CRCR - Certified Revenue Cycle Representative Program Patient Access and Registration Questions and Answers

Question 1

A patient presents to the emergency department after a car accident.
They are unconscious and have no identification.
According to the Emergency Medical Treatment and Labor Act (EMTALA), what is the first responsibility of the patient access staff?

Accepted Answer

Ensure the patient receives a medical screening examination to determine if an emergency medical condition exists.

Answer

Attempt to identify the patient and locate next of kin to obtain consent and insurance information.

Answer

Register the patient as 'self-pay' until insurance information can be obtained.

Answer

Wait for a law enforcement officer to arrive and identify the patient before proceeding.

Question 2

Which of the following is the PRIMARY reason for verifying a patient's insurance eligibility and benefits at the time of registration?

Accepted Answer

To determine the patient's potential out-of-pocket costs and prevent downstream billing issues.

Answer

To provide the clinical staff with the patient's medical history.

Answer

To ensure the patient's contact information is correct.

Answer

To comply with the hospital's marketing and patient outreach programs.

Question 3

A new patient is being registered for an outpatient procedure. They provide demographic and insurance information. What is the most crucial outcome of an accurate patient registration process?

Accepted Answer

Creating a foundation for a 'clean claim' and preventing denials.

Answer

Ensuring the patient receives appointment reminders.

Answer

Expediting the patient's wait time in the lobby.

Answer

Populating the patient's electronic health record with their photo.

Question 4

A child is brought in for treatment and is covered by insurance plans from both parents. To determine the primary payer, the patient access representative should apply the 'birthday rule.' How is the primary plan determined under this rule?

Accepted Answer

The plan of the parent whose birthday occurs earlier in the calendar year is primary.

Answer

The plan of the parent who is older is primary.

Answer

The plan that has been active for the longest period is primary.

Answer

The plan of the parent whose name comes first alphabetically is primary.

Question 5

During pre-registration for a scheduled surgery, the patient access representative determines that the procedure requires pre-authorization from the patient's insurance company. Which department is typically responsible for initiating this process?

Accepted Answer

The surgeon's clinical office or a centralized utilization management department.

Answer

Health Information Management (HIM)

Answer

Patient Financial Services

Answer

The hospital's compliance department.

Question 6

An Advance Beneficiary Notice of Noncoverage (ABN) is a critical tool used in Patient Access. In which of the following scenarios is an ABN required?

Accepted Answer

When a Medicare beneficiary is receiving a service that may not be considered medically necessary.

Answer

When a patient requests a copy of their medical records.

Answer

Before any patient receives emergency services under EMTALA.

Answer

When a patient has coverage under more than one commercial insurance plan.