CRCR Exam Prep Questions and Answers 2023 (Verified Answers) What are collection agency fees based on? - Correct Answer A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - Correct Answer Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - Correct Answer Case rates What customer service improvements might improve the patient accounts department?
- Correct Answer Holding staff accountable for customer service during performance
reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - Correct Answer Inform a Medicare beneficiary that Medicare may not pay for the order or service What type of account adjustment results from the patient's unwillingness to pay for a self-pay balance? - Correct Answer Bad debt adjustment What is the initial hospice benefit? - Correct Answer Two 90-day periods and an unlimited number of subsequent periods When does a hospital add ambulance charges to the Medicare inpatient claim? - Correct Answer If the patient requires ambulance transportation to a skilled nursing facility How should a provider resolve a late-charge credit posted after an account is billed? - Correct Answer Post a late-charge adjustment to the account an increase in the dollars aged greater than 90 days from date of service indicate what about accounts - Correct Answer They are not being processed in a timely manner What is an advantage of a preregistration program? - Correct Answer It reduces processing times at the time of service What are the two statutory exclusions from hospice coverage? - Correct Answer Medically unnecessary services and custodial care What core financial activities are resolved within patient access? - Correct Answer Scheduling, insurance verification, discharge processing, and payment of point-of- service receipts 1 / 2
What statement applies to the scheduled outpatient? - Correct Answer The services do not involve an overnight stay How is a mis-posted contractual allowance resolved? - Correct Answer Comparing the contract reimbursement rates with the contract on the admittance advice to identify the correct amount What type of patient status is used to evaluate the patient's need for inpatient care? - Correct Answer Observation Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has received what? - Correct Answer Medically necessary inpatient hospital services for at least 3 consecutive days before the skilled nursing care admission When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? - Correct Answer When the patient is the insured What are non-emergency patients who come for service without prior notification to the provider called? - Correct Answer Unscheduled patients If the insurance verification response reports that a subscriber has a single policy, what is the status of the subscriber's spouse? - Correct Answer Neither enrolled not entitled to benefits Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes what? - Correct Answer Disclosure rules for consumer credit sales and consumer loans What is a principal diagnosis? - Correct Answer Primary reason for the patient's admission Collecting patient liability dollars after service leads to what? - Correct Answer Lower accounts receivable levels What is the daily out-of-pocket amount for each lifetime reserve day used? - Correct Answer 50% of the current deductible amount What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not billable as an RHC services? - Correct Answer Inpatient care What code indicates the disposition of the patient at the conclusion of service? - Correct Answer Patient discharge status code What are hospitals required to do for Medicare credit balance accounts? - Correct Answer They result in lost reimbursement and additional cost to collect
- / 2