Patient Access and Registration Flashcards
7 cards from real CRCR practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Access and Registration flashcards as text
A patient arrives for a scheduled outpatient procedure and cannot produce their insurance card. What is the BEST first action for the registrar?
Answer: Call the insurer directly to verify eligibility using the patient's member ID from the system
Registrars should use available member IDs or real-time eligibility tools to verify coverage when a physical card is unavailable, avoiding unnecessary service disruption.
Which document notifies Medicare beneficiaries that a service may not be covered and requires their financial responsibility acknowledgment?
Answer: Advance Beneficiary Notice of Noncoverage (ABN)
The ABN must be issued before providing a potentially non-covered service so the Medicare patient can make an informed decision and accepts financial liability.
When a patient has both a primary and secondary insurance, the registration team's coordination of benefits (COB) process should do which of the following?
Answer: Identify the correct payer order and document it in the account
Proper COB documentation ensures claims are filed to payers in the correct order, maximizing reimbursement and avoiding denials.
A new patient presents to the ED with no ID and is unconscious. Under HIPAA, the hospital may:
Answer: Treat the patient and document as much identifying information as possible from available sources
HIPAA permits disclosure and treatment when necessary for emergency care; registration staff should document all available identifiers and create a temporary record.
Which federal law requires hospitals to provide a medical screening exam and stabilizing treatment regardless of the patient's ability to pay?
Answer: EMTALA
The Emergency Medical Treatment and Labor Act (EMTALA) prohibits patient dumping and requires emergency screening and stabilization for anyone presenting to a participating hospital ED.
Real-time eligibility (RTE) verification tools are primarily used during patient access to:
Answer: Confirm active coverage and benefit details before service is rendered
RTE tools query payer databases to confirm current coverage, deductible balances, copay amounts, and benefit limits at or before the point of service.
A registrar incorrectly enters a patient's date of birth, causing a claim denial. This is an example of which type of error?
Answer: Demographic/data entry error
Inaccurate demographic information such as incorrect date of birth is a leading cause of claim denials and is classified as a data entry or front-end registration error.