2024 CRCR Exam Prep 2 Guaranteed A+ Actual Questions and Answers, Complete 100%
1. HFMA
Answer: Healthcare Financial Management Association
2. Revenue Cycle Overview: What are the 3 segments?
Answer: Pre-Service, Time of Service, Post-Service
- Scheduling is part of which segment of the Revenue Cycle?
Answer: Pre-service
- Patient-Centric Revenue Cycle
Answer:
1) Engaged Consumer 2) Engaged Patient 3) Satisfied Customer
5. Healthcare Dollars & Sense: 1) Price Transparency
2) Patient Financial Communications 3) Medical Account Resolution
- Need for Price Transparency
Answer:
1) The type of service based on CPT or MS-DRG code 2) The patients health plan 3) The patients benefit plan
- Medical Account Resolution Best Practices
Answer:
1) Educate patients 2) Clear/Concise/Correct clear bills 3) Establish and follow policies 4) Be consistent in account resolution 5) Coordinate to avoid duplication 6) Use good judgement when communicating 7) Start account resolution when statement is sent 8) Report back to credit bureau when account is resolved
- / 3
8. HCAHPS
Answer: Hospital Consumer Assessment of Healthcare Providers and Systems
(Satisfaction Survey)
- Patient Access Process
Answer:
1) Insurance verification, pre-certification, pre-autho rization processes should be completed prior to patients scheduled visit.2) An incorrect estimate or incorrect application of the health plan and benefit rules resulting in debits and credits on the patients account after the insurance company has processed the claim.
- What is the objective of the HCAHPS Initiative?
Answer: To provide a standardized method for evaluating patients perspective on
hospital care.
- Departments that support and collaborate with the revenue cycle
Answer:
1) IT 2) Clinical Services 3) Finance 4) Health Plan Contracting
- Physician order should include
Answer:
1) Date 2) Valid diagnosis 3) Patients name 4) Physician name and signature 5) Description of test or test ordered
- Continuum providers
Answer:
1) Physician 2) Skilled Nursing Facility 3) Home Health Agency 4) Durable Medical Equipment 5) Hospice 6) Assisted Living
- / 3
- OIG stands for what?
Answer: Office of Inspector General
- FCA stands for what?
Answer: False Claims Act
- FERA stands for what?
Answer: Fraud Enforcement and Recovery Act 2009
- What does FERA do for the Government?
Answer: Close loopholes , Enhance the ability of the government, whistleblowers
and reporting individuals to identify and successfully pursue entities and individuals who improperly receive government funds.
- Compliance Program is defined as
Answer: Systematic procedures instituted by an organization to ensure that the
provisions of the regulations imposed by a govern ment agency are being met."
(2016)
- Corporate Compliance Program Elements
Answer:
1) Self reporting 2) Corporate culture 3) Full support 4) Oversight 5) Written procedures 6) Training and education 7) Hotline 8) Employment of excluded individuals 9) Standards compliance 10) Established compliance standards and procedures.11) Written communication standards and procedures.12) An effective plan to communicate to employees and agents.13) Discretionary authority vested in persons unlikely to engage in criminal conduct.14) Mechanisms for monitoring compliance, including independent evaluations.15) Appropriate and consistent disciplinary measures and mechanisms for employ- ees violating procedures/ethics.
16) Implementation of an audit plan with the following elements:
- Clearly defined goals that identify the specific company practices to be audited
- Personnel who will conduct the audit
- / 3