CRCR 2024 UPDATE COMPREHENSIVE QUESTIONS
AND VERIFIED CORRECT ANSWERS ( EXAM
PRACTICE)
Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations
operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct - (correct answer) A
A portion of the accounts receivable inventory which has
NOT qualified for billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not
activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency - (correct
answer) A
Local Coverage Determinations (LCD) and National
Coverage Determinations (NCD) are
Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred
to
,Medicaid - (correct answer) C
The disadvantages of outsourcing include all of the
following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts
receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on
outsourced staff - (correct answer) D
The Medicare fee-for service appeal process for both
beneficiaries and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's
panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for
Medicare
d) Review by the Medicare Appeals Council (Appeals
Council) - (correct answer) B
Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date - (correct answer) C
Patients are contacting hospitals to proactively inquire
about costs and fees prior to
,agreeing to service. The problem for hospitals in providing
such information is:
a) That hospitals don't want to establish a price without
knowing if
the patient has insurance and how much reimbursement
can be
expected
b) The fact that charge master lists the total charge, not net
charges
that reflect charges after a payer's contractual adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional
charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information -
(correct answer) B
Across all care settings, if a patient consents to a financial
discussion during a medical
encounter to expedite discharge, the HFMA best practice is
to:
a) Make sure that the attending staff can answer questions
and
assist in obtaining required patient financial data
b) Have a patient financial responsibilities kit ready for the
patient,
containing all of the required registration forms and
instructions
c) Support that choice, providing that the discussion does
not
interfere with patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt
patient
, care and patient flow - (correct answer) C
A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to
regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of
regulations imposed by a government agency are being met
d) The development of operational policies that correspond
to
regulations - (correct answer) C
Case Management requires that a case manager be
assigned
a) To patients of any physician requesting case
management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual
agreement - (correct answer) B
Pricing transparency is defined as readily available
information on the price of
healthcare services, that together with other information,
help define the value of those
services and enable consumers to
a) Identify, compare, and choose providers that offer the
desired
level of value
b) Customize health care with a personally chosen mix of
providers
AND VERIFIED CORRECT ANSWERS ( EXAM
PRACTICE)
Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations
operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct - (correct answer) A
A portion of the accounts receivable inventory which has
NOT qualified for billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not
activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency - (correct
answer) A
Local Coverage Determinations (LCD) and National
Coverage Determinations (NCD) are
Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred
to
,Medicaid - (correct answer) C
The disadvantages of outsourcing include all of the
following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts
receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on
outsourced staff - (correct answer) D
The Medicare fee-for service appeal process for both
beneficiaries and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's
panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for
Medicare
d) Review by the Medicare Appeals Council (Appeals
Council) - (correct answer) B
Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date - (correct answer) C
Patients are contacting hospitals to proactively inquire
about costs and fees prior to
,agreeing to service. The problem for hospitals in providing
such information is:
a) That hospitals don't want to establish a price without
knowing if
the patient has insurance and how much reimbursement
can be
expected
b) The fact that charge master lists the total charge, not net
charges
that reflect charges after a payer's contractual adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional
charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information -
(correct answer) B
Across all care settings, if a patient consents to a financial
discussion during a medical
encounter to expedite discharge, the HFMA best practice is
to:
a) Make sure that the attending staff can answer questions
and
assist in obtaining required patient financial data
b) Have a patient financial responsibilities kit ready for the
patient,
containing all of the required registration forms and
instructions
c) Support that choice, providing that the discussion does
not
interfere with patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt
patient
, care and patient flow - (correct answer) C
A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to
regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of
regulations imposed by a government agency are being met
d) The development of operational policies that correspond
to
regulations - (correct answer) C
Case Management requires that a case manager be
assigned
a) To patients of any physician requesting case
management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual
agreement - (correct answer) B
Pricing transparency is defined as readily available
information on the price of
healthcare services, that together with other information,
help define the value of those
services and enable consumers to
a) Identify, compare, and choose providers that offer the
desired
level of value
b) Customize health care with a personally chosen mix of
providers
