x
x
x
x
x
x
x
x
x
CRCR Practice Questions with complete
x x x x
x
solutions.
x
x
x
x
x
x
x
x
x
x
The x501(r) xregulations xrequire xnot-for-profit xproviders x501(c) x(3) xto xdo xwhich xof xthe
xfollowing xactivities? x
A. Complete xa xcommunity xneeds xassessment xand xdevelop xa xdiscount xprogram
xfor xpatient xbalances xafter xinsurance xpayment. x
B. Pursue xextraordinary xcollection xactivities xwith xall xpatients xeligible xfor xfinancial
xassistance. x
C. Implement xa xfinancial xassistance xprogram xfor xuninsured xand xunderinsured
xpatients. xD. xDiscount xall xcharges xto xself-pay xpatients xto xan xamount xgenerally xbilled
xto xall xother xpatients. x- x xcorrect xanswer. x x xA. xComplete xa xcommunity xneeds
xassessment xand xdevelop xa xdiscount xprogram xfor xpatient xbalances xafter xinsurance
xpayment x
x
The xaccurate xcapture xof xcharges xremains xcritically ximportant xbecause:
xA. xOf xthe xpotential xof xfraud xand xabuse xcharges xfrom xerroneous
xbilling. x
B. Charges xremain xone xof xthe xfew xconsistent xindicators xavailable xto xmonitor
xresource xuse. x
C. Charges xare xmeans xof xmeasuring xphysician xproductivity. x
D. Charges xprovide xthe xdata xused xin xactivity xbased xcosting. x- x xcorrect xanswer. x x xB. x
Charges xremain xone xof xthe xfew xconsistent xindicators xavailable xto xmonitor xresource
xuse x
x
The xACO xinvestment xmodel xwill xtest xthe xuse xof xpre-paid
xshared xsavings xto:
x
A. xInvest xin xtreatment xprotocols xthat xreduce xcosts
xto xMedicare
x
B. xAttract xphysicians xto xparticipate xin xthe xACO
xpayment xsystem.
x
C. xRaise xquality xratings xin xdesignated
xhospitals.
D. xEncourage xnew xACOs xto xform xin xrural xand xunderserved xareas. x- x
xcorrect xanswer. x x xD. x
, x
Encourage xnew xACOs xto xform xin xrural xand
xunderserved xareas
x
Across xall xcare xsettings, xif xa xpatient xconsents xto xa xfinancial xdiscussion xduring xa
xmedical xencounter xto xexpedite xdischarge, xthe xHFMA xbest xpractice xis xto: x
A. Have xa xpatient xfinancial xresponsibilities xkit xready xfor xthe xpatient, xcontaining xall
xof xthe xrequired xregistration xforms xand xinstructions. x
B. Make xsure xthat xthe xattending xstaff xcan xanswer xquestions xand xassist xin
xobtaining xrequired xpatient xfinancial xdata. x
C. Support xthat xchoice, xproviding xthat xthe xdiscussion xdoes xnot xinterfere xwith
xpatient xcare xor xdisrupt xpatient xflow. x
D. Decline xsuch xrequest xas xfinance xdiscussions xcan xdisrupt xpatient xcare xand
xpatient xflow. x- x xcorrect xanswer. x x xC. xSupport xthat xchoice, xproviding xthat xthe
xdiscussion xdoes xnot xinterfere xwith xpatient xcare xor xdisrupt xpatient xflow x
x
Activities xcompleted xwhen xthe xscheduled, xpre-registered xpatient xarrives xfor xservice
xincludes: x
A. Verifying xinsurance, xactivating xthe xrecord xand xdirecting xthe xpatient xto xthe xservice
xarea. x
B. Scanning xthe xdriver's xlicense xor xother xphot xidentification xand xdirecting xthe xpatient
xto xthe xfinancial xcounselor. x
C. Activating xthe xrecord, xobtaining xsignatures xand xfinalizing xfinancial xissues. x
D. Registering xthe xpatient xand xdirecting xthe xpatient xto xthe xservice xarea. x- x xcorrect
