Crcr Exam Multiple Choic

CRCR EXAM MULTIPLE CHOICE, CRCR
EXAM PREP, CERTIFIED REVENUE
CYCLE REPRESENTATIVE - CRCR (2021)



What8are8collection8agency8fees8based8on?8-8ans-A8percentage8of8dollars8collected

Self-
funded8benefit8plans8may8choose8to8coordinate8benefits8using8the8gender8rule8or8what8ot
her8rule?8-8ans-Birthday

In8what8type8of8payment8methodology8is8a8lump8sum8or8bundled8payment8negotiated8bet
ween8the8payer8and8some8or8all8providers?8-8ans-Case8rates

What8customer8service8improvements8might8improve8the8patient8accounts8department?
8-8ans-Holding8staff8accountable8for8customer8service8during8performance8reviews



What8is8an8ABN8(Advance8Beneficiary8Notice8of8Non-coverage)8required8to8do?8-8ans-
Inform8a8Medicare8beneficiary8that8Medicare8may8not8pay8for8the8order8or8service

What8type8of8account8adjustment8results8from8the8patient's8unwillingness8to8pay8for8a8sel
f-pay8balance?8-8ans-Bad8debt8adjustment

What8is8the8initial8hospice8benefit?8-8ans-Two890-
day8periods8and8an8unlimited8number8of8subsequent8periods

When8does8a8hospital8add8ambulance8charges8to8the8Medicare8inpatient8claim?8-8ans-
If8the8patient8requires8ambulance8transportation8to8a8skilled8nursing8facility

How8should8a8provider8resolve8a8late-charge8credit8posted8after8an8account8is8billed?8-
8ans-Post8a8late-charge8adjustment8to8the8account



an8increase8in8the8dollars8aged8greater8than8908days8from8date8of8service8indicate8what8
about8accounts8-8ans-They8are8not8being8processed8in8a8timely8manner

What8is8an8advantage8of8a8preregistration8program?8-8ans-
It8reduces8processing8times8at8the8time8of8service

,What8are8the8two8statutory8exclusions8from8hospice8coverage?8-8ans-
Medically8unnecessary8services8and8custodial8care

What8core8financial8activities8are8resolved8within8patient8access?8-8ans-
Scheduling,8insurance8verification,8discharge8processing,8and8payment8of8point-of-
service8receipts

What8statement8applies8to8the8scheduled8outpatient?8-8ans-
The8services8do8not8involve8an8overnight8stay

How8is8a8mis-posted8contractual8allowance8resolved?8-8ans-
Comparing8the8contract8reimbursement8rates8with8the8contract8on8the8admittance8advice
8to8identify8the8correct8amount



What8type8of8patient8status8is8used8to8evaluate8the8patient's8need8for8inpatient8care?8-
8ans-Observation



Coverage8rules8for8Medicare8beneficiaries8receiving8skilled8nursing8care8require8that8the8
beneficiary8has8received8what?8-8ans-
Medically8necessary8inpatient8hospital8services8for8at8least838consecutive8days8before8th
e8skilled8nursing8care8admission

When8is8the8word8"SAME"8entered8on8the8CMS815008billing8form8in8Field80$?8-8ans-
When8the8patient8is8the8insured

What8are8non-
emergency8patients8who8come8for8service8without8prior8notification8to8the8provider8called
?8-8ans-Unscheduled8patients

If8the8insurance8verification8response8reports8that8a8subscriber8has8a8single8policy,8what8i
s8the8status8of8the8subscriber's8spouse?8-8ans-Neither8enrolled8not8entitled8to8benefits

Regulation8Z8of8the8Consumer8Credit8Protection8Act,8also8known8as8the8Truth8in8Lending
8Act,8establishes8what?8-8ans-

Disclosure8rules8for8consumer8credit8sales8and8consumer8loans

What8is8a8principal8diagnosis?8-8ans-Primary8reason8for8the8patient's8admission

Collecting8patient8liability8dollars8after8service8leads8to8what?8-8ans-
Lower8accounts8receivable8levels

What8is8the8daily8out-of-pocket8amount8for8each8lifetime8reserve8day8used?8-8ans-
50%8of8the8current8deductible8amount

What8service8provided8to8a8Medicare8beneficiary8in8a8rural8health8clinic8(RHC)8is8not8billa
ble8as8an8RHC8services?8-8ans-Inpatient8care

,What8code8indicates8the8disposition8of8the8patient8at8the8conclusion8of8service?8-8ans-
Patient8discharge8status8code

