2024 CRCR Study Guide 2 A+ Rated Guide | Questions and Answers (Solved)
- This includes all the major processing steps required to process a pt account from
the request for service through closing the account with a zero balance and purging it from the system
Answer: Patient Centric Revenue Cycle
- this is the period in which scheduling and pre-access takes place, including different
steps that will be completed
Answer: pre-service
- what is it when the requested service is screened for medical necessity, health
plan coverage & benefits are verified, and pre-auth is obtained
Answer: pre-ser- vice
- what is it when a final account review is completed prior to the patient's arrival?
(Pre-reg record is activated, consents are signed, and co-payments and other amounts are collected)
Answer: scheduled patient- Time of Service
- pre-processed patient's can report to this, which is a desk located in a centralized
access, upon their arrival.
Answer: express arrival
- this includes account activities that occur after the patient is d/c until the account
reaches a zero balance
Answer: post-service
- Final coding of all services, perparation and submission of claims, payment
processing and balance billing are all included and finalized when?
Answer: post-ser- vice
- This brings consistency, clarity, and transparency to patient financial com-
munications
Answer: Patient Financial Communications Best Practices
- this outlines steps to help patient's understand the cost of services they receive,
their insurance coverage, and their individual responsibility (review Patient Financial Comm. Best Practice document)
Answer: Patient Financial Communications Best Practices
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10. true or false: Conversations should occur in a location and manner that are
sensitive to the patient's needs
Answer: true
- this type of discussion will help ensure that patient's understand their financial
obligation and that providers are aware of the patient's ability to pay
Answer: timely discussions
- the person responsible for payment of the bill
Answer: guarantor
- true or false: A financial counselor or supervisor should be involved for complex
situations such as uninsured or underinsured patient's
Answer: true
- true or false: You MUST obtain basic registration info and insurance cov- erage
before the patient is cared for in the ED.Answer: false; NO patient financial discussions should occur before a patient is screened and stabilized
- true or false: When the provider takes the initiative to communicate financial
matters with the patient, it actually take a burden off the patient.
Answer: true
16. true or false: Technology evaluation can ONLY be done by a qualified
individual, internal to the facililty
Answer: false; Technology evaluation may be performed by ANY qualified
individual or organization, internal or external
- this program is a recognition for providers who implement and support the best
practices are eligible and encouraged to apply
Answer: HFMA's Adopter Program
- Through what document does a hospital est. compliance standards?
Answer: Code of Conduct
- what is the purpose OIG work plan?
Answer: Identify acceptable compliance pro- grams in various provider setting
- If a Medicare pt is admitted on Friday, what services fall within the 3-day DRG
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window rule?Answer: non-diagnostic services provided on Tuesday through Friday