xanswer. x x xC. xActivating xthe xrecord, xobtaining xsignatures xand x
x
The xactivity xwhich xresults xin xthe xaccurate xrecording xof xpatient xbed xand xlevel xof xcare
xassessment, xpatient xtransfer xand xpatient xdischarge xstatus xon xa xreal-time xbasis xis
xknown xas: x
A. Utilization xreview x
B. Case xManagement x x
C. Census xManagement x
D. Patient xthrough-put x- x xcorrect xanswer. x x xA. xUtilization xreview xor x x
B. xCase xManagement x
x
An xadvantage xof xa xpre-registration xprogram xis: x
A. The xmarkets xvalue xof xsuch xa xprogram x
B. The xability xto xeliminate xno-show xappointments. x
C. The xopportunity xto xreduce xprocessing xtimes xat xthe xtime xof xservice. x
D. The xopportunity xto xreduce xcorporate xcompliance xfailures xwithin xthe xregistration
xprocess. x- x xcorrect xanswer. x x xC. xThe xopportunity xto xreduce xprocessing xtimes xat
xthe xtime xof xservice. x
x
The xAffordable xCare xAct xlegislated xthe xdevelopment xof xHealth xInsurance
xExchanges, xwhere xindividuals xand xsmall xbusinesses xcan: xA. xObtain xprice
xestimates xfor xmedical xservices x
B. Negotiate xthe xprice xof xmedical xservices xwith xproviders x
,C. Purchase xqualified xhealth xbenefit xplans xregardless xof xinsured's xhealth xstatus xD.
xMeet xfederal xmandates xfor xinsurance xcoverage xand xobtain xthe xcorresponding
xtax xdeduction x- x xcorrect xanswer. x x xC. xPurchase xqualified xhealth xbenefit xplans
xregardless xof xinsured's xhealth xstatus. x
x
All xof xthe xfollowing xare xconditions xthat xdisqualify xa xprocedure xor xservice xfrom xbeing
xpaid x
x
for xby xMedicare
xEXCEPT:
x
A. xOffered xin xan xoutpatient
xsetting
x
B. xMedically
xunnecessary
x
C. xNot xdelivered xin xa xMedicare xlicensed xcare
xsetting.
x
D. xServices xand xprocedures xthat xare xcustodial xin xnature x- x xcorrect xanswer. x x
xC. xNot
x
delivered xin xa xMedicare xlicensed xcare
xsetting
x
All xof xthe xfollowing xare xreference xresources xused xto xhelp xguide xin xthe xapplication
xfor xbusiness xethics xEXCEPT: xA. xConsumer xsatisfaction xreports x
B. Mission x& xValue xStatements x
C. Code xof xEthics x/ xCode xof xConduct x
D. Compliance xOffice x& xPolicies x- x xcorrect xanswer. x x xA. xConsumer xsatisfaction
xreports x
x
All xof xthe xfollowing xare xsteps xin xsafeguarding xcollections xEXCEPT: x
A. Placing xcollections xin xa xlock-box xfor xposting xreview xthe xnext xbusiness xday. x
B. Posting xthe xpayment xto xthe xpatient's xaccount x x
C. Completing xbalancing xactivities x
D. Issuing xreceipts x- x xcorrect xanswer. x x xA. xPlacing xcollections xin xa xlock-box xfor
xposting xreview xthe xnext xbusiness xday x
x
All xof xthe xfollowing xare xsteps xin xverifying xinsurance xEXCEPT: x
A. Sequencing xplans xinvolved xin xa xcoordination xof xbenefits x(COB) xsituation. x
B. The xpatient xsigning xthe xstatement xof xfinancial xresponsibility. x
C. Identifying xand xdocumenting xthe xpatient's xhealth xplan xbenefits x
D. Confirming xthe xpatient's xeligibility xfor xbenefits x- x xcorrect xanswer. x x xB. xThe xpatient
xsigning xthe xstatement xof xfinancial xresponsibility x
x
All xof xthe xfollowing xinformation xis xused xto xidentify xa xpatient
xEXCEPT:
x
A. xDate xof
xBirth
, x
B.