What8are8hospitals8required8to8do8for8Medicare8credit8balance8accounts?8-8ans-
They8result8in8lost8reimbursement8and8additional8cost8to8collect

When8an8undue8delay8of8payment8results8from8a8dispute8between8the8patient8and8the8thi
rd8party8payer,8who8is8responsible8for8payment?8-8ans-Patient

Medicare8guidelines8require8that8when8a8test8is8ordered8for8a8LCD8or8NCD8exists,8the8inf
ormation8provided8on8the8order8must8include:8-8ans-A8valid8CPT8or8HCPCS8code

With8advances8in8internet8security8and8encryption,8revenue-
cycle8processes8are8expanding8to8allow8patients8to8do8what?8-8ans-
Access8their8information8and8perform8functions8on-line

What8date8is8required8on8all8CMS815008claim8forms?8-8ans-onset8date8of8current8illness

What8does8scheduling8allow8provider8staff8to8do8-8ans-
Review8appropriateness8of8the8service8request

What8code8is8used8to8report8the8provider's8most8common8semiprivate8room8rate?8-8ans-
Condition8code

Regulations8and8requirements8for8coding8accountable8care8organizations,8which8allows8
providers8to8begin8creating8these8organizations,8were8finalized8in:8-8ans-2012

What8is8a8primary8responsibility8of8the8Recover8Audit8Contractor?8-8ans-
To8correctly8identify8proper8payments8for8Medicare8Part8A8&8B8claims

How8must8providers8handle8credit8balances?8-8ans-
Comply8with8state8statutes8concerning8reporting8credit8balance

Insurance8verification8results8in8what?8-8ans-
The8accurate8identification8of8the8patient's8eligibility8and8benefits

What8form8is8used8to8bill8Medicare8for8rural8health8clinics?8-8ans-CMS81500

What8activities8are8completed8when8a8scheduled8pre-
registered8patient8arrives8for8service?8-8ans-
Registering8the8patient8and8directing8the8patient8to8the8service8area

In8addition8to8being8supported8by8information8found8in8the8patient's8chart,8a8CMS815008cl
aim8must8be8coded8using8what?8-8ans-
HCPCS8(Healthcare8Common8Procedure8Coding8system)

, What8results8from8a8denied8claim?8-8ans-The8provider8incurs8rework8and8appeal8costs

Why8does8the8financial8counselor8need8pricing8for8services?8-8ans-
To8calculate8the8patient's8financial8responsibility

What8type8of8provider8bills8third-party8payers8using8CMS815008form8-8ans-Hospital-
based8mammography8centers

How8are8disputes8with8nongovernmental8payers8resolved?8-8ans-
Appeal8conditions8specified8in8the8individual8payer's8contract

The8important8message8from8Medicare8provides8beneficiaries8with8information8concerni
ng8what?8-8ans-
Right8to8appeal8a8discharge8decision8if8the8patient8disagrees8with8the8services

Why8do8managed8care8plans8have8agreements8with8hospitals,8physicians,8and8other8hea
lthcare8providers8to8offer8a8range8of8services8to8plan8members?8-8ans-
To8improve8access8to8quality8healthcare

If8a8patient8remains8an8inpatient8of8an8SNF8(skilled8nursing8facility8for8more8than8308days
,8what8is8the8SNF8permitted8to8do?8-8ans-Submit8interim8bills8to8the8Medicare8program.

90.8MSP8(Medicare8Secondary8Payer)8rules8allow8providers8to8bill8Medicare8for8liability8cl
aims8after8what8happens?8-8ans-
1208days8passes,8but8the8claim8then8be8withdrawn8from8the8liability8carrier

What8data8are8required8to8establish8a8new8MPI8entry?8-8ans-
The8patient's8full8legal8name,8date8of8birth,8and8sex

What8should8the8provider8do8if8both8of8the8patient's8insurance8plans8pay8as8primary?8-
8ans-Determine8the8correct8payer8and8notify8the8incorrect8payer8of8the8processing8error



What8do8EMTALA8regulations8require8on-call8physicians8to8do?8-8ans-
Personally8appear8in8the8emergency8department8and8attend8to8the8patient8within8a8reaso
nable8time

At8the8end8of8each8shift,8what8must8happen8to8cash,8checks,8and8credit8card8transaction8
documents?8-8ans-They8must8be8balanced

What8will8cause8a8CMS815008claim8to8be8rejected?8-8ans-
The8provider8is8billing8with8a8future8date8of8service

Under8Medicare8regulations,8which8of8the8following8is8not8included8on8a8valid8physician's
8order8for8services?8-8ans-The8cost8of8the8test