CRCR CRCR - Certified Revenue Cycle Representative Program Payment Posting and Reconciliation Questions and Answers 4 — Questions and Answers
Question 1: A payment is received with an EOB indicating a 'contractual adjustment' of $200 on a $500 charge. What amount should be posted as the contractual adjustment?
- $200 (Correct answer)
- $300
- $500
- $100
Correct answer: $200
The contractual adjustment should equal the exact amount specified on the EOB, which is $200.
Question 2: Which of the following best describes a 'credit balance' on a patient account?
- The payer owes the provider additional payment
- The provider owes the patient or payer a refund (Correct answer)
- The patient has an outstanding balance due
- The claim has been denied and requires an appeal
Correct answer: The provider owes the patient or payer a refund
A credit balance means the provider has been overpaid and owes a refund to the patient or payer.
Question 3: When performing a daily payment batch reconciliation, the total payments posted should match which document?
- The facility's charge description master
- The remittance advice or bank deposit total (Correct answer)
- The accounts receivable aging report
- The provider's fee schedule
Correct answer: The remittance advice or bank deposit total
Daily batch totals must reconcile to the remittance advice or bank deposit to confirm accurate posting.
Question 4: A payer issues a recoupment for a claim paid 18 months ago. What is the provider's most appropriate first step?
- Immediately refund the recouped amount
- Review the payer contract for timely recoupment provisions (Correct answer)
- Write off the amount as a bad debt
- Resubmit the original claim to the payer
Correct answer: Review the payer contract for timely recoupment provisions
Payer contracts often include time limits for recoupment, so reviewing contractual terms is the first step before taking action.
Question 5: An ERA is received but the payment does not appear in the bank account. What should the payment poster do?
- Post the ERA immediately and adjust the difference
- Contact the payer to confirm EFT deposit status before posting (Correct answer)
- Deny the ERA and request a paper check
- Post the payment and flag for write-off
Correct answer: Contact the payer to confirm EFT deposit status before posting
Payment should never be posted until funds are confirmed in the bank account to prevent posting fictitious payments.
Question 6: What does 'unapplied cash' refer to in payment posting?
- Payments that have been fully applied to patient accounts
- Funds received but not yet matched to a specific claim or account (Correct answer)
- Adjustments written off as contractual allowances
- Payments returned to the payer due to claim denial
Correct answer: Funds received but not yet matched to a specific claim or account
Unapplied cash represents received funds that cannot yet be allocated to a specific patient account or claim.
Question 7: Which process ensures that the amount listed on the remittance advice matches the actual check or EFT deposit received?
- Charge capture audit
- Payment reconciliation (Correct answer)
- Denial management
- Eligibility verification
Correct answer: Payment reconciliation
Payment reconciliation is the process of confirming that remittance advice amounts equal actual funds deposited.
CRCR CRCR - Certified Revenue Cycle Representative Program Payment Posting and Reconciliation Questions and Answers 4
A payment is received with an EOB indicating a 'contractual adjustment' of $200 on a $500 charge.
What amount should be posted as the contractual adjustment?