CRCR Account Follow-Up and Collections 2

Question 1

When a claim is denied due to a coordination of benefits (COB) issue, what is the FIRST step in the follow-up process?

Accepted Answer

Identify which payer is primary and which is secondary

Answer

Determining the correct payer order is essential before resubmitting a COB-related denial.

Question 2

A payer has not responded to a claim within the timely filing period. What action should a revenue cycle representative take?

Accepted Answer

Submit a claim tracer or proof-of-timely-filing documentation

Answer

A claim tracer or proof of timely filing can support resubmission even when the original claim response is overdue.

Question 3

Which type of denial requires the provider to submit additional clinical documentation to support medical necessity?

Accepted Answer

Medical necessity denial

Answer

Medical necessity denials require clinical records, physician notes, or an appeal with supporting documentation.

Question 4

What is the purpose of an aging report in the collections process?

Accepted Answer

To identify overdue accounts and prioritize collection efforts

Answer

Aging reports categorize outstanding balances by time intervals, helping staff prioritize the oldest and largest accounts.

Question 5

Under the Fair Debt Collection Practices Act (FDCPA), which of the following is PROHIBITED when contacting patients about balances?

Accepted Answer

Using threatening or abusive language

Answer

The FDCPA prohibits harassment, abuse, and deceptive practices when collecting consumer debts.

CRCR - Certified Revenue Cycle Representative Program Practice Test