2024 CRCR Assessment Test A++ Test with All New Qs & As - Guaranteed Pass!
- What is the traditional three segments in the Revenue Cycle?
Answer: Pre-service, Time of Service, Post service
- Define Pre-Service and activities included
Answer: PT is scheduled and pre registered for service, encounter record is generated and the PT/GTR info is collected / updat- ed. The requested service is screened for medical necessity then the health plan and or coverage is verified, pre-authorizations, are obtained, cost of scheduled service is identified and pts plan and or benefits are used to calculate price of service to the pt, if the service is deemed not medically necessary additional processing required, pt is notified their financial responsibility including any co-pays, deductibles, co-insurance and eligibility for financial assistance is assessed
- Define time of service and activities included
Answer: Scheduled pts, final account review completed prior to the pts arrival.
Ideally the patient arrive and make their co payment deductible and or other amts agreed to be paid and consents signed
For unscheduled patients is comprehensive registration and financial assistance processing completed at time of service, mirrors process of scheduled pts prior to arrival
- Define post service and the activities included
Answer: Post service includes 3rd final step, activities after pt is discharged until accts reaches $0 such as final coding, preparation of submits claims and pmt processing balance billing and resolution
- What is an engaged consumer?
Answer: Ease of access, improved consumer service improved quality
- What is an Engaged Patient?
Answer: Coordination of care, coordinated financial and clinical care, compliant clinical documentation
- What is a Satisfied Customer?
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Answer: Appropriate payment, effective and efficient account resolution, decreased cost to collect
- Best practice for financial conversations in the Emergency Department?
Answer: - NO FINANCIAL CONVERSATIONS occur before a patient is screened
and stabilized in accordance with local regulations governing the emergency department, if medical screen determines a medical emergency Financial conversations should occur at time of discharge process, if no medical emergency is determined the financial conversations can occur either at registration or at time of discharge
- Price Transparency
- Type of hospital service based on CPT- or MS-DRG code
Answer: needed as most consumers bear a portion of cost for their services, Patients contact hospitals for price prior to service The problem: charge master lists total charge not net charge that reflect charges after a payers contract allowance, to provide a patient w/ info that is meaningful several factors must be included
-The patients health plan -The patients benefit plan
- Best Practices for Efficiency of Revenue Cycle & Patient Experience
Answer:
-Educating patients and follow best practices for communication
- Make billing all communication clear, concise, correct and patient friendly
- Coordinate with business affiliates to avoid duplicate patient contacts
- Start account resolution clock when the 1st statement is sent to the patient
-Establish policy and ensure they're followed internally and by business affiliates Be consistent in key aspects of account resolution, from billing disputes to payment application
-Exercise good judgement about best ways to communicate with patients about their bills
-Report back to credit bureaus when account is resolved and track all consumer complaints
- What does CMS stand for?
Answer: Centers for Medicare and Medicaid Services
- What does HCAHPS stand for? and what is their objective?
Answer: Hospital Consumer Assessment of Healthcare Providers and Systems
Objective- Is to provide standardized method for evaluating patients perspective on
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