HFMACRCR
MULTIPLECHOICEEXAM
2024/2025
Questions&Answers VerifiedAnswers A+Guaranteed!!
(ALLANSWERS100%CORRECT)
Whatarecollectionagencyfeesbasedon?-ANSWERApercentageofdollars collected Self-fundedbenefitplansmaychoosetocoordinatebenefitsusingthegenderruleor whatotherrule?-ANSWERBirthday Inwhattypeofpaymentmethodologyisalumpsumorbundledpaymentnegotiated betweenthepayerandsomeorallproviders?-ANSWERCaserates Whatcustomerserviceimprovementsmightimprovethepatientaccountsdepartment?-ANSWERHoldingstaffaccountableforcustomerserviceduringperformance reviews WhatisanABN(AdvanceBeneficiaryNoticeofNon-coverage)requiredtodo?- ANSWERInformaMedicarebeneficiarythatMedicaremaynotpayfortheorderor service Whattypeofaccountadjustmentresultsfromthepatient'sunwillingnesstopayfora self-paybalance?-ANSWERBaddebtadjustment 1 / 4
Whatistheinitialhospicebenefit?-ANSWERTwo90-dayperiodsandanunlimited numberofsubsequentperiods WhendoesahospitaladdambulancechargestotheMedicareinpatientclaim?- ANSWERIfthepatientrequiresambulancetransportationtoaskillednursingfacility Howshouldaproviderresolvealate-chargecreditpostedafteranaccountisbilled?- ANSWERPostalate-chargeadjustmenttotheaccount anincreaseinthedollarsagedgreaterthan90daysfromdateofserviceindicatewhat aboutaccounts-ANSWERTheyarenotbeingprocessedinatimelymanner Whatisanadvantageofapreregistrationprogram?-ANSWERItreduces processingtimesatthetimeofservice Whatarethetwostatutoryexclusionsfromhospicecoverage?-ANSWERMedically unnecessaryservicesandcustodialcare Whatcorefinancialactivitiesareresolvedwithinpatientaccess?-ANSWER Scheduling,insuranceverification,dischargeprocessing,andpaymentof point-of-servicereceipts Whatstatementappliestothescheduledoutpatient?-ANSWERTheservicesdonot involveanovernightstay Howisamis-postedcontractualallowanceresolved?-ANSWERComparingthe contractreimbursementrateswiththecontractontheadmittanceadvicetoidentifythe correctamount Whattypeofpatientstatusisusedtoevaluatethepatient'sneedforinpatientcare?- ANSWERObservation CoveragerulesforMedicarebeneficiariesreceivingskillednursingcarerequirethatthe beneficiaryhasreceivedwhat?-ANSWERMedicallynecessaryinpatienthospital servicesforatleast3consecutivedaysbeforetheskillednursingcareadmission Whenistheword"SAME"enteredontheCMS1500billingforminField0$?- ANSWERWhenthepatientistheinsured 2 / 4
Whatarenon-emergencypatientswhocomeforservicewithoutpriornotificationtothe providercalled?-ANSWERUnscheduledpatients Iftheinsuranceverificationresponsereportsthatasubscriberhasasinglepolicy,what isthestatusofthesubscriber'sspouse?-ANSWERNeitherenrollednotentitledto benefits RegulationZoftheConsumerCreditProtectionAct,alsoknownastheTruthinLending Act,establisheswhat?-ANSWERDisclosurerulesforconsumercreditsalesand consumerloans Whatisaprincipaldiagnosis?-ANSWERPrimaryreasonforthepatient'sadmission Collectingpatientliabilitydollarsafterserviceleadstowhat?-ANSWERLower accountsreceivablelevels Whatisthedailyout-of-pocketamountforeachlifetimereservedayused?- ANSWER50%ofthecurrentdeductibleamount WhatserviceprovidedtoaMedicarebeneficiaryinaruralhealthclinic(RHC)isnot billableasanRHCservices?-ANSWERInpatientcare Whatcodeindicatesthedispositionofthepatientattheconclusionofservice?- ANSWERPatientdischargestatuscode WhatarehospitalsrequiredtodoforMedicarecreditbalanceaccounts?-ANSWER Theyresultinlostreimbursementandadditionalcosttocollect Whenanunduedelayofpaymentresultsfromadisputebetweenthepatientandthe thirdpartypayer,whoisresponsibleforpayment?-ANSWERPatient MedicareguidelinesrequirethatwhenatestisorderedforaLCDorNCDexists,the
informationprovidedontheordermustinclude:-ANSWERAvalidCPTorHCPCS
code Withadvancesininternetsecurityandencryption,revenue-cycleprocessesare expandingtoallowpatientstodowhat?-ANSWERAccesstheirinformationand performfunctionson-line 3 / 4
WhatdateisrequiredonallCMS1500claimforms?-ANSWERonsetdateofcurrent illness Whatdoesschedulingallowproviderstafftodo-ANSWERReviewappropriateness oftheservicerequest Whatcodeisusedtoreporttheprovider'smostcommonsemiprivateroomrate?- ANSWERConditioncode Regulationsandrequirementsforcodingaccountablecareorganizations,whichallows
providerstobegincreatingtheseorganizations,werefinalizedin:-ANSWER2012
WhatisaprimaryresponsibilityoftheRecoverAuditContractor?-ANSWERTo correctlyidentifyproperpaymentsforMedicarePartA&Bclaims Howmustprovidershandlecreditbalances?-ANSWERComplywithstatestatutes concerningreportingcreditbalance Insuranceverificationresultsinwhat?-ANSWERTheaccurateidentificationofthe patient'seligibilityandbenefits WhatformisusedtobillMedicareforruralhealthclinics?-ANSWERCMS1500 Whatactivitiesarecompletedwhenascheduledpre-registeredpatientarrivesfor service?-ANSWERRegisteringthepatientanddirectingthepatienttotheservice area Inadditiontobeingsupportedbyinformationfoundinthepatient'schart,aCMS1500 claimmustbecodedusingwhat?-ANSWERHCPCS(HealthcareCommon ProcedureCodingsystem) Whatresultsfromadeniedclaim?-ANSWERTheproviderincursreworkandappeal costs Whydoesthefinancialcounselorneedpricingforservices?-ANSWERTocalculate thepatient'sfinancialresponsibility Whattypeofproviderbillsthird-partypayersusingCMS1500form-ANSWER Hospital-basedmammographycenters
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