CRCR EXAM MULTIPLE CHOICE,
CRCR Exam Prep, Certified Revenue
Cycle Representative - CRCR
90. MSP (Medicare Secondary Payer) guidelines permit carriers to bill Medicare for legal
responsibility claims after what takes place? - ANS-one hundred twenty days passes, but the
claim then be withdrawn from the legal responsibility service
ninety. MSP (Medicare Secondary Payer) rules allow companies to invoice Medicare for
liability claims after what happens? - ANS-one hundred twenty days passes, but the declare
then be withdrawn from the legal responsibility provider
A 68 12 months vintage patient, a Medicare beneficiary, turned into in a vehicle accident. A
medical health insurance claim became filed with the car insurance service. Six months later
this claim remains unpaid. How can the company pursue price from Medicare? - ANS-The
provider ought to first invoice the automobile insurer; but, after a period of a hundred and
twenty days, if the declare stays unpaid, the provider may cancel the legal responsibility
claim and invoice Medicare.
A claim is denied for the following motives, EXCEPT:
a) The fitness plan can not pick out the subscriber
b) The frequency of provider changed into outside the insurance timeline
c) The submitted claim does not have the physicians signature
d) The subscriber turned into not enrolled at the time of provider - ANS-C
A complete "Compliance Program" is described as
a) Annual criminal audit and evaluate for adherence to policies
b) Educating personnel on guidelines
c) Systematic strategies to make certain that the provisions of
policies imposed by way of a government company are being met
d) The improvement of operational rules that correspond to
regulations - ANS-C
A selection on whether or not a patient need to be admitted as an inpatient or emerge as an
outpatient statement patient calls for clinical judgments based totally on all the following
EXCEPT
a) The patient's home care coverage
b) Current clinical wishes
c) The probability of an negative event happening to the patient
,d) The affected person's clinical records - ANS-A
A 4 digit range code installed by means of the National Uniform Billing Committee (NUBC)
that categorizes/classifies a line item within the rate grasp is known as
a) HCPCs codes
b) ICD-10 Procedural codes
c) CPT codes
d) Revenue codes - ANS-D
A massive range of credit balances are not the result of overpayments but of
a) Posting errors inside the pt accounting device
b) Incorrect claim submissions
c) Inadequate body of workers schooling
d) Banking transaction mistakes - ANS-A
A Medicare Part A benefit period starts:
a) With admission as an inpatient
b) The first day wherein an person has now not been a hospital
inpatient not in a professional nursing facility for the preceding 60 days
c) Upon the day the insurance premium is paid
d) Immediately as soon as authorization for treatment is supplied with the aid of the
health plan - ANS-A
A nightly room fee may be wrong if the patient's
a) Discharge for the next day has now not been charted
b) Condition has not been mentioned during the shift exchange record
assembly
c) Pharmacy orders to the ICU have now not been entered inside the
pharmacy gadget
d) Transfer from ICU (intensive care unit) to the Medical/Surgical
ground isn't always meditated within the registration machine - ANS-D
A part of the bills receivable inventory which has NOT certified for billing
includes
a) Charitable pledges
b) Accounts assigned to a pre-collection business enterprise
c) Accounts coded but held in the suspense period
d) Accounts created during pre-registration however now not activated - ANS-A
A part of the money owed receivable stock which has NOT qualified for billing
consists of:
a) Charitable pledges
b) Accounts created throughout pre-registration however no longer activated
c) Accounts coded however held inside the suspense length
d) Accounts assigned to a pre-collection enterprise - ANS-A
,A recurring/collection registration is characterized with the aid of
a) A creation of more than one registrations for more than one offerings
b) The introduction of one registration report for more than one days of service
c) The advent of multiple affected person sorts for one date of carrier
d) The creation of 1 registration file consistent with diagnosis in line with go to - ANS-B
A ordinary/collection registration is characterised by way of
a) The creation of one registration record for multiple days of service
b) The creation of more than one registrations for multiple offerings
c) The introduction of 1 registration file in line with analysis per visits
d) The creation of more than one pt sorts for one date of provider - ANS-A
A scheduled inpatient represents an possibility for the provider to do which of the
following?
A) Refer the patient to another region with the fitness device
b) Comply with EMTALA (Emergency Medical Treatment and Labor Act)
requirements earlier than service
c) Complete registration and coverage approval earlier than carrier
d) Register the patient after she or he is placed in a mattress on that carrier
unit. - ANS-C
ABC Hospital has skilled a sixteen% growth in new patients over the last 6 months. The
health center is understaffed in its coverage declare and fee processing branch and can't
deal with this growth in paintings load. It is considering hiring an outsourcing dealer to help.
What are the stairs that the hospital desires to take to set up and ensure a a success seller
dating? - ANS-**A. Distribute a RFP to solicit seller abilities, examine supplier's know-how to
provide outsourcing services, visit seller places, carry out seller reference assessments,
speak with supplier clients, interview dealer employees to evaluate revel in level.
B. Evaluate vendor's information in presenting outsourcing offerings, visit dealer places,
interview vendor personnel to assess understanding stage.
Access - ANS-An man or woman's capability to reap medical offerings on a well timed and
financially applicable level
Access - ANS-An character's potential to attain clinical offerings on a well timed and
financially appropriate level
According to the Department of Health and Human Services guidelines, what is NOT taken
into consideration income? - ANS-Sale of property, house, or car
According to the Department of Health and Human Services suggestions, what's NOT taken
into consideration earnings? - ANS-Sale of belongings, residence, or automobile
Accurate identification of the patient is the first step in the scheduling process. Identifiers
used in numerous aggregate to attain correct patient identification include? - ANS-Full felony
name, date of start, sex and social protection range
, Across all care settings, if a affected person is of the same opinion to a economic discussion
for the duration of a clinical
come across to expedite discharge, the HFMA best practice is to:
a) Make certain that the attending group of workers can solution questions and
help in acquiring required patient monetary data
b) Have a affected person monetary duties package ready for the patient,
containing all of the required registration bureaucracy and commands
c) Support that desire, providing that the discussion does not
intrude with patient care or disrupt affected person waft
d) Decline such request as finance discussions can disrupt affected person
care and affected person float - ANS-C
Across all care settings, if a pt consents to a financial dialogue all through a medical
encounter
to expedite discharge, the HFMA fine practice is to
a) Have a pt monetary responsibilities kit geared up for the pt containing all the required
registration paperwork and instructions
b) Make positive that the attending staff can solution questions and assist in obtaining
required pt monetary facts
c) Support that preference, providing that the dialogue does now not interfere with pt care or
disrupt pt float
d) Decline such request as finance discussions can disrupt pt care and pt flow - ANS-C
Administrative Services Only (ASO) - ANS-Usually reduced in size administrative services to
a self-insured health plan
Administrative Services Only (ASO) - ANS-Usually gotten smaller administrative services to
a self-insured fitness plan
Agency costs are: - ANS-A. Paid by sufferers.
**B. The fee to the company for series agency monies offset with the aid of the go back on
baddebt accounts.
C. Only pronounced annually to the company.
D. Waived for debts elderly extra than three hundred and sixty five days from date of
provider.
All of the subsequent are situations that disqualify a procedure or service from being paid
for through Medicare EXCEPT
a) Medically pointless
b) Not added in a Medicare licensed care setting
c) Offered in an outpatient putting
d) Services and methods which might be custodial in nature - ANS-D
All of the subsequent are styles of medical institution fee contracting EXCEPT
CRCR Exam Prep, Certified Revenue
Cycle Representative - CRCR
90. MSP (Medicare Secondary Payer) guidelines permit carriers to bill Medicare for legal
responsibility claims after what takes place? - ANS-one hundred twenty days passes, but the
claim then be withdrawn from the legal responsibility service
ninety. MSP (Medicare Secondary Payer) rules allow companies to invoice Medicare for
liability claims after what happens? - ANS-one hundred twenty days passes, but the declare
then be withdrawn from the legal responsibility provider
A 68 12 months vintage patient, a Medicare beneficiary, turned into in a vehicle accident. A
medical health insurance claim became filed with the car insurance service. Six months later
this claim remains unpaid. How can the company pursue price from Medicare? - ANS-The
provider ought to first invoice the automobile insurer; but, after a period of a hundred and
twenty days, if the declare stays unpaid, the provider may cancel the legal responsibility
claim and invoice Medicare.
A claim is denied for the following motives, EXCEPT:
a) The fitness plan can not pick out the subscriber
b) The frequency of provider changed into outside the insurance timeline
c) The submitted claim does not have the physicians signature
d) The subscriber turned into not enrolled at the time of provider - ANS-C
A complete "Compliance Program" is described as
a) Annual criminal audit and evaluate for adherence to policies
b) Educating personnel on guidelines
c) Systematic strategies to make certain that the provisions of
policies imposed by way of a government company are being met
d) The improvement of operational rules that correspond to
regulations - ANS-C
A selection on whether or not a patient need to be admitted as an inpatient or emerge as an
outpatient statement patient calls for clinical judgments based totally on all the following
EXCEPT
a) The patient's home care coverage
b) Current clinical wishes
c) The probability of an negative event happening to the patient
,d) The affected person's clinical records - ANS-A
A 4 digit range code installed by means of the National Uniform Billing Committee (NUBC)
that categorizes/classifies a line item within the rate grasp is known as
a) HCPCs codes
b) ICD-10 Procedural codes
c) CPT codes
d) Revenue codes - ANS-D
A massive range of credit balances are not the result of overpayments but of
a) Posting errors inside the pt accounting device
b) Incorrect claim submissions
c) Inadequate body of workers schooling
d) Banking transaction mistakes - ANS-A
A Medicare Part A benefit period starts:
a) With admission as an inpatient
b) The first day wherein an person has now not been a hospital
inpatient not in a professional nursing facility for the preceding 60 days
c) Upon the day the insurance premium is paid
d) Immediately as soon as authorization for treatment is supplied with the aid of the
