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This document serves as a study guide for the certified revenue cycle representative (crcr) exam, focusing on key concepts and regulations within revenue cycle management. It includes questions and answers covering topics such as collection agency fees, self-funded benefit plans, medicare guidelines, and patient access activities. The guide aims to help candidates navigate the path to becoming a certified professional in revenue cycle operations, with updated information for 2025/2026. It also covers aspects like insurance verification, claim processing, and compliance standards, providing a comprehensive overview of the essential knowledge required for the exam. This study guide is designed to improve understanding of revenue cycle processes and enhance exam readiness.
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What are collection agency fees based on? - ansA percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - ansBirthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - ansCase rates What customer service improvements might improve the patient accounts department? - ansHolding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - ansInform a Medicare beneficiary that Medicare may not pay for the order or service What type of account adjustment results from the patient's unwillingness to pay for a self-pay balance? - ansBad debt adjustment What is the initial hospice benefit? - ansTwo 90-day periods and an unlimited number of subsequent periods When does a hospital add ambulance charges to the Medicare inpatient claim? - ansIf the patient requires ambulance transportation to a skilled nursing facility How should a provider resolve a late-charge credit posted after an account is billed? - ansPost a late-charge adjustment to the account an increase in the dollars aged greater than 90 days from date of service indicate what about accounts - ansThey are not being processed in a timely manner What is an advantage of a preregistration program? - ansIt reduces processing times at the time of service What are the two statutory exclusions from hospice coverage? - ansMedically unnecessary services and custodial care What core financial activities are resolved within patient access? - ansScheduling, insurance verification, discharge processing, and payment of point-of-service receipts What statement applies to the scheduled outpatient? - ansThe services do not involve an overnight stay How is a mis-posted contractual allowance resolved? - ansComparing the contract reimbursement rates with the contract on the admittance advice to identify the correct amount What type of patient status is used to evaluate the patient's need for inpatient care? - ansObservation Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has received what? - ansMedically necessary inpatient hospital services for at least 3 consecutive days before the skilled nursing care admission When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? - ansWhen the patient is the insured What are non-emergency patients who come for service without prior notification to the provider called? - ansUnscheduled patients If the insurance verification response reports that a subscriber has a single policy, what is the status of the subscriber's spouse? - ansNeither enrolled not entitled to benefits Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes what? - ansDisclosure rules for consumer credit sales and consumer loans What is a principal diagnosis? - ansPrimary reason for the patient's admission Collecting patient liability dollars after service leads to what? - ansLower accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? - ans50% of the current deductible amount What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not billable as an RHC services? - ansInpatient care What code indicates the disposition of the patient at the conclusion of service? - ansPatient discharge status code What are hospitals required to do for Medicare credit balance accounts? - ansThey result in lost reimbursement and additional cost to collect When an undue delay of payment results from a dispute between the patient and the third party payer, who is responsible for payment? - ansPatient Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information provided on the order must include: - ansA valid CPT or HCPCS code With advances in internet security and encryption, revenue-cycle processes are expanding to allow patients to do what? - ansAccess their information and perform functions on-line What date is required on all CMS 1500 claim forms? - ansonset date of current illness What does scheduling allow provider staff to do - ansReview appropriateness of the service request What code is used to report the provider's most common semiprivate room rate? - ansCondition code Regulations and requirements for coding accountable care organizations, which allows providers to begin creating these organizations, were finalized in: - ans What is a primary responsibility of the Recover Audit Contractor? - ansTo correctly identify proper payments for Medicare Part A & B claims How must providers handle credit balances? - ansComply with state statutes concerning reporting credit balance Insurance verification results in what? - ansThe accurate identification of the patient's eligibility and benefits What form is used to bill Medicare for rural health clinics? - ansCMS 1500 What activities are completed when a scheduled pre-registered patient arrives for service? - ansRegistering the patient and directing the patient to the service area In