xGender
x
C. xSocial x Security
xNumber
x
D. xAddress x- x x correct xanswer. x x x D.
xAddress
x
All xof xthe xfollowing xinformation xshould xbe xreviewed xas xpart xof xschedule
xfinalization x
x
EXCEPT:
x
A. xThe xestimated xpatient xfinancial
xobligations
x
B. xThe xservice xto xbe
xprovided
x
C. xThe xarrival xtime xand xprocedure
xtime
D. xThe xpatient's xpreparation xinstructions x- x xcorrect xanswer. x x xA. xThe xestimated
xpatient x
x
financial
xobligations
x
Ambulance xservices xare xbilled xdirectly xto xthe xhealth xplan xfor x: x
A. All xpre-admission xemergency xtransports x
B. Transport xdeemed xmedically xnecessary xby xthe xattending xparamedic-ambulance
xcrew xC. xServices xprovided xbefore xa xpatient xis xadmitted xand xfor xambulance xrides
xarranged xto xpick xup xthe xpatient xfrom xthe xhospital xafter xdischarge xto xtake xhim/her
xhome xor xto xanother xfacility x
D. xThe xportion xof xthe xbill xoutside xof xthe xpatient's xself-pay x- x xcorrect xanswer. x x xC.
xServices xprovided xbefore xa xpatient xis xadmitted xand xfor xambulance xrides xarranged xto
xpick xup xthe xpatient xfrom xthe xhospital xafter xdischarge xto xtake xhim/her xhome xor xthe
xanother xfacility x
x
Any xhealthcare xinsurance xplan xthat xprovides xor xensures xcomprehensive xhealth
xmaintenance xand xtreatment xservices xfor xan xenrolled xgroup xof xpersons xon xa xmonthly
xfee xis xknown xas xa: x
A. HMO x
B. PPO x
C. MSO x
D. GPO x- x xcorrect xanswer. x x xA. xHMO x
x
Any xprovider xthat xhas xfiled xa xtimely xcost xreport xmay xappeal xan xadverse xfinal
xdecision xreceived xfrom xthe xMedicare xAdministrative xContractor x(MAC). xThis xappeal
xmay xbe xfiled xwith: x
A. The xProvider xReimbursement xReview xBoard x
B. The xDepartment xof xHealth xand xHuman xServices xProvider xRelations xDivision x
x
x
x
x
x
x
x
x
CRCR Practice Questions with complete
x x x x
x
solutions.
x
x
x
x
x
x
x
x
x
x
The x501(r) xregulations xrequire xnot-for-profit xproviders x501(c) x(3) xto xdo xwhich xof xthe
xfollowing xactivities? x
A. Complete xa xcommunity xneeds xassessment xand xdevelop xa xdiscount xprogram
xfor xpatient xbalances xafter xinsurance xpayment. x
B. Pursue xextraordinary xcollection xactivities xwith xall xpatients xeligible xfor xfinancial
xassistance. x
C. Implement xa xfinancial xassistance xprogram xfor xuninsured xand xunderinsured
xpatients. xD. xDiscount xall xcharges xto xself-pay xpatients xto xan xamount xgenerally xbilled
xto xall xother xpatients. x- x xcorrect xanswer. x x xA. xComplete xa xcommunity xneeds
xassessment xand xdevelop xa xdiscount xprogram xfor xpatient xbalances xafter xinsurance
xpayment x
x
The xaccurate xcapture xof xcharges xremains xcritically ximportant xbecause:
xA. xOf xthe xpotential xof xfraud xand xabuse xcharges xfrom xerroneous
xbilling. x
B. Charges xremain xone xof xthe xfew xconsistent xindicators xavailable xto xmonitor
xresource xuse. x
C. Charges xare xmeans xof xmeasuring xphysician xproductivity. x
D. Charges xprovide xthe xdata xused xin xactivity xbased xcosting. x- x xcorrect xanswer. x x xB. x
Charges xremain xone xof xthe xfew xconsistent xindicators xavailable xto xmonitor xresource
xuse x
x
The xACO xinvestment xmodel xwill xtest xthe xuse xof xpre-paid
xshared xsavings xto:
x
A. xInvest xin xtreatment xprotocols xthat xreduce xcosts
xto xMedicare
x
B. xAttract xphysicians xto xparticipate xin xthe xACO
xpayment xsystem.
x
C. xRaise xquality xratings xin xdesignated
xhospitals.
