled in Medicare who is dissatisfied with the government's claim determination is entitled to reconsideration of the decision. This type of appeal is known as A beneficiary appeal Insurance verification results in which of the following The accurate identification of the patient's eligibility and benefits The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the following levels EXCEPT: Judicial review by a federal district court