CRCR Patient Access and Front-End Processes 4

Question 1

A patient presents to the ED without insurance and states they cannot afford to pay. What is the FIRST action the patient access representative should take?

Accepted Answer

Screen the patient for financial assistance programs

Answer

Federal law (EMTALA) requires emergency screening and stabilization regardless of ability to pay, and patients should be screened for charity care or Medicaid eligibility.

Question 2

Which document authorizes a patient access representative to share a patient's PHI with their adult child who is present at registration?

Accepted Answer

A signed HIPAA Authorization form

Answer

A signed HIPAA Authorization form is required to release PHI to family members unless the patient is incapacitated or an emergency exception applies.

Question 3

During pre-registration, a patient's insurance is found to be inactive. What is the BEST next step?

Accepted Answer

Contact the patient to obtain current insurance information or alternative coverage

Answer

Contacting the patient to resolve the insurance discrepancy before the visit reduces claim denials and ensures the patient understands their financial responsibility.

Question 4

A patient requests an interpreter for their appointment. Under federal law, the hospital must:

Accepted Answer

Provide a qualified interpreter at no cost to the patient

Answer

Title VI of the Civil Rights Act requires covered entities to provide meaningful access to services, including qualified interpreter services at no charge to the patient.

Question 5

What is the purpose of an Advance Beneficiary Notice (ABN) in the Medicare context?

Accepted Answer

To inform the patient that Medicare may deny a service and the patient may be responsible for payment

Answer

An ABN notifies Medicare beneficiaries in advance that a specific service may not be covered, giving them the choice to receive the service and accept financial responsibility.

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR Patient Access and Front-End Processes 4