CRCR CRCR - Certified Revenue Cycle Representative Program Revenue Cycle Management Fundamentals Questions and Answers 4

Question 1

Which federal act established the requirement for hospitals to provide emergency medical treatment regardless of ability to pay?

Accepted Answer

EMTALA

Answer

EMTALA (Emergency Medical Treatment and Labor Act) requires hospitals with emergency departments to provide stabilizing treatment to any patient regardless of insurance status or ability to pay.

Question 2

In revenue cycle management, what does 'clean claim' refer to?

Accepted Answer

A claim that passes all edits and requires no additional information before processing

Answer

A clean claim contains all required data elements, passes all payer edits, and can be processed without requesting additional information, leading to faster reimbursement.

Question 3

What is the primary purpose of a Remittance Advice (RA) in the revenue cycle?

Accepted Answer

To communicate payment decisions and adjustments made to submitted claims

Answer

A Remittance Advice details how a payer processed each claim, including payment amounts, denial reasons, and contractual adjustments, and is used to post payments accurately.

Question 4

Which metric measures the average number of days it takes a provider to collect payment after services are rendered?

Accepted Answer

Days in Accounts Receivable (AR)

Answer

Days in AR is a key performance indicator calculated by dividing total AR by average daily charges, indicating the efficiency of the billing and collections process.

Question 5

A patient's insurance requires a $500 deductible and 20% coinsurance after the deductible. The allowed amount for a service is $1,500. If the deductible has not been met, what is the patient's responsibility?

Accepted Answer

$700

Answer

The patient pays $500 for the deductible plus 20% of the remaining $1,000 ($200), totaling $700 in patient responsibility.

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR CRCR - Certified Revenue Cycle Representative Program Revenue Cycle Management Fundamentals Questions and Answers 4