CRCR EXAM MULTIPLE CHOICE, CRCR
Exam Prep, Certified Revenue Cycle
Representative - CRCR (2023)/ Questions
and Answers/ Verified /Graded A+
What are collection agency fees based on? - -A percentage of
dollars collected
-Self-funded benefit plans may choose to coordinate benefits
using the gender rule or what other rule? - -Birthday
-In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all
providers? - -Case rates
-What customer service improvements might improve the patient
accounts department? - -Holding staff accountable for customer
service during performance reviews
-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
-What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance? - -Bad debt
adjustment
,-What is the initial hospice benefit? - -Two 90-day periods and an
unlimited number of subsequent periods
-When does a hospital add ambulance charges to the Medicare
inpatient claim? - -If the patient requires ambulance
transportation to a skilled nursing facility
-How should a provider resolve a late-charge credit posted after
an account is billed? - -Post a late-charge adjustment to the
account
-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
-What is an advantage of a preregistration program? - -It reduces
processing times at the time of service
-What are the two statutory exclusions from hospice coverage? -
-Medically unnecessary services and custodial care
-What core financial activities are resolved within patient access?
- -Scheduling, insurance verification, discharge processing, and
payment of point-of-service receipts
, -What statement applies to the scheduled outpatient? - -The
services do not involve an overnight stay
-How is a mis-posted contractual allowance resolved? - -
Comparing the contract reimbursement rates with the contract on
the admittance advice to identify the correct amount
-What type of patient status is used to evaluate the patient's
need for inpatient care? - -Observation
-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
-When is the word "SAME" entered on the CMS 1500 billing form
in Field 0$? - -When the patient is the insured
-What are non-emergency patients who come for service without
prior notification to the provider called? - -Unscheduled patients
-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
, -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
-What is a principal diagnosis? - -Primary reason for the patient's
admission
-Collecting patient liability dollars after service leads to what? - -
Lower accounts receivable levels
-What is the daily out-of-pocket amount for each lifetime reserve
day used? - -50% of the current deductible amount
-What service provided to a Medicare beneficiary in a rural health
clinic (RHC) is not billable as an RHC services? - -Inpatient care
-What code indicates the disposition of the patient at the
conclusion of service? - -Patient discharge status code
-What are hospitals required to do for Medicare credit balance
accounts? - -They result in lost reimbursement and additional
cost to collect
-When an undue delay of payment results from a dispute
between the patient and the third party payer, who is responsible
for payment? - -Patient
Exam Prep, Certified Revenue Cycle
Representative - CRCR (2023)/ Questions
and Answers/ Verified /Graded A+
What are collection agency fees based on? - -A percentage of
dollars collected
-Self-funded benefit plans may choose to coordinate benefits
using the gender rule or what other rule? - -Birthday
-In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all
providers? - -Case rates
-What customer service improvements might improve the patient
accounts department? - -Holding staff accountable for customer
service during performance reviews
-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
-What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance? - -Bad debt
adjustment
,-What is the initial hospice benefit? - -Two 90-day periods and an
unlimited number of subsequent periods
-When does a hospital add ambulance charges to the Medicare
inpatient claim? - -If the patient requires ambulance
transportation to a skilled nursing facility
-How should a provider resolve a late-charge credit posted after
an account is billed? - -Post a late-charge adjustment to the
account
-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
-What is an advantage of a preregistration program? - -It reduces
processing times at the time of service
-What are the two statutory exclusions from hospice coverage? -
-Medically unnecessary services and custodial care
-What core financial activities are resolved within patient access?
- -Scheduling, insurance verification, discharge processing, and
payment of point-of-service receipts
, -What statement applies to the scheduled outpatient? - -The
services do not involve an overnight stay
-How is a mis-posted contractual allowance resolved? - -
Comparing the contract reimbursement rates with the contract on
the admittance advice to identify the correct amount
-What type of patient status is used to evaluate the patient's
need for inpatient care? - -Observation
-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
-When is the word "SAME" entered on the CMS 1500 billing form
in Field 0$? - -When the patient is the insured
-What are non-emergency patients who come for service without
prior notification to the provider called? - -Unscheduled patients
-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
, -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
-What is a principal diagnosis? - -Primary reason for the patient's
admission
-Collecting patient liability dollars after service leads to what? - -
Lower accounts receivable levels
-What is the daily out-of-pocket amount for each lifetime reserve
day used? - -50% of the current deductible amount
-What service provided to a Medicare beneficiary in a rural health
clinic (RHC) is not billable as an RHC services? - -Inpatient care
-What code indicates the disposition of the patient at the
conclusion of service? - -Patient discharge status code
-What are hospitals required to do for Medicare credit balance
accounts? - -They result in lost reimbursement and additional
cost to collect
-When an undue delay of payment results from a dispute
between the patient and the third party payer, who is responsible
for payment? - -Patient