addition to being supported by information found in the patient's chart, a CMS 1500 claim must be coded using what? - ansHCPCS (Healthcare Common Procedure Coding system) What results from a denied claim? - ansThe provider incurs rework and appeal costs Why does the financial counselor need pricing for services? - ansTo calculate the patient's financial responsibility What type of provider bills third-party payers using CMS 1500 form - ansHospital-based mammography centers How are disputes with nongovernmental payers resolved? - ansAppeal conditions specified in the individual payer's contract The important message from Medicare provides beneficiaries with information concerning what? - ansRight to appeal a discharge decision if the patient disagrees with the services Why do managed care plans have agreements with hospitals, physicians, and other healthcare providers to offer a range of services to plan members? - ansTo improve access to quality healthcare
What is a serious consequence of misidentifying a patient in the MPI? - ansThe services will be documented in the wrong record When a patient reports directly to a clinical department for service, what will the clinical department staff do? - ansRedirect the patient to the patient access department for registration What process can be used to shorten claim turnaround time? - ansSend high-dollar hard-copy claims with required attachments by overnight mail or registered mail How are patient reminder calls used? - ansTo make sure the patient follows the prep instructions and arrives at the scheduled time for service If a patient declares a straight bankruptcy, what must the provider do? - ansWrite off the account to the contractual adjustment account According to the Department of Health and Human Services guidelines, what is NOT considered income? - ansSale of property, house, or car The situation where neither the patient nor spouse is employed is described to the patient using: - ansA condition code What option is an alternative to valid long-term payment plans? - ansBank loans What is an advantage of using a collection agency to collect delinquent patient accounts? - ansCollection agencies collect accounts faster than hospital does What statement DOES NOT apply to revenue codes? - ansrevenue codes identify the payer When a patient's illness results in an unusually high amount of medical bills not covered by insurance or other patient pay resources, what type of account is created - anscatastrophic charity What happens when a patient receives non-emergent services from and out-of-network provider? - ansPatient payment responsibility is higher Every patient who is new to the healthcare provider must be offered what? - ansA printed copy of the provider's privacy notice How may a collection agency demonstrate its performance? - ansCalculate the rate of recovery What is true of the information the provider supplies to indicate that an authorization for service has been received from the patient's primary payer? - ansIt is posted on the remittance advice by the payer What standard claim forms are currently used by the healthcare industry to submit claims to third-party payers? - ansThe UB-04 and the CMS 1500 Unless the patient encounter is an emergency, what is the efficient and effective procedure for obtaining information? - ansObtain the required demographic and insurance information before services are rendered what protocol was developed through the Patient Friendly Billing Project? - ansProvide information using language that is easily understood by the average reader What technique is acceptable way to complete the MSP screening for a facility situation? - ansAsk if the patient's current services was accident related What is a valid reason for a payer to delay a claim? - ansFailure to complete authorization requirements IF outpatient diagnostic services are provided within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges - ansThey must be combined with the inpatient bill and paid under the MS-DRG system
What do large adjustments require? - ansManager-level approval What items are valid identifiers to establish a patient's identification? - ansPhoto identification, date of birth, and social security number What must a provider do to qualify an account as a Medicare bad debts? - ansPursue the account for 120 days and then refer it to an outside collection agency What restriction does a managed care plan place on locations that must be used if the plan is to pay for the services provided? - ansSite-of-service limitation What is an example of an outcome of the Patient Friendly Billing Project? - ansRedesigned patient billing statements using patient-friendly language What statement describes the APC (Ambulatory payment classification) system? - ansAPC rates are calculated on a national basis and are wage-adjusted by geographic region What is a benefit of insurance verification? - ansPre-certification or pre-authorization requirements are confirmed What is an effective tool to help staff collect payments at the time of service? - ansDevelop scripts for the process of requesting payments What is a benefit of electronic claims processing? - ansProviders can electronically view patient's eligibility What does Medicare Part D provide coverage for? - ansPrescription drugs What are some core elements of a board-approved financial policy - ansCharity care, payment methods, and installment payment guidelines What circumstance would result in an incorrect nightly room charge? - ansIf the patient's discharge, ordered for tomorrow, has not been charted What is NOT a typical charge