CRCR Certification exam review 2023 questions and answers Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by - correct answer The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid - correct answer Meet Income and Assets Requirements In choosing a setting for patient financial discussions, organizations should first and foremost - correct answer Respect the patients privacy A nightly room charge will be incorrect if the patient's - correct 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 - correct answer Purchase qualified health benefit plans regardless of insured's health status CRCR Certification exam review 2023 questions and answers A portion of the accounts receivable inventory which has NOT qualified for billing includes: - correct answer Charitable pledges What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare? - correct 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 - correct 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 - correct answer Case management Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? - correct answer Registration staff may routinely contact managed are plans for prior authorizations before the patient is seen by the on-duty physician CRCR Certification exam review 2023 questions and answers 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 - correct answer The Internal Revenue Service Checks received through mail, cash received through mail, and lock box are all examples of - correct answer Control points for cash posting What are some core elements if a board-approved financial assistance policy? - correct answer Eligibility, application process, and nonpayment collection activities A recurring/series registration is characterized by - correct answer The creation of one registration 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 - correct answer Assist patients in understanding their insurance coverage and their financial obligation CRCR Certification exam review 2023 questions and answers The purpose of a financial report is to: - correct answer Present financial information to decision makers Patient financial communications best practices produce communications that are - correct answer Consistent, clear and transparent Medicare has established guidelines called the Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) that establish - correct 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 - correct answer The Provider Reimbursement Review Board Concurrent review and discharge planning - correct answer Occurs during service Duplicate payments occur: - correct answer When providers re-bill claims based on nonpayment from the initial bill submission CRCR Certification exam review 2023 questions and answers 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 - correct answer A beneficiary appeal Insurance verification results in which of the following - correct 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: - correct 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? - correct answer Medical screening and stabilizing treatment Ambulance services are billed directly to the health plan for - correct 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