2024 CRCR Ultimate Test Bank Guide Guaranteed A+ Test Bank Actual Questions and Answers, Complete 100%
- Overall aggregate payments made to a hospice are subject to a computed "cap
amount" calculated by
Answer: The Medicare Administrative Contractor (MAC) at the end of the hospice
cap period
- Which of the following is required for participation in Medicaid
Answer: Meet Income and Assets Requirements
- In choosing a setting for patient financial discussions, organizations should first and
foremost
Answer: Respect the patients privacy
- A nightly room charge will be incorrect if the patient's
Answer: Transfer from ICU (intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
- The Affordable Care Act legislated the development of Health Insurance
Exchanges, where individuals and small businesses can
Answer: Purchase qualified health benefit plans regardless of insured's
health status
- A portion of the accounts receivable inventory which has NOT qualified for
billing includes:
Answer: Charitable pledges
- What is required for the UB-04/837-I, used by Rural Health Clinics to generate
payment from Medicare?
Answer: Revenue codes
- This directive was developed to promote and ensure healthcare quality and value
and also to protect consumers and workers in the healthcare system. This directive is called
Answer: Patient bill of rights
- The activity which results in the accurate recording of patient bed and level of
care assessment, patient transfer and patient discharge status on a real-time basis is known as
Answer: Case management 1 / 3
- Which statement is an EMTALA (Emergency Medical Treatment and Active
Labor Act) violation?
Answer: Registration staff may routinely contact managed care plans for prior
authorizations before the patient is seen by the on-duty physician
- HIPAA had adopted Employer Identification Numbers (EIN) to be used in
standard transactions to identify the employer of an individual described in a transaction EIN's are assigned by
Answer: The Internal Revenue Service
- Checks received through mail, cash received through mail, and lock box are all
examples of
Answer: Control points for cash posting
- What are some core elements if a board-approved financial assistance policy?
Answer: Eligibility, application process, and nonpayment collection activities
- A recurring/series registration is characterized by
Answer: The creation of one reg istration record for multiple days of service
- With the advent of the Affordable Care Act Health Insurance Marketplaces and
the expansion of Medicaid in some states, it is more important than ever for hospitals to Answer: Assist patients in understanding their insurance coverage and their financial obligation
16. The purpose of a financial report is to:
Answer: Present financial information to decision makers
- Patient financial communications best practices produce communications that are
Answer: Consistent, clear and transparent
- Medicare has established guidelines called the Local Coverage Determinations
(LCD) and National Coverage Determinations (NCD) that establish
Answer: What services or healthcare items are covered under Medicare
- Any provider that has filed a timely cost report may appeal an adverse final
decision received from the Medicare Administrative Contractor (MAC). This appeal may be filed with
Answer: The Provider Reimbursement Review Board
- / 3
- Concurrent review and discharge planning
Answer: Occurs during service/through- out the patient stay
21. Duplicate payments occur:
Answer: When providers re-bill claims based on nonpay ment from the initial bill submission
- An individual enrolled in Medicare who is dissatisfied with the government's
claim determination is entitled to reconsideration of the decision. This type of appeal is known as
Answer: A beneficiary appeal
- Insurance verification results in which of the following
Answer: The accurate identification of the patient's eligibility and benefits
- The Medicare fee-for service appeal process for both beneficiaries and providers
includes all of the following levels EXCEPT:
Answer: Judicial review by a federal district court
- Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the
providermay not ask about a patient's insurance information if it would delay what?
Answer: Medical screening and stabilizing treatment
- Ambulance services are billed directly to the health plan for
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
- Key performance indicators (KPIs) set standards for accounts receivables (A/R)
and
Answer: Provide a method of measuring the collection and control of A/R
- he patient discharge process begins when
Answer: The physician writes the dis- charge orders
- The nightly room charge will be incorrect if the patient's
Answer: Transfer from ICU to the Medical/Surgical floor is not reflected in the
registration system.
- The soft cost of a dissatisfied customer is
- / 3
Answer: The customer passing on info about their negative experience to potential pts or through social media channels