master problem that can result in a denial? - ansDoes not include required modifiers Access - ansAn individual's ability to obtain medical services on a timely and financially acceptable level Administrative Services Only (ASO) - ansUsually contracted administrative services to a self-insured health plan Case management - ansThe process whereby all health-related components of a case are managed by a designated health professional. Intended to ensure continuity of healthcare accessibility and services Claim - ansA demand by an insured person for the benefits provided by the group contract Coordination of benefits (COB) - ansa typical insurance provision that determines the responsibility for primary payment when the patient is covered by more than one employer- sponsored health benefit program Discounted fee-for-service - ansA reimbursement methodology whereby a provider agrees to provide service on a fee for service basis, but the fees are discounted by certain packages Eligibility - ansPatient status regarding coverage for healthcare insurance benefits First dollar coverage - ansA healthcare insurance policy that has no deductible and covers the first dollar of an insured's expenses Gatekeeping - ansA concept wherein the primary care physician provides all primary patient care and coordinates all diagnostic testing and specialty referrals required for a patient's medical care Health plan - ansan insurance company that provides for the delivery or payment of healthcare services
Out of pocket payment - ansThe portion of the total payment for medical services and treatment for which the patient is responsible, including copayments, coinsurance, and deductibles Price transparency - ansIn health care, readily available information on the price of healthcare services that, together, with other information helps define the value of those services and enables patients and other care purchasers to identify, compare, and choose providers that offer the desired level of value Value - ansThe quality of a healthcare service in relation to the total price paid for the service by care purchasers What areas does the code of conduct typically focus on? - ansHuman resources. Privacy/confidentiality. Quality of care. Billing/coding. Conflicts of interest. Laws/regulations FERA - ansFraud Enforcement and Recovery act ESRD - ansEnd-stage renal disease. The patient has permanent kidney failure, is covered by a GHP, and has not yet completed the 30-month coordination period What is the purpose of a compliance program? - ansMitigate potential fraud and abuse in the industry-specific key risk areas What is important about an effective corporate compliance program? - ansA program that embodies many elements to create a program that is transparent, clearly articulated and emphasized at all employee levels as a seriously held personal and organizational responsibility, one that relies on full communication inside and outside the organization What is a CCO - ansChief compliance officer - they typically report directly to the board of directors/trustees as well as the chief executive officer, and has limited responsibilities for other operational aspects of the organization What are the situations where another payer may be completely responsible for payment? - ansWork-related accidents, black lung program services, patient is enrolled in Medicare Advantage, Federal grant programs Under Medicare rules, certain outpatient services that are provided within three days of the admission date, by hospitals or by entities owned or controlled by hospitals, must be billed as part of an inpatient stay. - ansTRUE The OIG has issued compliance guidance/model compliance plans for all of the following entities: - anshospices. physician practices. ambulance providers Providers who are found to be in violation of CMS regulations are subject to: - ansCorporate integrity agreements What MSP situation requires LGHP - ansDisability The disadvantages of outsourcing include all of the following EXCEPT: a) The impact of customer service or patient relations b) The impact of loss of direct control of accounts receivable services c) Increased costs due to vendor ineffectiveness d) Reduced internal staffing costs and a reliance on outsourced staff - ansD The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the following levels EXCEPT: a) Medical necessity review by an independent physician's panel b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for Medicare d) Review by the Medicare Appeals Council (Appeals Council) - ansB Business ethics, or organizational ethics represent: a) The principles and standards by which organizations operate b) Regulations that must be followed by law c) Definitions of appropriate customer service d) The code of acceptable conduct - ansA A portion of the accounts receivable inventory which has NOT qualified for billing includes: a) Charitable pledges b) Accounts created during pre-registration but not activated c) Accounts coded but held within the suspense period d) Accounts assigned to a pre-collection agency - ansA Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) are Medicare established guideline(s) used to determine: a) Medicare and Medicaid provider eligibility b) Medicare outpatient reimbursement rates c) Which diagnoses, signs, or symptoms are reimbursable d) What Medicare reimburses and what should be referred to Medicaid - ansC Days in A/R is calculated based on the value of: a) The total accounts receivable on a specific date b) Total anticipated revenue minus expenses c) The time it takes to collect anticipated revenue d) Total cash received to date - ansC Patients are contacting hospitals to proactively inquire about costs and fees prior to agreeing to service. The problem for hospitals in providing such information is: a) That hospitals don't want to establish a price without knowing if the patient has insurance and how much reimbursement can be expected b) The fact that charge master lists the total charge, not net charges that reflect charges after a payer's contractual adjustment c) That hospitals don't want to be put in the position of "guaranteeing" price without having room for additional charges that may arise in the course of treatment d) Their reluctance to share proprietary information - ansB Across all care settings, if a patient consents to a financial discussion during a medical encounter to expedite discharge, the HFMA best practice is to:
