HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM 600 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE EXAM AND A STUDY GUIDE LATEST 2024 ACTUAL EXAM 600 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ HFMA CRCR EXAM Hospital can only convert an inpatient case to observation if: - ANSWER- The hospital utilization review committee determines before the patient is discharged and prior to billing that an observation setting would be more appropriate. Hospital need which of the following information sets to assess a patient's financial status? - ANSWER- Demographic, Income, Assets and Expenses. HIPAA privacy rules require covered entities to take all, of the following actions EXCEPT: - ANSWER- Use only designated software platforms to secure patient date. When Recovery Audit Contractors (RAC) identify improper payments as overpayment. the claims processing contractor must: - ANSWER- Send a demand letter to the provider to recover the over payment amount. Which HIPPA transaction set provides electronic processing of 8insurance verification requests and responses? - ANSWERThe 270-271 set Across all care settings, if a patient consents to a financial discussion during a medical encounter to expedite discharge, the HFMA best practice is to: - ANSWER- Support that choice, providing that the discussion does not interfere with patient care or disrupt patient flow. A scheduled inpatient represents an opportunity for the provider to do which of the following? - ANSWER- Complete registration and insurance approval before service The Medicare Bundled Payments for Care Initiative (BCP) is designed to: - ANSWER- Align incentives between hospitals, physicians, and non-physician providers in-order to better coordinate patient care. To maximize the value derived from customer complaints, all consumer complaints should be: - ANSWER- Tracked and shared to improve customer experience The soft cost of a dissatisfied customer is: - ANSWER- The customer passing on information about their negative experience to potential patients or through social media channels. Applying the contracted payment methodology to the total charges yields: - ANSWER- An estimate price The importance of medical records maintained by HIM is that the patient records: - ANSWER- Are the primary source for clinical data required for reimbursement by health plans and liability payers Important Revenue Cycle Activities in the pre-service stage include: - ANSWER- Obtaining or updating patient and guarantor information In the pre-service stage, the cost of the schedule services is identified and the patient's health plan and benefits are used to calculate: - ANSWER- The amount the patient may be expected to pay after insurance. The disadvantage of outsourcing includes all, of the following Except - ANSWER- Reduces internal staffing costs and a reliance on outsourced staff. Marinating routine contact with health plan or liability payer, making sure all required information is provided and all needed approvals are obtained is the responsibility of who: - ANSWERCase Management A claim is denied for the following reasons EXCEPT: - ANSWER- The submitted claim does not have the physician signature All Hospitals are required to establish a written financial assistance policy that applies to: - ANSWER- All emergency and medically necessary care Examples of ethics violation that impact the revenue cycle include all of the following EXCEPT: - ANSWER- Seeking payment options for self-pay Verbal orders from a physician for a service(s) are: - ANSWERAcceptable if given to "qualified" staff as defined in a hospitals policies and procedures Medicare has established guidelines called Local Coverage Determination (LCD) and National Coverage Determination