CRCR MULTIPLE CHOICE

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CRCR MULTIPLE CHOICE

ACTUAL EXAM WITH CORRECT SOLUTIONS.

The disadvantages of outsourcing include all of the following

EXCEPT:

a) The impact of customer service or patient relations

b) The impact of loss of direct control of accounts receivable

services

c) Increased costs due to vendor ineffectiveness

d) Reduced internal staffing costs and a reliance on outsourced

staff - correct answer- D

The Medicare fee-for service appeal process for both beneficiaries and providers

includes all of the following levels EXCEPT:

a) Medical necessity review by an independent physician's

panel

b) Judicial review by a federal district court

c) Redetermination by the company that handles claims for

Medicare

d) Review by the Medicare Appeals Council (Appeals Council) -

correct answer- B

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Business ethics, or organizational ethics represent:

a) The principles and standards by which organizations operate

b) Regulations that must be followed by law

c) Definitions of appropriate customer service

d) The code of acceptable conduct - correct answer- A

A portion of the accounts receivable inventory which has NOT qualified for billing

includes:

a) Charitable pledges

b) Accounts created during pre-registration but not activated

c) Accounts coded but held within the suspense period

d) Accounts assigned to a pre-collection agency - correct

answer- A

Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) are

Medicare established guideline(s) used to determine:

a) Medicare and Medicaid provider eligibility

b) Medicare outpatient reimbursement rates 2 / 4

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c) Which diagnoses, signs, or symptoms are reimbursable

d) What Medicare reimburses and what should be referred to

Medicaid - correct answer- C

Days in A/R is calculated based on the value of:

a) The total accounts receivable on a specific date

b) Total anticipated revenue minus expenses

c) The time it takes to collect anticipated revenue

d) Total cash received to date - correct answer- C

Patients are contacting hospitals to proactively inquire about costs and fees prior to agreeing to service. The problem for hospitals in providing such

information is:

a) That hospitals don't want to establish a price without knowing

if the patient has insurance and how much reimbursement can be expected

b) The fact that charge master lists the total charge, not net

charges that reflect charges after a payer's contractual adjustment

c) That hospitals don't want to be put in the position of 3 / 4

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"guaranteeing" price without having room for additional charges that may arise in the course of treatment

d) Their reluctance to share proprietary information - correct

answer- B

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:

a) Make sure that the attending staff can answer questions and

assist in obtaining required patient financial data

b) Have a patient financial responsibilities kit ready for the

patient, containing all of the required registration forms and instructions

c) Support that choice, providing that the discussion does not

interfere with patient care or disrupt patient flow

d) Decline such request as finance discussions can disrupt

patient care and patient flow - correct answer- C

A comprehensive "Compliance Program" is defined as

a) Annual legal audit and review for adherence to regulations

b) Educating staff on regulations

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