CRCR FINAL EXAM 2024 Latest Update 2024-2025 Actual Exam 150 Questions and 100% Verified Correct Answers Guaranteed A+
- MSP (Medicare Secondary Payer) rules allow providers to bill Medicare for liability claims after what
happens? - CORRECT ANSWER: 120 days passes, but the claim then be withdrawn from the liability carrier
Access - CORRECT ANSWER: An individual's ability to obtain medical services on a timely and financially acceptable level
According to the Department of Health and Human Services guidelines, what is NOT considered income?
- CORRECT ANSWER: Sale of property, house, or car
Administrative Services Only (ASO) - CORRECT ANSWER: Usually contracted administrative services to a self-insured health plan
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
At the end of each shift, what must happen to cash, checks, and credit card transaction documents? -
CORRECT ANSWER: They must be balanced
Care purchaser - CORRECT ANSWER: Individual or entity that contributes to the purchase of healthcare services
Case management - CORRECT ANSWER: The process whereby all health-related components of a case are managed by a designated health professional. Intended to ensure continuity of healthcare accessibility and services
Charge - CORRECT ANSWER: The dollar amount a provider sets for services rendered before negotiating any discounts. The charge can be different from the amount paid 1 / 2
Claim - CORRECT ANSWER: A demand by an insured person for the benefits provided by the group contract
Collecting patient liability dollars after service leads to what? - CORRECT ANSWER: Lower accounts receivable levels
Coordination of benefits (COB) - CORRECT ANSWER: a typical insurance provision that determines the responsibility for primary payment when the patient is covered by more than one employer-sponsored health benefit program
Cost - CORRECT ANSWER: The definition of cost varies by party incurring the expense
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
Discounted fee-for-service - CORRECT ANSWER: A reimbursement methodology whereby a provider agrees to provide service on a fee for service basis, but the fees are discounted by certain packages
Eligibility - CORRECT ANSWER: Patient status regarding coverage for healthcare insurance benefits
ESRD - CORRECT ANSWER: End-stage renal disease. The patient has permanent kidney failure, is covered by a GHP, and has not yet completed the 30-month coordination period
Every patient who is new to the healthcare provider must be offered what? - CORRECT ANSWER: A printed copy of the provider's privacy notice
FERA - CORRECT ANSWER: Fraud Enforcement and Recovery act
First dollar coverage - CORRECT ANSWER: A healthcare insurance policy that has no deductible and covers the first dollar of an insured's expenses
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