HFMA CRCR EXAM Questions with Detailed Verified Answers

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HFMA CRCR EXAM Questions with
Detailed Verified Answers

Question: What are collection agency fees based on?
Answer: A percentage of dollars collected


Question: Self-funded benefit plans may choose to coordinate benefits
using the gender rule or what other rule?
Answer: Birthday


Question: In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all providers?
Answer: Case rates


Question: What customer service improvements might improve the patient
accounts department?
Answer: Holding staff accountable for customer service during performance
reviews


Question: What is an ABN (Advance Beneficiary Notice of Non-coverage)
required to do?
Answer: Inform a Medicare beneficiary that Medicare may not pay for the
order or service

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Question: What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance?
Answer: Bad debt adjustment


Question: What is the initial hospice benefit?
Answer: Two 90-day periods and an unlimited number of subsequent periods


Question: When does a hospital add ambulance charges to the Medicare
inpatient claim?
Answer: If the patient requires ambulance transportation to a skilled nursing
facility


Question: How should a provider resolve a late-charge credit posted after
an account is billed?
Answer: Post a late-charge adjustment to the account


Question: an increase in the dollars aged greater than 90 days from date of
service indicate what about accounts
Answer: They are not being processed in a timely manner


Question: What is an advantage of a preregistration program?
Answer: It reduces processing times at the time of service


Question: What are the two statutory exclusions from hospice coverage?
Answer: Medically unnecessary services and custodial care


Question: What core financial activities are resolved within patient access?

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Answer: Scheduling, insurance verification, discharge processing, and
payment of point-of-service receipts


Question: What statement applies to the scheduled outpatient?
Answer: The services do not involve an overnight stay


Question: How is a mis-posted contractual allowance resolved?
Answer: Comparing the contract reimbursement rates with the contract on
the admittance advice to identify the correct amount


Question: What type of patient status is used to evaluate the patient's need
for inpatient care?
Answer: Observation


Question: Coverage rules for Medicare beneficiaries receiving skilled
nursing care require that the beneficiary has received what?
Answer: Medically necessary inpatient hospital services for at least 3
consecutive days before the skilled nursing care admission


Question: When is the word "SAME" entered on the CMS 1500 billing form
in Field 0$?
Answer: When the patient is the insured


Question: What are non-emergency patients who come for service without
prior notification to the provider called?
Answer: Unscheduled patients

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Question: If the insurance verification response reports that a subscriber has
a single policy, what is the status of the subscriber's spouse?
Answer: Neither enrolled not entitled to benefits


Question: Regulation Z of the Consumer Credit Protection Act, also known
as the Truth in Lending Act, establishes what?
Answer: Disclosure rules for consumer credit sales and consumer loans


Question: What is a principal diagnosis?
Answer: Primary reason for the patient's admission


Question: Collecting patient liability dollars after service leads to what?
Answer: Lower accounts receivable levels


Question: What is the daily out-of-pocket amount for each lifetime reserve
day used?
Answer: 50% of the current deductible amount


Question: What service provided to a Medicare beneficiary in a rural health
clinic (RHC) is not billable as an RHC services?
Answer: Inpatient care


Question: What code indicates the disposition of the patient at the
conclusion of service?
Answer: Patient discharge status code