are paid some portion of the amount owed c) The court vacates all claims against a debtor with the understanding that the debtor may not apply for credit without court supervision d) The court establishes a creditor payment schedule with the longest outstanding claims paid first - ansA The core financial activities resolved within patient access include: a) Scheduling, pre-registration, insurance verification and managed care processing b) Scheduling, insurance verification, clinical discharge processing and payment posting of point of service receipts c) Scheduling, registration, charge entry and managed care processing d) Scheduling, pre-registration, registration, medical necessity screening and patient refunds - ansA Which of the following is NOT contained in a collection agency agreement? a) A clear understanding that the provider retains ownership of any outsourced activities b) Specific language as to who will pay legal fees, if needed c) An annual renewal clause d) A mutual hold-harmless clause - ansD Maintaining routine contact with the health plan or liability payer, making sure all required information is provided and all needed approvals are obtained is the responsibility of: a) Patient Accounts b) Managed Care Contract Staff c) HIM staff d) Case Management - ansD What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare? a) Revenue codes b) Correct Part A and B procedural codes c) The CMS 1500 Part B attachment d) Medical necessity documentation - ansA Before classifying and subsequently writing off an account to financial assistance or bad debt, the hospital must establish policy, define appropriate criteria, implement procedures for identifying and processing accounts: a) Monitor compliance b) Have the account triaged for any partial payment possibilities c) Assist in arranging for a commercial bank loan d) Obtain the patients income tax statements from the prior 2 years - ansA
For routine scenarios, such as patients with insurance coverage or a known ability to pay, financial discussions: a) Are optional b) Should take place between the patient or guarantor and properly trained provider representatives c) May take place between the patient and discharge planning d) Are focused on verifying required third-party payer information - ansB The purpose of a financial report is to: a) Provide a public record, if reqluested b) Present financial information to decision makers c) Prepare tax documents d) Monitor expenses - ansB Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? a) Registration staff may routinely contact managed are plans for prior authorizations before the patient is seen by the on-duty physician b) Initial registration activities may occur so long as these activities do not delay treatment or suggest that treatment with not be provided to uninsured individuals c) Co-payments may be collected at the time of service once the medical screening and stabilization activities are completed d) Signage must be posted where it can be easily seen and read by patients - ansA A claim is denied for the following reasons, EXCEPT: a) The health plan cannot identify the subscriber b) The frequency of service was outside the coverage timeline c) The submitted claim does not have the physicians signature d) The subscriber was not enrolled at the time of service - ansC Any provider that has filed a timely cost report may appeal an adverse final decision received from the Medicare Administrative Contractor (MAC). This appeal may be filed with a) A court appointed federal mediator b) The Department of Health and Human Services Provider Relations Division c) The Office of the Inspector General d) The Provider Reimbursement Review Board - ansD Charges, as the most appropriate measurement of utilization, enables a) Generation of timely and accurate billing b) Managing of expense budgets c) Accuracy of expense and cost capture
The most common resolution methods for credit balances include all of the following EXCEPT: a) Designate the overpayment for charity care b) Submit the corrected claim to the payer incorporating credits c) Either send a refund or complete a takeback form as directed by the payer d) Determine the correct primary payer and notify incorrect payer of overpayment - ansA EFT (electronic funds transfer) is a) An electronic claim submission b) The record of payments in the hospital's accounting system c) An electronic confirmation that a payment is due d) An electronic transfer of funds from payer to payee - ansD Revenue cycle activities occurring at the point-of-service include all of the following EXCEPT: a) The monitoring of charges b) The provision of case management and discharge planning services c) Providing charges to the third-party payer as they are incurred d) The generation