HFMA CRCR LATEST 2024 172 QUESTIONS AND
VERIFIED CORRECT ANSWERS GAUARNTEED
A+ AT FIRST ATTEMPT
A claim is denied for the following reasons EXCEPT: - CORRECT ANSWER: The submitted claim does not have the physician signature
A common billing issue with hospital-based physician's is - CORRECT ANSWER: They are not contracted with the patient's health plan to provide services
A decision on whether a patient should be admitted as an inpatient or become an outpatient observation patient requires medical judgement based on all of the following EXCEPT: - CORRECT ANSWER: The patient's home care coverage
A four-digit number code established by the National Uniform Billing Committee (NUBC) that categorizes/classifies a line in the charge master is known as: - CORRECT
ANSWER: Revenue codes
A patient has met the $200 individual deductible and $900 of the $1000 co-insurance responsibility. The co-insurance rate is 20%. The estimated insurance plan responsibility is $1975.00. What amount of coinsurance is due from the patient? -
CORRECT ANSWER: $100.00
A portion of the accounts receivable inventory which has NOT qualified for billing includes: - CORRECT ANSWER: Accounts created during pre-registration but not activated
A scheduled inpatient represents an opportunity for the provider to do which of the following? - CORRECT ANSWER: Complete registration and insurance approval before service
Account Receivable (A/R) aging reports - CORRECT ANSWER: Identify past due
accounts likely to become bad debit
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: - CORRECT ANSWER: Support that choice, providing that the discussion does not interfere with patient care or disrupt patient flow.
All Hospitals are required to establish a written financial assistance policy that applies to: - CORRECT ANSWER: All emergency and medically necessary care
All of following are steps in safeguarding collections EXCEPT: - CORRECT ANSWER: Placing collections in a lock-box for posting review the next business day
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All of the following are potential causes of credit balances EXCEPT: - CORRECT
ANSWER: A patient's choice to build up a credit against future medical bills
Ambulance services are billed directly to the health plan for: - CORRECT ANSWER: Services provided before a patient is admitted and for ambulance rides arranged to pick up the patient from the hospital after discharge to take him/her home or to another facility.
An advantage of a pre-registration program in - CORRECT ANSWER: The opportunity
to reduce processing times at the time of service
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
Any healthcare insurance plan that providers or insures comprehensive health maintenance and services for an enrolled group of persons based on a monthly fee is
known as a - CORRECT ANSWER: HMO
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and treatment services for an enrolled group of persons on a monthly fee is known as: - CORRECT ANSWER: HMO
Any provider that has filed a timely cost report may appeal in an adverse final decision received from the Medicare Administrative Contractor (MAC), the appeal may be filed with: - CORRECT ANSWER: The Provider Reimbursement Review Board.
Applying the contracted payment amount to the amount of total charges yields: -
CORRECT ANSWER: An estimated price for the patient's responsibility
Applying the contracted payment methodology to the total charges yields: - CORRECT
ANSWER: An estimate price
Appropriate training for patient financial counseling staff must cover all of the following EXCEPT: - CORRECT ANSWER: Documenting the conversation in the medical records
Before classifying and subsequently writing off an account to financial assistance or bad debit, the hospital must establish policy define appropriate criteria, implement procedures for identifying accounts and: - CORRECT ANSWER: Monitor compliance
Chapter 11 Bankruptcy permits a debtor to: - CORRECT ANSWER: Work out a court- supervised plan with creditors
Charges, as the most appropriate measurement of utilization, enables: - CORRECT
ANSWER: Generation of timely and accurate billing
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