HFMA CRCR | 172 Questions And Answers
Question : Through what document does a hospital establish
compliance standards?
CORRECT ANSWER : code of conduct
Question : What is the purpose OIG work plant?
CORRECT ANSWER : Identify Acceptable compliance
programs in various provider setting
Question : If a Medicare patient is admitted on Friday, what
services fall within the three-day DRG window rule?
CORRECT ANSWER : Non-diagnostic service provided on
Tuesday through Friday
Question : What does a modifier allow a provider to do?
CORRECT ANSWER : Report a specific circumstance that
affected a procedure or service without changing the code or its definition
Question : IF outpatient diagnostic services are provided
within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges
CORRECT ANSWER : They must be billed separately to the
part B Carrier
Question : what is a recurring or series registration?
CORRECT ANSWER : One registration record is created for
multiple days of service
Question : What are nonemergency patients who come for
service without prior notification to the provider called?
CORRECT ANSWER : Unscheduled patients
Question : Which of the following statement apply to the
observation patient type?
CORRECT ANSWER : It is used to evaluate the need for an
inpatient admission
Question : which services are hospice programs required to
provide around the clock patient
CORRECT ANSWER : Physician, Nursing, Pharmacy
Question : Scheduler instructions are used to prompt the
scheduler to do what?
CORRECT ANSWER : Complete the scheduling process
correctly based on service requeste
Question : The Time needed to prepare the patient before
service is the difference between the patients arrival time and which of the following?
CORRECT ANSWER : Procedure time
Question : Medicare guidelines require that when a test is
ordered for a LCD or NCD exists, the information provided
on the order must include:
CORRECT ANSWER : Documentation of the medical
necessity for the test
Question : What is the advantage of a pre-registration
program
CORRECT ANSWER : It reduces processing times at the
time of service
Question : What date are required to establish a new
MPI(Master patient Index) entry
CORRECT ANSWER : The responsible party's full legal
name, date of birth, and social security number
Question : Which of the following statements is true about
third-party payments?
CORRECT ANSWER : The payments are received by the
provider from the payer responsible for reimbursing the provider for the patient's covered services.
Question : Which provision protects the patient from medical
expenses that exceed the pre-set level