of charges - ansC Medicare beneficiaries remain in the same "benefit period" a) Up to hospitalization discharge b) Until the beneficiary is "hospitalization and/or skilled nursing facility-free" for 60 consecutive days c) Each calendar year d) Up to 60 days - ansB Key Performance Indicators (KPIs) set standards for accounts receivables (A/R) and a) Provide evidence of financial status b) Provide a method of measuring the collection and control of A/R c) Establish productivity targets d) Make allowance for accurate revenue forecasting - ansB Recognizing that health coverage is complicated and not all patients are able to navigate this terrain, HFMA best practices specify that a) The patient accounts staff have someone assigned to research coverage on behalf of patients b) Patients should be given the opportunity to request a patient advocate, family member, or other designee to help them in these discussions c) Patient coverage education may need to be provided by the
health plan d) A representative of the health plan be included in the patient financial responsibilities discussion - ansB When there is a request for service, the scheduling staff member must confirm the patient's unique identification information to a) Check if there is any patient balance due b) Verify the patient's insurance coverage if the patient is a returning customer c) Confirm that physician orders have been received d) Ensure that she/he accesses the correct information in the historical database - ansD Once the price is estimated in the pre-service stage, a provider's financial best practice is to a) Explain to the patient their financial responsibility and to determine the plan for payment b) Allow the patient time to compare prices with other providers c) Lock-in the prices d) Have another employee double check the price estimate - ansA What type of account adjustment results from the patient's unwillingness to pay a self- pay balance? a) Charity adjustment b) Bad debt adjustment c) Contractual adjustment d) Administrative adjustment - ansB All of the following are conditions that disqualify a procedure or service from being paid for by Medicare EXCEPT a) Medically unnecessary b) Not delivered in a Medicare licensed care setting c) Offered in an outpatient setting d) Services and procedures that are custodial in nature - ansD All of the following are forms of hospital payment contracting EXCEPT a) Contracted Rebating b) Per Diem Payment c) Fixed Contracting d) Bundled Payment - ansA Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by: a) The Center for Medicare and Medicaid Services (CMS) b) Each state's Medicaid plan
outpatient status d) Will have his/her case reviewed by the attending physician, a consulting physician and the primary care physician and a future course of care will then be determined - ansB It is important to have high registration quality standards because a) Incomplete registrations will trigger exclusion from Medicare participation b) Incomplete registrations will raise satisfaction scores for the hospital c) Inaccurate registration may cause discharge before full treatment is obtained d) Inaccurate or incomplete patient data will delay payment or cause denials - ansD Medicare will only pay for tests and services that a) Constitute appropriate treatment and are fairly priced b) Have solid documentation c) Can be demonstrated as necessary d) Medicare determines are "reasonable and necessary" - ansD Room and bed charges are typically posted a) From case management reports generated for contracted payers b) Through the case management daily resource report c) At the end of each business day d) From the midnight census - ansD The process of creating the pre=registration record ensures a) Ability to pursue extraordinary collection activities b) Early and productive communication with a third-party payer c) Accurate billing d) That access staff will have the compete and valid information needed to finalize any remaining pre-access activities - ansC Once the EMTALA requirements are satisfied a) Third-party payer information should be collected from the patient and the payer should be notified of the ED visit b) The patient then assumes full liability for services unless a third- party is notified or the patient applies for financial assistance with the first 48 hours c) The remaining registration processing is initiated at the bedside or in a registration area d) An initial registration records is completed so that the proper coding can be initiated - ansC This directive was developed to promote and ensure healthcare quality and value and also to protect consumers and workers in the healthcare system. This directive is called a) Payer quality monitoring b) Medicare patient and staff safety standards
c) Joint Commission for Accreditation of Healthcare Organizations (JCAHO) safety d) Patient bill of rights - ansD A scheduled inpatient represents an opportunity for the provider to do which of the following? a) Refer the patient to another location with the health system b) Comply with EMTALA (Emergency Medical Treatment and Labor Act) requirements before service c) Complete registration and insurance approval before service d) Register the patient after he or she is placed in a bed on that service unit. - ansC The first and most critical step in registering a patient, whether scheduled or unscheduled, is a) Having the patient initial the HIPAA privacy statement b) Verifying insurance to activate the patient medical record c) Verifying the patient's identification d) Check the schedule for treatment availability - ansC The legal