CRCR Financial Counseling and Patient Financial Services 2

Question 1

Which term describes the out-of-pocket amount a patient must pay each year before their insurance plan begins paying benefits?

Accepted Answer

Deductible

Answer

A deductible is the annual amount a patient must pay out-of-pocket before their health insurance plan starts covering most services.

Question 2

What is 'presumptive eligibility' in the context of Medicaid and financial counseling?

Accepted Answer

A temporary determination that a patient is likely eligible for Medicaid based on preliminary information, allowing coverage to begin immediately

Answer

Presumptive eligibility allows qualified entities to make a temporary Medicaid eligibility determination so patients can receive covered services while their full application is processed.

Question 3

A financial counselor uses a 'propensity to pay' score for a patient. What does this score measure?

Accepted Answer

The probability that a patient will pay their bill based on financial and behavioral data

Answer

A propensity to pay score uses financial and demographic data to predict how likely a patient is to pay their bill, helping staff prioritize financial counseling efforts.

Question 4

Which type of payment plan allows a patient to pay their balance in fixed monthly installments over a set period without interest?

Accepted Answer

Interest-free installment agreement

Answer

An interest-free installment agreement allows patients to spread their balance across monthly payments without incurring additional interest charges.

Question 5

Under HIPAA, when can a financial counselor share a patient's account balance information with a patient's family member who is present during counseling?

Accepted Answer

When the patient is present and does not object, or when the patient has given prior permission

Answer

HIPAA allows disclosure of relevant information to family members or friends involved in a patient's care when the patient is present and does not object or has previously given permission.

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR Financial Counseling and Patient Financial Services 2