FREE MISCELLANEOUS AND STUDY GAMES ABOUT CRCR

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FREE MISCELLANEOUS AND STUDY GAMES ABOUT CRCR

PREP 2 EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -78 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation Question 1: The nation's oldest and largest family of private health benefits companies.

Answer:

Blue Cross/Blue Shield Question 2: Patient service costs are calculated in the pre-service process for scheduled patients.

Answer:

True Question 3: Sue Smith came into the hospital. Her insurance provider sent an EFT directly into the hospitals account at the bank. John, the hospital representative, receives an electronic Level 2 ERA. What should he do next?

Answer:

Manually match the ERA to the patient account

Question 4: Which option is NOT a continuum of care provider?

Answer:

Health Plan Contracting

Question 5: What is the purpose of insurance verification?

Answer:

To ensure accuracy of the health plan information

Question 6: What is the first component of a pricing determination?

Answer:

Verification of the patient's insurance eligibility and benefits

Question 7: Restrictions on Garnishment

Answer:

Title III Question 8: The patient is scheduled and registered for service is a time-of-service activity.

Answer:

False

Question 9: Which patients are considered scheduled?

Answer:

Recuning/Series Patients Question 10: Which option is a federally-aided, state-operated program to provide health and long-term care coverage?

Answer:

Medicaid

Question 11: In what manner do case managers assist revenue cycle staff?

Answer:

Providing assistance with written appeals to health plans related to utilization and other care issues.Question 12: Which option is NOT a department that supports and collaborates with the revenue cycle?

Answer:

Assisted Living Services

Question 13: Which concept is NOT a contracted payment model?

Answer:

Stop-Loss Provision

Question 14: Cover almost all services without authorization requirements.

Answer:

Commercial Indemnity Plans Question 15: The following statement represents an advantage of outsourcing: Access to qualified staff.

Answer:

True

Question 16: Which option is NOT a specific managed care requirement?

Answer:

Preferred Provider Organization Question 17: The patient account is monitored for payment is a time-of-service activity.

Answer:

False Question 18: Annually, the OIG publishes a work plan of compliance issues and objectives that will be focused on throughout the following year. Identify which option is NOT a work plan task mentioned in this course.

Answer:

Standard Unique Employer Identifier Question 19: Section 6404 of the Patient Protection and ACA states that claims with dates of service on or after January 1, 2010, received later than one calendar year beyond the date of service, will be denied by Medicare.

Answer:

Time Limits for Billing

Question 20: The following statement represents an advantage of outsourcing: Capitalizes on the economics of scale

Answer:

True Question 21: A mother sees a charge on her hospital bill for a circumcision for a newborn girl.This is an example of falsifying medical records to boost reimbursement.

Answer:

False Question 22: A patient access staff member takes several file folders and highlighters home for personal use. This is an example of theft of property.

Answer:

True Question 23: Which option is NOT a bankruptcy type governed by the 1979 Bankruptcy Act?

Answer:

Creditor priority

Question 24: Which option is NOT a lien type?

Answer:

Subrogation Question 25: A health plan that provides comprehensive healthcare services, within a designated population, on a pre-payment basis.

Answer:

HMO Question 26: A physician documents a fictitious epidural in a patients medical record in an effort to receive additional payment. This is an example of miscoding claims.

Answer:

False