HFMA CRCR EXAM LATEST 2023-2024 EXAM 170+ QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS)

HFMA CRCR EXAM LATEST 2023-2024

EXAM 170+ QUESTIONS AND CORRECT

ANSWERS(VERIFIED ANSWERS)

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 -

ANSWER- They must be billed separately to the part B Carrier

what is a recurring or series registration? - ANSWER- One registration

record is created for multiple days of service

What are nonemergency patients who come for service without prior

notification to the provider called? - ANSWER- Unscheduled patients

Which of the following statement apply to the observation patient type?

- ANSWER- It is used to evaluate the need for an inpatient admission

which services are hospice programs required to provide around the

clock patient - ANSWER- Physician, Nursing, Pharmacy

Scheduler instructions are used to prompt the scheduler to do what? -

ANSWER- Complete the scheduling process correctly based on service

requeste

The Time needed to prepare the patient before service is the difference

between the patients arrival time and which of the following? -

ANSWER- Procedure time

Medicare guidelines require that when a test is ordered for a LCD or

NCD exists, the information provided on the order must include: -

ANSWER- Documentation of the medical necessity for the test

What is the advantage of a pre-registration program - ANSWER- It

reduces processing times at the time of service

What date are required to establish a new MPI(Master patient Index)

entry - ANSWER- The responsible party's full legal name, date of birth,

and social security number

Which of the following statements is true about third-party payments? -

ANSWER- The payments are received by the provider from the payer

responsible for reimbursing the provider for the patient's covered

services.

Which provision protects the patient from medical expenses that exceed

the pre-set level - ANSWER- stop loss

what documentation must a primary care physician send to HMO patient

to authorize a visit to a specialist for additional testing or care? -

ANSWER- Referral

Under EMTALA (Emergency Medical Treatment and Labor Act)

regulations, the provider may not ask about a patient's insurance

information if it would delay what? - ANSWER- Medical screening and

stabilizing treatment

Which of the following is a step in the discharge process? - ANSWERHave a case management service complete the discharge plan

The hospital has a APC based contract for the payment of outpatient

services. Total anticipated charges for the visit are $2,380. The approved

APC payment rate is $780. Where will the patients benefit package be

applied? - ANSWER- To the approved APC payment rate

A patient has met the $200 individual deductible and $900 of the $1000

co-insurance responsibility. The co-insurance rate is 20%. The estimated

insurance plan responsibility is $1975.00. What amount of coinsurance

is due from the patient? - ANSWER- $100.00

When is a patient considered to be medically indigent? - ANSWER- The

patient's outstanding medical bills exceed a defined dollar amount or

percentage of assets.

What patient assets are considered in the financial assistance

application? - ANSWER- Sources of readily available funds , vehicles,

campers, boats and saving accounts

If the patient cannot agree to payment arrangements, What is the next

option? - ANSWER- Warn the patient that unpaid accounts are placed

with collection agencies for further processing

What core financial activities are resolved within patient access? -

ANSWER- scheduling , pre-registration, insurance verification and

managed care processing

What is an unscheduled direct admission? - ANSWER- A patient who

arrives at the hospital via ambulance for treatment in the emergency

department

When is it not appropriate to use observation status? - ANSWER- As a

substitute for an inpatient admission

Patients who require periodic skilled nursing or therapeutic care receive

services from what type of program? - ANSWER- Home health agency

Every patient who is new to the healthcare provider must be offered

what? - ANSWER- A printed copy of the provider privacy notice