HFMA CRCR Exam Preparation– Updated CompleteExam
Set with 170+ Verified Questions and Correct
Answers
Through whatdocumentdoesa hospitalestablishcompliancestandards?- ANSWER--code of conduct
Whatis thepurposeOIG workplant?- ANSWER--IdentifyAcceptable compliance programs in
various provider setting
If a Medicare patient is admitted on Friday, what services fall within the
-day
three
DRG windowrule?
- ANSWER--Non-diagnosticserviceprovided on Tuesday through Friday
Whatdoesa modifierallowa providerto do? - ANSWER--Reporta specific circumstance that affected
a procedure or service without changing the code or its definition
IF outpatient diagnostic services are provided within three days of the admission
of a Medicare
beneficiaryto an IPPS (InpatientProspective Payment System) hospital, what must happen to
these charges-
ANSWER--They mustbebilledseparatelyto thepart B Carrier
what is a recurring or series registration?- ANSWER--One registration record is created for
multiple days of service
What are nonemergency patients who come for service without prior notification
to theprovider
called?- ANSWER--Unscheduledpatients
,HFMA CRCR Exam Preparation– Updated CompleteExam
Set with 170+ Verified Questions and Correct
Answers
Which of thefollowingstatementapplyto theobservationpatienttype?- ANSWER--It is used to
evaluate the need for an inpatient admission
whichservicesarehospiceprogramsrequiredto providearoundtheclock patient- ANSWER--
Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what?
- ANSWER--Completethe
schedulingprocesscorrectlybasedon servicerequeste
The Time needed to prepare the patient before service is the difference between
thepatientsarrival
timeand whichof thefollowing?- ANSWER-- Procedure time
Medicareguidelinesrequirethatwhena testis orderedfor a LCD or NCD exists, the information
provided on the order must include:
- ANSWER-- Documentation of the medical necessity for the test
Whatis theadvantageof a pre-registrationprogram- ANSWER--It reduces processing times at the
time of service
Whatdatearerequiredto establisha newMPI(MasterpatientIndex) entry- ANSWER --The
responsible party's full legal name, date of birth, and social security number
Which of the following statements is true about third
-party payments?- ANSWER--The payments
are received by the provider from the payer responsible
for reimbursingtheproviderfor thepatient's
coveredservices.
, HFMA CRCR Exam Preparation– Updated CompleteExam
Set with 170+ Verified Questions and Correct
Answers
Which provisionprotectsthepatientfrom medicalexpensesthatexceed the pre
-set level-
ANSWER--stop loss
whatdocumentationmusta primarycarephysiciansendto HMO patientto authorize a visit to a
specialist for additional testing or care?
- ANSWER-- Referral
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not
ask about a patient's insurance information
if it woulddelaywhat?- ANSWER--Medicalscreening
and stabilizing treatment
Which of thefollowingis a stepin thedischargeprocess?- ANSWER-- Have a case management
service complete the discharge plan
The hospital has a APC based contract for the payment of outpatient services.
Total anticipated
chargesfor thevisit are$2,380.The approved APC payment rate is $780. Where will the patients
benefit package be applied?- ANSWER--To the approved APC payment rate
A patienthas metthe$200individualdeductibleand $900of the$1000co- insurance responsibility.
The co-insurance rate is 20%. The estimated insurance plan responsibility is $1975.00. What amount
of coinsurance is due from the patient?
- ANSWER--$100.00
Set with 170+ Verified Questions and Correct
Answers
Through whatdocumentdoesa hospitalestablishcompliancestandards?- ANSWER--code of conduct
Whatis thepurposeOIG workplant?- ANSWER--IdentifyAcceptable compliance programs in
various provider setting
If a Medicare patient is admitted on Friday, what services fall within the
-day
three
DRG windowrule?
- ANSWER--Non-diagnosticserviceprovided on Tuesday through Friday
Whatdoesa modifierallowa providerto do? - ANSWER--Reporta specific circumstance that affected
a procedure or service without changing the code or its definition
IF outpatient diagnostic services are provided within three days of the admission
of a Medicare
beneficiaryto an IPPS (InpatientProspective Payment System) hospital, what must happen to
these charges-
ANSWER--They mustbebilledseparatelyto thepart B Carrier
what is a recurring or series registration?- ANSWER--One registration record is created for
multiple days of service
What are nonemergency patients who come for service without prior notification
to theprovider
called?- ANSWER--Unscheduledpatients
,HFMA CRCR Exam Preparation– Updated CompleteExam
Set with 170+ Verified Questions and Correct
Answers
Which of thefollowingstatementapplyto theobservationpatienttype?- ANSWER--It is used to
evaluate the need for an inpatient admission
whichservicesarehospiceprogramsrequiredto providearoundtheclock patient- ANSWER--
Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what?
- ANSWER--Completethe
schedulingprocesscorrectlybasedon servicerequeste
The Time needed to prepare the patient before service is the difference between
thepatientsarrival
timeand whichof thefollowing?- ANSWER-- Procedure time
Medicareguidelinesrequirethatwhena testis orderedfor a LCD or NCD exists, the information
provided on the order must include:
- ANSWER-- Documentation of the medical necessity for the test
Whatis theadvantageof a pre-registrationprogram- ANSWER--It reduces processing times at the
time of service
Whatdatearerequiredto establisha newMPI(MasterpatientIndex) entry- ANSWER --The
responsible party's full legal name, date of birth, and social security number
Which of the following statements is true about third
-party payments?- ANSWER--The payments
are received by the provider from the payer responsible
for reimbursingtheproviderfor thepatient's
coveredservices.
, HFMA CRCR Exam Preparation– Updated CompleteExam
Set with 170+ Verified Questions and Correct
Answers
Which provisionprotectsthepatientfrom medicalexpensesthatexceed the pre
-set level-
ANSWER--stop loss
whatdocumentationmusta primarycarephysiciansendto HMO patientto authorize a visit to a
specialist for additional testing or care?
- ANSWER-- Referral
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not
ask about a patient's insurance information
if it woulddelaywhat?- ANSWER--Medicalscreening
and stabilizing treatment
Which of thefollowingis a stepin thedischargeprocess?- ANSWER-- Have a case management
service complete the discharge plan
The hospital has a APC based contract for the payment of outpatient services.
Total anticipated
chargesfor thevisit are$2,380.The approved APC payment rate is $780. Where will the patients
benefit package be applied?- ANSWER--To the approved APC payment rate
A patienthas metthe$200individualdeductibleand $900of the$1000co- insurance responsibility.
The co-insurance rate is 20%. The estimated insurance plan responsibility is $1975.00. What amount
of coinsurance is due from the patient?
- ANSWER--$100.00
