2024 CRCR Exam Prep 1 Guaranteed A+ Actual Questions and Answers, Complete 100%
- What are collection agency fees based on?
Answer: A percentage of dollars collected
- Self-funded benefit plans may choose to coordinate benefits using the gender rule
or what other rule?
Answer: Birthday
- In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers?
Answer: Case rates
- What customer service improvements might improve the patient accounts
department?
Answer: Holding staff accountable for customer service during performance
reviews
- What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
Answer: Inform a Medicare beneficiary that Medicare may not pay for the order or service
- What type of account adjustment results from the patient's unwillingness to pay
for a self-pay balance?
Answer: Bad debt adjustment
- What is the initial hospice benefit?
Answer: Two 90-day periods and an unlimited number of subsequent periods
- When does a hospital add ambulance charges to the Medicare inpatient claim?
Answer: If the patient requires ambulance transportation to a skilled nursing facility
- How should a provider resolve a late-charge credit posted after an account is
billed?
Answer: Post a late-charge adjustment to the account
- an increase in the dollars aged greater than 90 days from date of service indicate
what about accounts
Answer: They are not being processed in a timely manner
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- What is an advantage of a preregistration program?
Answer: It reduces processing times at the time of service
- What are the two statutory exclusions from hospice coverage?
Answer: Medically unnecessary services and custodial care
- What core financial activities are resolved within patient access?
Answer: Scheduling, insurance verification, discharge processing, and payment of point-of-service receipts
- What statement applies to the scheduled outpatient?
Answer: The services do not involve an overnight stay
- How is a mis-posted contractual allowance resolved?
Answer: Comparing the con- tract reimbursement rates with the contract on the
admittance advice to identify the correct amount
- What type of patient status is used to evaluate the patient's need for inpatient
care?
Answer: Observation
- Coverage rules for Medicare beneficiaries receiving skilled nursing care require
that the beneficiary has received what?Answer: Medically necessary inpatient hospital services for at least 3 consecutive days before the skilled nursing care admission
- When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
Answer: When the patient is the insured
- What are non-emergency patients who come for service without prior
notification to the provider called?
Answer: Unscheduled patients
- If the insurance verification response reports that a subscriber has a single policy,
what is the status of the subscriber's spouse?
Answer: Neither enrolled not entitled to benefits
- Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what?
Answer: Disclosure rules for consumer credit sales and consumer loans
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