D. xEncourage xnew xACOs xto xform xin xrural xand xunderserved xareas. x- x
xcorrect xanswer. x x xD. x
, x
Encourage xnew xACOs xto xform xin xrural xand
xunderserved xareas
x
Across xall xcare xsettings, xif xa xpatient xconsents xto xa xfinancial xdiscussion xduring xa
xmedical xencounter xto xexpedite xdischarge, xthe xHFMA xbest xpractice xis xto: x
A. Have xa xpatient xfinancial xresponsibilities xkit xready xfor xthe xpatient, xcontaining xall
xof xthe xrequired xregistration xforms xand xinstructions. x
B. Make xsure xthat xthe xattending xstaff xcan xanswer xquestions xand xassist xin
xobtaining xrequired xpatient xfinancial xdata. x
C. Support xthat xchoice, xproviding xthat xthe xdiscussion xdoes xnot xinterfere xwith
xpatient xcare xor xdisrupt xpatient xflow. x
D. Decline xsuch xrequest xas xfinance xdiscussions xcan xdisrupt xpatient xcare xand
xpatient xflow. x- x xcorrect xanswer. x x xC. xSupport xthat xchoice, xproviding xthat xthe
xdiscussion xdoes xnot xinterfere xwith xpatient xcare xor xdisrupt xpatient xflow x
x
Activities xcompleted xwhen xthe xscheduled, xpre-registered xpatient xarrives xfor xservice
xincludes: x
A. Verifying xinsurance, xactivating xthe xrecord xand xdirecting xthe xpatient xto xthe xservice
xarea. x
B. Scanning xthe xdriver's xlicense xor xother xphot xidentification xand xdirecting xthe xpatient
xto xthe xfinancial xcounselor. x
C. Activating xthe xrecord, xobtaining xsignatures xand xfinalizing xfinancial xissues. x
D. Registering xthe xpatient xand xdirecting xthe xpatient xto xthe xservice xarea. x- x xcorrect
xanswer. x x xC. xActivating xthe xrecord, xobtaining xsignatures xand x
x
The xactivity xwhich xresults xin xthe xaccurate xrecording xof xpatient xbed xand xlevel xof xcare
xassessment, xpatient xtransfer xand xpatient xdischarge xstatus xon xa xreal-time xbasis xis
xknown xas: x
A. Utilization xreview x
B. Case xManagement x x
C. Census xManagement x
D. Patient xthrough-put x- x xcorrect xanswer. x x xA. xUtilization xreview xor x x
B. xCase xManagement x
x
An xadvantage xof xa xpre-registration xprogram xis: x
A. The xmarkets xvalue xof xsuch xa xprogram x
B. The xability xto xeliminate xno-show xappointments. x
C. The xopportunity xto xreduce xprocessing xtimes xat xthe xtime xof xservice. x
D. The xopportunity xto xreduce xcorporate xcompliance xfailures xwithin xthe xregistration
xprocess. x- x xcorrect xanswer. x x xC. xThe xopportunity xto xreduce xprocessing xtimes xat
xthe xtime xof xservice. x
x
The xAffordable xCare xAct xlegislated xthe xdevelopment xof xHealth xInsurance
xExchanges, xwhere xindividuals xand xsmall xbusinesses xcan: xA. xObtain xprice
xestimates xfor xmedical xservices x
B. Negotiate xthe xprice xof xmedical xservices xwith xproviders x
,C. Purchase xqualified xhealth xbenefit xplans xregardless xof xinsured's xhealth xstatus xD.
xMeet xfederal xmandates xfor xinsurance xcoverage xand xobtain xthe xcorresponding
xtax xdeduction x- x xcorrect xanswer. x x xC. xPurchase xqualified xhealth xbenefit xplans
xregardless xof xinsured's xhealth xstatus. x
x
All xof xthe xfollowing xare xconditions xthat xdisqualify xa xprocedure xor xservice xfrom xbeing
xpaid x
x
for xby xMedicare
xEXCEPT:
x
A. xOffered xin xan xoutpatient
xsetting
x
B. xMedically
xunnecessary
x
C. xNot xdelivered xin xa xMedicare xlicensed xcare
xsetting.