authority to request and analyze provider clam documentation to ensure that IPPS services were reasonable and necessary is given to a) Recovery Audit Contractors (RAC) b) The Office of the U.S. Inspector General (OIG) c) All health plans d) State insurance commissioners - ansB An advantage of a pre-registration program is a) The opportunity to reduce processing times at the time of service b) The ability to eliminate no-show appointments c) The opportunity to reduce the corporate compliance failures within the registration process d) The marketing value of such a program - ansC Claims with dates of service received later than one calendar year beyond the date of service, will be a) Denied by Medicare b) The provider's responsibility but can be deemed charity care c) Fully paid with interest d) The full responsibility of the patient. - ansA This concept encompasses all activities required to send a request for payment to a third-party health plan for payment of benefits a) Third-party invoicing b) Account resolution c) Claims processing
a) Are the primary source for clinical data required for reimbursement by health plans and liability payers b) Are the strongest evidence and defense in the event of a Medicare audit c) Are evidence used in assessing the quality of care d) Are the evidence cited in quality review - ansA A decision on whether a patient should be admitted as an inpatient or become an outpatient observation patient requires medical judgments based on all of the following EXCEPT a) The patient's home care coverage b) Current medical needs c) The likelihood of an adverse event occurring to the patient d) The patient's medical history - ansA Medicare has established guidelines called the Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) that establish a) Provider and physician reimbursement for specific diagnoses and tests b) Prospective Medicare patient financial responsibilities for a given diagnosis c) Reasonable and customary prices for services in a given area d) What services or healthcare items are covered under Medicare - ansD What are some core elements if a board-approved financial assistance policy? a) Payment requirements, staffing hours, and admission policies b) Case management, payment methods, and discharge policies c) Deposit requirements, pre-registration calling hours, and charity care policy d) Eligibility, application process, and nonpayment collection activities - ansD The ICD-10 codes set and CPT/HCPCS code sets combines provide a) Pricing floors for services b) The financial data required for activity-based costing c) Patients an overview of services covered by their health insurance plan d) The specificity and coding needed to support reimbursement claims - ansD A recurring/series registration is characterized by a) A creation of multiple registrations for multiple services b) The creation of one registration record for multiple days of service c) The creation of multiple patient types for one date of service d) The creation of one registration record per diagnosis per visit - ansB Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not ask about a patient's insurance information if it would delay what? a) Complete course of treatment b) Medical screening and stabilizing treatment
c) Admission to observation status d) Transfer to another facility - ansB In resolving medical accounts, a law firm may be used as: a) An independent auditor of a financial assistance policy b) Legal counsel to patients regarding financing options c) An independent broker of patient financial assistance from banks d) A substitute for a collection agency - ansD The unscheduled "direct" admission represents a patient who: a) Is admitted from a physician's office on an urgent basis b) Arrives at the hospital via ambulance for treatment in the emergency room c) Is an ambulatory patient who collapses in the hospital lobby d) Arrives on the medical helicopter for trauma services - ansA In the balance resolution process, providers should: a) Stress to the patient that serious consequences may result from refusal to pay b) Remind the patient of their legal responsibility to pay the balance due c) Ask the patient if he or she would like to receive information about payment options and supportive financial assistance programs d) Tag the patients record for possible financial assistance for bad debt - ansC Which of the following in NOT included in the Standardized Quality Measures a) Clinical outcomes b) Patient perceptions c) Health care processes d) Cost of services - ansD In the pre-service stage, the requested service is screened for medical necessity, health plan coverage and benefits are verified and: a) Billing authorization is signed by the patient b) The patient signs the consents for treatment c) The patient signs a statement attesting an understanding and acceptance of payment policies d) Pre-authorization are obtained - ansD Improving the overall patient experience requires revenue cycle leadership and staff to simultaneously be: a) Clear on policies and consistent in applying the policies b) Careful in screening patient demands c) Monitoring the costs and charges the patient incurs d) Inquisitive, responsive and flexible - ansA Hospitals need which of the following information sets to assess a patient's financial status: a) Income, expenses, debt b) Patient and guarantor's income, expenses and assets c) Income, expenses and capacity to take on more debt d) Assets liquidity, Income, expenses, credit worthiness - ansB For scheduled patients, important revenue cycle activities I the Time of Service stage DO NOT INCLUDE: