HFMA CRCR with correct answers 2025

HFMA CRCR with
correct answers
2025




Throughvwhatvdocumentvdoesvavhospitalvestablishvcompliancevstandards?v-
vvcorrectvanswersvcodevofvconduct




WhatvisvthevpurposevOIGvworkvplant?v-
vvcorrectvanswersvIdentifyvAcceptablevcompliancevprogramsvinvvariousvprovidervsetting




IfvavMedicarevpatientvisvadmittedvonvFriday,vwhatvservicesvfallvwithinvthevthree-
dayvDRGvwindowvrule?v-vvcorrectvanswersvNon-
diagnosticvservicevprovidedvonvTuesdayvthroughvFriday

,Whatvdoesvavmodifiervallowvavprovidervtovdo?v-
vvcorrectvanswersvReportvavspecificvcircumstancevthatvaffectedvavprocedurevorvservicevwithoutvcha


ngingvthevcodevorvitsvdefinition



IFvoutpatientvdiagnosticvservicesvarevprovidedvwithinvthreevdaysvofvthevadmissionvofvavMedicarevb
eneficiaryvtovanvIPPSv(InpatientvProspectivevPaymentvSystem)vhospital,vwhatvmustvhappenvtovthes
evchargesv-vvcorrectvanswersvTheyvmustvbevbilledvseparatelyvtovthevpartvBvCarrier



whatvisvavrecurringvorvseriesvregistration?v-
vvcorrectvanswersvOnevregistrationvrecordvisvcreatedvforvmultiplevdaysvofvservice




Whatvarevnonemergencyvpatientsvwhovcomevforvservicevwithoutvpriorvnotificationvtovthevproviderv
called?v-vvcorrectvanswersvUnscheduledvpatients



Whichvofvthevfollowingvstatementvapplyvtovthevobservationvpatientvtype?v-
vvcorrectvanswersvItvisvusedvtovevaluatevthevneedvforvanvinpatientvadmission




whichvservicesvarevhospicevprogramsvrequiredvtovprovidevaroundvthevclockvpatientv-
vvcorrectvanswersvPhysician,vNursing,vPharmacy




Schedulervinstructionsvarevusedvtovpromptvthevschedulervtovdovwhat?v-
vvcorrectvanswersvCompletevthevschedulingvprocessvcorrectlyvbasedvonvservicevrequeste




ThevTimevneededvtovpreparevthevpatientvbeforevservicevisvthevdifferencevbetweenvthevpatientsvarri
valvtimevandvwhichvofvthevfollowing?v-vvcorrectvanswersvProcedurevtime



MedicarevguidelinesvrequirevthatvwhenvavtestvisvorderedvforvavLCDvorvNCDvexists,vthevinformationvp
rovidedvonvthevordervmustvinclude:v-
vvcorrectvanswersvDocumentationvofvthevmedicalvnecessityvforvthevtest

, Whatvisvthevadvantagevofvavpre-registrationvprogramv-
vvcorrectvanswersvItvreducesvprocessingvtimesvatvthevtimevofvservice




WhatvdatevarevrequiredvtovestablishvavnewvMPI(MastervpatientvIndex)ventryv-
vvcorrectvanswersvThevresponsiblevparty'svfullvlegalvname,vdatevofvbirth,vandvsocialvsecurityvnumber




Whichvofvthevfollowingvstatementsvisvtruevaboutvthird-partyvpayments?v-
vvcorrectvanswersvThevpaymentsvarevreceivedvbyvthevprovidervfromvthevpayervresponsiblevforvreim


bursingvthevprovidervforvthevpatient'svcoveredvservices.



Whichvprovisionvprotectsvthevpatientvfromvmedicalvexpensesvthatvexceedvthevpre-setvlevelv-
vvcorrectvanswersvstopvloss




whatvdocumentationvmustvavprimaryvcarevphysicianvsendvtovHMOvpatientvtovauthorizevavvisitvtovav
specialistvforvadditionalvtestingvorvcare?v-vvcorrectvanswersvReferral



UndervEMTALAv(EmergencyvMedicalvTreatmentvandvLaborvAct)vregulations,vthevprovidervmayvnotv
askvaboutvavpatient'svinsurancevinformationvifvitvwouldvdelayvwhat?v-
vvcorrectvanswersvMedicalvscreeningvandvstabilizingvtreatment




Whichvofvthevfollowingvisvavstepvinvthevdischargevprocess?v-
vvcorrectvanswersvHavevavcasevmanagementvservicevcompletevthevdischargevplan




ThevhospitalvhasvavAPCvbasedvcontractvforvthevpaymentvofvoutpatientvservices.vTotalvanticipatedvc
hargesvforvthevvisitvarev$2,380.vThevapprovedvAPCvpaymentvratevisv$780.vWherevwillvthevpatientsvb
enefitvpackagevbevapplied?v-vvcorrectvanswersvTovthevapprovedvAPCvpaymentvrate



Avpatientvhasvmetvthev$200vindividualvdeductiblevandv$900vofvthev$1000vco-
insurancevresponsibility.vThevco-