Hfma crcr
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HFMA CRCR 3
Latest content Hfma crcr
Pre-Service activities 
 ANSWER : 1. Requested service is screened for med necessity, health 
coverage/benefits verified, preauthorization obtained and estimate to patient oop costs 
generated within guidelines of NSA and state regulations. 
2. Patient notified of financial responsibility including copayment and health plan 
deductibles, eligibility of financial assistance assessed. 
3. Patient is scheduled 
4. Encounter record is generated and patient and guarantor info is obtained and 
u...
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- • 84 pages's •
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HFMA CRCR•HFMA CRCR
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Comprehensive Mastery Package for HFMA CRCR Exams• By ScoreSmart
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Pre-Service activities 
 ANSWER : 1. Requested service is screened for med necessity, health 
coverage/benefits verified, preauthorization obtained and estimate to patient oop costs 
generated within guidelines of NSA and state regulations. 
2. Patient notified of financial responsibility including copayment and health plan 
deductibles, eligibility of financial assistance assessed. 
3. Patient is scheduled 
4. Encounter record is generated and patient and guarantor info is obtained and 
u...
What are collection agency fees based on? 
 ANSWER : A percentage of dollars collected 
Self-funded benefit plans may choose to coordinate benefits using the gender rule or 
what other rule? 
 ANSWER : Birthday 
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 
What customer service improvements might improve the patient accounts department? 
 ANSWER : Holding staff accountable for customer servi...
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- • 136 pages's •
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HFMA CRCR•HFMA CRCR
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Comprehensive Mastery Package for HFMA CRCR Exams• By ScoreSmart
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What are collection agency fees based on? 
 ANSWER : A percentage of dollars collected 
Self-funded benefit plans may choose to coordinate benefits using the gender rule or 
what other rule? 
 ANSWER : Birthday 
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 
What customer service improvements might improve the patient accounts department? 
 ANSWER : Holding staff accountable for customer servi...
Through what document does a hospital establish compliance standards? 
 ANSWER : code of conduct 
What is the purpose OIG work plant? 
 ANSWER : Identify Acceptable compliance programs in various provider setting 
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG 
window rule? 
 ANSWER : Non-diagnostic service provided on Tuesday through Friday 
What does a modifier allow a provider to do? 
 ANSWER : Report a specific circumstance that affected a procedure...
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- • 29 pages's •
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HFMA CRCR•HFMA CRCR
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Comprehensive Mastery Package for HFMA CRCR Exams• By ScoreSmart
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Through what document does a hospital establish compliance standards? 
 ANSWER : code of conduct 
What is the purpose OIG work plant? 
 ANSWER : Identify Acceptable compliance programs in various provider setting 
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG 
window rule? 
 ANSWER : Non-diagnostic service provided on Tuesday through Friday 
What does a modifier allow a provider to do? 
 ANSWER : Report a specific circumstance that affected a procedure...