FREE AND STUDY GAMES ABOUT ENSEMBLE CRCR 2020

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FREE AND STUDY GAMES ABOUT ENSEMBLE CRCR 2020

EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -99 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation

Question 1: Managed Care plans do not permit balance billing except for in what

circumstance?

Answer:

Deductible and Co-payment

Question 2: What is the benefit of the Medicare Advantage Plan?

Answer:

Patients generally have their Medicare coverage healthcare through the plan and do not need to worry about "Part A" or "Part B" benefits.

Question 3: What is a benefit of pre-registering patients for service?

Answer:

Patient arrival processing is expedited, reducing wait times and delays.Question 4: In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers?

Answer:

Case rates

Question 5: What is a principal diagnosis?

Answer:

Primary reason for the patient's admission.

Question 6: Indemnity plans usually reimburse?

Answer:

A claim up to 80% of the charges.Question 7: What statement is NOT a possible consequence of selecting the wrong patient in the MPI (master patient index)?

Answer:

Claim is paid in full.Question 8: What type of patient status is used to evaluate the patient's need for inpatient care?

Answer:

Observation Question 9: True or False: Patients who join the Medicare Advantage plan will not receive a health insurance card from the payer they select.

Answer:

False Question 10: What is the purpose of the initial step in the outpatient testing scheduling process?

Answer:

Identify the correct patient in the providers data base or add the patient to the data base.

Question 11: What is the initial hospice benefit?

Answer:

Two 90-day periods and an unlimited number of subsequent periods.

Question 12: Which option is NOT a HFMA best practice?

Answer:

Coordinate the resolution of bad debt accounts with a law firm.

Question 13: The result of accurate census balancing on a daily basis is?

Answer:

The overall accuracy of resource planning.

Question 14: What are KPIs?

Answer:

Key Performance Indicators which set standards for accounts receivable (A/R) and provide a method of measuring the collection and control of A/R.

Question 15: Successful account resolution begins with?

Answer:

Educating patients on their estimated financial responsibility.Question 16: How should a provider resolve a late-charge credit posted after an account is billed?

Answer:

Post a late-charge adjustment to the account.

Question 17: Charges are the basis for?

Answer:

Third party and regulatory review of resources used.Question 18: Internal controls addressing coding and reimbursement changes are put in place to guard against?

Answer:

Compliance fraud by "upcoding" Question 19: HFMA's best practices for patient financial communications specify that patients

should be told about the types of services provided and:

Answer:

The service providers that typically participate in the service.Question 20: What type of plan assumes the employer has direct responsibility and risk for healthcare claims?

Answer:

Self Insured Claims

Question 21: In addition to being supported by information found in the patient's chart, a CMS 1500 claim must be coded using what?

Answer:

HCPCS (Healthcare Common Procedure Coding system) Question 22: If a patient remains an inpatient of a skilled nursing facility (SNF)for more than 30 days, what is the SNF permitted to do?

Answer:

Submit interim bills to the Medicare program.

Question 23: Insurance verification results in what?

Answer:

The accurate identification of the patient's eligibility and benefits.

Question 24: Net Accounts Receivable is?

Answer:

The amount an entity is reasonably confident of collecting from overall accounts receivable.Question 25: Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule?

Answer:

DOB Question 26: The revenue cycle begins with scheduling a patient for service and ends with what?

Answer:

The archiving of the fully resolved account.

Question 27: What does EMTALA require hospitals to do?

Answer:

To provide a medical screening examination and stabilizing treatment to every person presenting at an ED and requesting medical evaluation of treatment .