health plan - ANS-A
A nightly room fee may be wrong if the patient's
a) Discharge for the next day has now not been charted
b) Condition has not been mentioned during the shift exchange record
assembly
c) Pharmacy orders to the ICU have now not been entered inside the
pharmacy gadget
d) Transfer from ICU (intensive care unit) to the Medical/Surgical
ground isn't always meditated within the registration machine - ANS-D
A part of the bills receivable inventory which has NOT certified for billing
includes
a) Charitable pledges
b) Accounts assigned to a pre-collection business enterprise
c) Accounts coded but held in the suspense period
d) Accounts created during pre-registration however now not activated - ANS-A
A part of the money owed receivable stock which has NOT qualified for billing
consists of:
a) Charitable pledges
b) Accounts created throughout pre-registration however no longer activated
c) Accounts coded however held inside the suspense length
d) Accounts assigned to a pre-collection enterprise - ANS-A
,A recurring/collection registration is characterized with the aid of
a) A creation of more than one registrations for more than one offerings
b) The introduction of one registration report for more than one days of service
c) The advent of multiple affected person sorts for one date of carrier
d) The creation of 1 registration file consistent with diagnosis in line with go to - ANS-B
A ordinary/collection registration is characterised by way of
a) The creation of one registration record for multiple days of service
b) The creation of more than one registrations for multiple offerings
c) The introduction of 1 registration file in line with analysis per visits
d) The creation of more than one pt sorts for one date of provider - ANS-A
A scheduled inpatient represents an possibility for the provider to do which of the
following?
A) Refer the patient to another region with the fitness device
b) Comply with EMTALA (Emergency Medical Treatment and Labor Act)
requirements earlier than service
c) Complete registration and coverage approval earlier than carrier
d) Register the patient after she or he is placed in a mattress on that carrier
unit. - ANS-C
ABC Hospital has skilled a sixteen% growth in new patients over the last 6 months. The
health center is understaffed in its coverage declare and fee processing branch and can't
deal with this growth in paintings load. It is considering hiring an outsourcing dealer to help.
What are the stairs that the hospital desires to take to set up and ensure a a success seller
dating? - ANS-**A. Distribute a RFP to solicit seller abilities, examine supplier's know-how to
provide outsourcing services, visit seller places, carry out seller reference assessments,
speak with supplier clients, interview dealer employees to evaluate revel in level.
B. Evaluate vendor's information in presenting outsourcing offerings, visit dealer places,
interview vendor personnel to assess understanding stage.
Access - ANS-An man or woman's capability to reap medical offerings on a well timed and
financially applicable level
Access - ANS-An character's potential to attain clinical offerings on a well timed and
financially appropriate level
According to the Department of Health and Human Services guidelines, what is NOT taken
into consideration income? - ANS-Sale of property, house, or car
According to the Department of Health and Human Services suggestions, what's NOT taken
into consideration earnings? - ANS-Sale of belongings, residence, or automobile
Accurate identification of the patient is the first step in the scheduling process. Identifiers
used in numerous aggregate to attain correct patient identification include? - ANS-Full felony
name, date of start, sex and social protection range
, Across all care settings, if a affected person is of the same opinion to a economic discussion
for the duration of a clinical
come across to expedite discharge, the HFMA best practice is to:
a) Make certain that the attending group of workers can solution questions and
help in acquiring required patient monetary data
b) Have a affected person monetary duties package ready for the patient,
containing all of the required registration bureaucracy and commands
c) Support that desire, providing that the discussion does not
intrude with patient care or disrupt affected person waft
d) Decline such request as finance discussions can disrupt affected person
care and affected person float - ANS-C
Across all care settings, if a pt consents to a financial dialogue all through a medical
encounter
to expedite discharge, the HFMA fine practice is to
a) Have a pt monetary responsibilities kit geared up for the pt containing all the required
registration paperwork and instructions
b) Make positive that the attending staff can solution questions and assist in obtaining
required pt monetary facts
c) Support that preference, providing that the dialogue does now not interfere with pt care or
disrupt pt float
d) Decline such request as finance discussions can disrupt pt care and pt flow - ANS-C
Administrative Services Only (ASO) - ANS-Usually reduced in size administrative services to
a self-insured health plan
Administrative Services Only (ASO) - ANS-Usually gotten smaller administrative services to
a self-insured fitness plan
Agency costs are: - ANS-A. Paid by sufferers.
**B. The fee to the company for series agency monies offset with the aid of the go back on
baddebt accounts.
C. Only pronounced annually to the company.
D. Waived for debts elderly extra than three hundred and sixty five days from date of
provider.
All of the subsequent are situations that disqualify a procedure or service from being paid
for through Medicare EXCEPT
a) Medically pointless
b) Not added in a Medicare licensed care setting
c) Offered in an outpatient putting
d) Services and methods which might be custodial in nature - ANS-D
All of the subsequent are styles of medical institution fee contracting EXCEPT
