HFMA CRCR Test Questions and 100% Correct Answers/ HFMA CRCR Test Question Updated 2023-2024
What do Case Managers do? -------- Correct Answer -------- Monitor high resource cases to ensure effective utilization
What is HIM responsible for? -------- Correct Answer -------- all pt medical records: transcribe, coding, release to biling, answer requests for documentation
What is utilization management responsible for? -------- Correct Answer -------- manage
cases: services correct, on time
What are the three types of utilization review? -------- Correct Answer -------- Prospective, Concurrent, Retrospective
Where can home health services be offered? -------- Correct Answer -------- Home,
Assist Living, neighbors: just not SNF nor Hospital
To receive -Care payments, what must a SNF have when receiving a pt from a hosp? -- ------ Correct Answer -------- A transfer agreement approved by -Care.
Can a home health agency employ another agency to provide services? -------- Correct Answer -------- Yes, so long as at least one employee of the original agency provides care.
What is the Net Collection Rate? -------- Correct Answer -------- how much cash was collected as a % of available to collect?
What is the Net Collection Rate benchmark? -------- Correct Answer -------- 95%
What is the benchmark for denials -------- Correct Answer -------- <2% on first submission
Formual for cost to collect -------- Correct Answer -------- total PFS expenses/gross pt care collections
What is the benchmark for cost to collect -------- Correct Answer -------- 2.25%
What % of the UB-04 source of data is from pt access? -------- Correct Answer -------- 40%
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What % of the UB-04 source of data is from service depts? -------- Correct Answer -------
- 11%
What % of the UB-04 source of data is from HIM? -------- Correct Answer -------- 20%
What % of the UB-04 source of data is from billing? -------- Correct Answer -------- 20%
What % of the UB-04 source of data is not used? -------- Correct Answer -------- 9%
What % of the CMS 1500 source of data is from pt access? -------- Correct Answer -------
- 53%
What % of the CMS 1500 source of data is from service? -------- Correct Answer -------- 14%
What % of the CMS 1500 source of data is from HIM -------- Correct Answer -------- 7%
What % of the CMS 1500 source of data is from billing? -------- Correct Answer -------- 26%
From whom is the UB-04 directed? -------- Correct Answer -------- institutional: hospitals, SNF, hospice
From whom is the CMS 1500? -------- Correct Answer -------- non-institutional:
physicians, DME
In the FDCA, what is Title I -------- Correct Answer -------- Truth in Lending Act
What is the Truth in Lending Act -------- Correct Answer -------- 5 points must be triggered (such as interest will be charged), then must disclose APR, total payments, late payment charges, etc.
What are the penalties for violating the FDCA? -------- Correct Answer -------- creditors can be sued
Who enforces the FDCA for hospitals? -------- Correct Answer -------- FTC
In the FDCA, what is Title III -------- Correct Answer -------- limits garnishments
In the FDCA, what is Title IV -------- Correct Answer -------- Fair Credit Reporting Act
What is the Fair Credit Reporting Act? -------- Correct Answer -------- provides consumer rights in reporting loans
Are there rules for how a debt collector communicates with debtor? -------- Correct Answer -------- Yes, eg no profane language, can't contact before 8 AM
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