CRCR Patient Access and Registration 5

Question 1

A patient scheduled for a same-day surgery is found to lack the required pre-authorization. The registrar should:

Accepted Answer

Notify the surgeon and authorization team immediately so authorization can be obtained or the case rescheduled

Answer

Timely notification allows the clinical and authorization teams to obtain approval or make an informed decision about rescheduling, protecting the patient and the facility's reimbursement.

Question 2

Which of the following BEST describes 'insurance portability' as it relates to HIPAA?

Accepted Answer

Employees can maintain continuous health coverage when changing jobs without being denied due to pre-existing conditions

Answer

The portability provisions of HIPAA protect workers from losing health coverage due to pre-existing conditions when transitioning between employer-sponsored health plans.

Question 3

A patient's insurance requires a $50 copay at time of service. The patient says they will pay on the way out. Best practice dictates the registrar should:

Accepted Answer

Collect the copay before or at the time of the encounter per facility policy

Answer

Point-of-service copay collection is standard best practice and reduces the cost of downstream billing and collections; consistent collection also satisfies payer contract requirements.

Question 4

When verifying a Medicaid patient's eligibility, the registrar learns coverage ended the previous month. The appropriate next step is to:

Accepted Answer

Inform the patient of the lapse and screen for Medicaid reinstatement or other financial assistance

Answer

A coverage lapse requires immediate patient notification and financial counseling to explore reinstatement, other coverage, or charity care options before or after service.

Question 5

Which of the following is considered a 'front-end' revenue cycle function directly performed by the patient access team?

Accepted Answer

Verifying insurance eligibility prior to the patient visit

Answer

Eligibility verification is a pre-service, front-end function; payment posting and denial appeals are mid- and back-end revenue cycle activities.

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR Patient Access and Registration 5