x
D. xServices xand xprocedures xthat xare xcustodial xin xnature x- x xcorrect xanswer. x x
xC. xNot
x
delivered xin xa xMedicare xlicensed xcare
xsetting
x
All xof xthe xfollowing xare xreference xresources xused xto xhelp xguide xin xthe xapplication
xfor xbusiness xethics xEXCEPT: xA. xConsumer xsatisfaction xreports x
B. Mission x& xValue xStatements x
C. Code xof xEthics x/ xCode xof xConduct x
D. Compliance xOffice x& xPolicies x- x xcorrect xanswer. x x xA. xConsumer xsatisfaction
xreports x
x
All xof xthe xfollowing xare xsteps xin xsafeguarding xcollections xEXCEPT: x
A. Placing xcollections xin xa xlock-box xfor xposting xreview xthe xnext xbusiness xday. x
B. Posting xthe xpayment xto xthe xpatient's xaccount x x
C. Completing xbalancing xactivities x
D. Issuing xreceipts x- x xcorrect xanswer. x x xA. xPlacing xcollections xin xa xlock-box xfor
xposting xreview xthe xnext xbusiness xday x
x
All xof xthe xfollowing xare xsteps xin xverifying xinsurance xEXCEPT: x
A. Sequencing xplans xinvolved xin xa xcoordination xof xbenefits x(COB) xsituation. x
B. The xpatient xsigning xthe xstatement xof xfinancial xresponsibility. x
C. Identifying xand xdocumenting xthe xpatient's xhealth xplan xbenefits x
D. Confirming xthe xpatient's xeligibility xfor xbenefits x- x xcorrect xanswer. x x xB. xThe xpatient
xsigning xthe xstatement xof xfinancial xresponsibility x
x
All xof xthe xfollowing xinformation xis xused xto xidentify xa xpatient
xEXCEPT:
x
A. xDate xof
xBirth
, x
B.
xGender
x
C. xSocial x Security
xNumber
x
D. xAddress x- x x correct xanswer. x x x D.
xAddress
x
All xof xthe xfollowing xinformation xshould xbe xreviewed xas xpart xof xschedule
xfinalization x
x
EXCEPT:
x
A. xThe xestimated xpatient xfinancial
xobligations
x
B. xThe xservice xto xbe
xprovided
x
C. xThe xarrival xtime xand xprocedure
xtime
D. xThe xpatient's xpreparation xinstructions x- x xcorrect xanswer. x x xA. xThe xestimated
xpatient x
x
financial
xobligations
x
Ambulance xservices xare xbilled xdirectly xto xthe xhealth xplan xfor x: x
A. All xpre-admission xemergency xtransports x
B. Transport xdeemed xmedically xnecessary xby xthe xattending xparamedic-ambulance
xcrew xC. xServices xprovided xbefore xa xpatient xis xadmitted xand xfor xambulance xrides
xarranged xto xpick xup xthe xpatient xfrom xthe xhospital xafter xdischarge xto xtake xhim/her
xhome xor xto xanother xfacility x
D. xThe xportion xof xthe xbill xoutside xof xthe xpatient's xself-pay x- x xcorrect xanswer. x x xC.
xServices xprovided xbefore xa xpatient xis xadmitted xand xfor xambulance xrides xarranged xto
xpick xup xthe xpatient xfrom xthe xhospital xafter xdischarge xto xtake xhim/her xhome xor xthe
xanother xfacility x
x
Any xhealthcare xinsurance xplan xthat xprovides xor xensures xcomprehensive xhealth
xmaintenance xand xtreatment xservices xfor xan xenrolled xgroup xof xpersons xon xa xmonthly
xfee xis xknown xas xa: x
A. HMO x
B. PPO x
C. MSO x
D. GPO x- x xcorrect xanswer. x x xA. xHMO x
x
Any xprovider xthat xhas xfiled xa xtimely xcost xreport xmay xappeal xan xadverse xfinal
xdecision xreceived xfrom xthe xMedicare xAdministrative xContractor x(MAC). xThis xappeal
xmay xbe xfiled xwith: x
A. The xProvider xReimbursement xReview xBoard x
B. The xDepartment xof xHealth xand xHuman xServices xProvider xRelations xDivision x
