CRCR Practice Questions and Verified Correct Answers Using Marking Scheme Guaranteed A+ At First Attempt 2024 Brand New
A "Compliance Program" is defined as:
- Educating staff on regulations
- The development of operational policies that correspond to regulations
- Systematic procedures to ensure that the provisions of regulations imposed by a
government agency are being met
D. Annual legal audit and review for adherence to regulations - CORRECT ANSWER:
- Systematic procedures to ensure that provisions of regulations imposed by
government agency are being met
A benefit period begins:
- With admission as an inpatient
- Upon the day the coverage premium is paid
- The first day in which a patient is furnished extended care services in the period the
- Immediately once authorization for treatment is provided by the health plan -
patient is entitled to hospital insurance
CORRECT ANSWER: C. The first day in which a patient is furnished extended care
services in the period the patient is entitled to hospital insurance
A decision of whether a patient should be admitted as an inpatient or become an outpatient observation patient requires medical judgments based on all of the following
EXCEPT:
- The patient's medical history
- The safe-guarding against medical error
- Current medical needs
D. The Medical predictability of something adverse happening - CORRECT ANSWER:
- The safe-guarding against medical error
A four digit number code established by the National Uniform Billing (NUBC) that
categorizes/classifies a line item in the chargemaster is known as:
- HCPCs codes
- ICD-10 Procedural codes
- CPT codes
D. Revenue codes - CORRECT ANSWER: D. Revenue codes
A nightly room charge will be incorrect if the patient's:
- Transfer from the ICU (Intensive care unit) to the Medical/Surgical floor is not
- Pharmacy orders have not been entered into the pharmacy system
- Condition has not been discussed during the shift change report meeting 1 / 3
reflected in the registration system
- Discharge for the next day has not been charted - CORRECT ANSWER: A. Transfer
from the ICU (intensive care unit) to the Medical/Surgical floor is not reflected in the registration system
A recurring/series registration is characterized by:
- The creation of one registration record for multiple days of service
- The creation of multiple registrations for multiple services
- The creation of one registration record per diagnosis per visit
- The creation of multiple patient types for one date of service - CORRECT ANSWER:
- The creation of one registration record for multiple days of service
A successful pre-registration program:
- Helps the patient feel welcome
- Identifies clearly what information must be gathered including demographic data,
- Thoroughly discusses the patient's financial obligation
- Collects patient deductibles and co-pays - CORRECT ANSWER: B. Identifies clearly
insurance data, and financial information
what information must be gathered including demographic data, insurance data, and financial information
Across all care settings, if a patient consents to a financial discussion during a medical
encounter to expedite discharge, the HFMA best practice is to:
- Have a patient financial responsibilities kit ready for the patient, containing all of the
- Make sure that the attending staff can answer questions and assist in obtaining
- Support that choice, providing that the discussion does not interfere with patient care
- Decline such request as finance discussions can disrupt patient care and patient
required registration forms and instructions.
required patient financial data.
or disrupt patient flow.
flow. - CORRECT ANSWER: C. Support that choice, providing that the discussion does not interfere with patient care or disrupt patient flow
Activities completed when the scheduled, pre-registered patient arrives for service
includes:
- Verifying insurance, activating the record and directing the patient to the service
- Scanning the driver's license or other phot identification and directing the patient to
- Activating the record, obtaining signatures and finalizing financial issues.
- Registering the patient and directing the patient to the service area. - CORRECT
area.
the financial counselor.
ANSWER: C. Activating the record, obtaining signatures and
All of the following are conditions that disqualify a procedure or service from being paid
for by Medicare EXCEPT:
- Offered in an outpatient setting
- Medically unnecessary 2 / 3
- Not delivered in a Medicare licensed care setting.
- Services and procedures that are custodial in nature - CORRECT ANSWER: C. Not
delivered in a Medicare licensed care setting
All of the following are reference resources used to help guide in the application for
business ethics EXCEPT:
- Consumer satisfaction reports
- Mission & Value Statements
- Code of Ethics / Code of Conduct
D. Compliance Office & Policies - CORRECT ANSWER: A. Consumer satisfaction
reports
All of the following are steps in safeguarding collections EXCEPT:
- Placing collections in a lock-box for posting review the next business day.
- Posting the payment to the patient's account
- Completing balancing activities
D. Issuing receipts - CORRECT ANSWER: A. Placing collections in a lock-box for
posting review the next business day
All of the following are steps in verifying insurance EXCEPT:
- Sequencing plans involved in a coordination of benefits (COB) situation.
- The patient signing the statement of financial responsibility.
- Identifying and documenting the patient's health plan benefits
- Confirming the patient's eligibility for benefits - CORRECT ANSWER: B. The patient
signing the statement of financial responsibility
All of the following information is used to identify a patient EXCEPT:
- Date of Birth
- Gender
- Social Security Number
D. Address - CORRECT ANSWER: D. Address
All of the following information should be reviewed as part of schedule finalization
EXCEPT:
- The estimated patient financial obligations
- The service to be provided
- The arrival time and procedure time
D. The patient's preparation instructions - CORRECT ANSWER: A. The estimated
patient financial obligations
Ambulance services are billed directly to the health plan for :
- All pre-admission emergency transports
- Transport deemed medically necessary by the attending paramedic-ambulance crew
- Services provided before a patient is admitted and for ambulance rides arranged to
- / 3
pick up the patient from the hospital after discharge to take him/her home or to another facility