CRCR Financial Counseling and Patient Financial Services 5

Question 1

A patient is eligible for both Medicaid and Medicare. In the revenue cycle, this patient is referred to as a:

Accepted Answer

Dual-eligible beneficiary

Answer

Patients covered by both Medicare and Medicaid are called dual-eligible beneficiaries; Medicare is billed first and Medicaid serves as the payer of last resort.

Question 2

Which of the following BEST describes the purpose of a financial hardship application in the hospital revenue cycle?

Accepted Answer

To determine a patient's eligibility for reduced or waived charges based on income and assets

Answer

A financial hardship application assesses a patient's financial situation to determine eligibility for charity care or discounted care programs offered by the hospital.

Question 3

A patient's insurance was terminated one month before a scheduled elective procedure, but the patient did not inform the hospital. The financial counselor discovers this at check-in. The BEST course of action is to:

Accepted Answer

Discuss self-pay options, payment plans, and potential assistance programs with the patient before proceeding

Answer

The financial counselor should present all available financial options to the patient so an informed decision can be made about proceeding with the elective service.

Question 4

Under the Affordable Care Act (ACA), non-profit hospitals must meet which requirement related to financial assistance?

Accepted Answer

Establish and publicize a written Financial Assistance Policy (FAP)

Answer

Section 501(r) of the Internal Revenue Code, as part of the ACA, requires non-profit hospitals to have a written Financial Assistance Policy that is widely publicized to the community.

Question 5

During financial counseling, a patient indicates they are a veteran. Which resource should the financial counselor consider exploring for coverage of the patient's healthcare costs?

Accepted Answer

Department of Veterans Affairs (VA) benefits

Answer

Veterans may be eligible for VA healthcare benefits that could cover or offset the cost of services received at civilian healthcare facilities.

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR Financial Counseling and Patient Financial Services 5