HFMA CRCR exam 2024 with 100% correct answers
HFMA CRCR exam 2024 with 100% correct
answers
Through what document does a hospital establish compliance
... [Show More] standards?
Code of Conduct
What is the purpose of the OIG work plan?
Communicate Issues that will be reviewed during the year for compliance with
Medicare Regulations
If a Medicare patient is admitted on Friday, what services fall within the three-day
DRG window rule?
Diagnostic services and related charges provided on Wednesday, Thursday and
Friday before admission.
What does a modifier allow a provider to do?
Report a specific circumstance that affected a procedure or service without
changing the code or its definition
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?
They must be combined with the inpatient bill and paid under the MS-DRG
(diagnosis related group) system.
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?
It reviews Medicare payments for beneficiaries who have other insurance and
assesses the effectiveness of procedures in preventing inappropriate Medicare
payments for beneficiaries with other insurance coverage.
What is a recurring or series registration?
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?
Unscheduled Patients
Which of the following statements apply to the observation patient type?
It is used to evaluate the need for an inpatient admission.
Which services are hospice programs required to provide on an around-the-clock
basis?
Physician, nursing and pharmacy
What is the purpose of the initial step in the outpatient testing scheduling process?
Identify the correct patient on the providers database or add the patient to the
database
Scheduler instructions are used to prompt the scheduler to do what?
Complete the scheduling process correctly based on service requested.
The time needed to prepare the patient before service is the difference between the
patient's arrival time and which of the following?
Procedure time
Medicare guidelines require that when a test is ordered for which as LCD (local
coverage determination) or NCD (national coverage determination) exist, the
information provided on the order must include which of the following?
Documentation of the medical necessity of the test.
What is an advantage of a preregistration program?
It reduces processing times at the time of service
What data are required to establish a new MPI (master patient index) entry?
The patients full legal name, date of birth and sex
Which HIPAA transition set provides electronic processing of insurance
verification requests and responses?
The 270-271 Set
A mother and father both cover their 16-year-old child as a dependent on their
health insurance plans, which both follow the birthday rule. The mothers date of
birth is January 19, 1968; the father's date of birth is July 19, 1967. Whose plan is
the primary payer? [Show Less]