CRCR Part 4: 41 Questions with Answers 2023, Exams of Nursing

Download CRCR Part 4: 41 Questions with Answers 2023 and more Exams Nursing in PDF only on Docsity!

CRCR Part 4|41 Questions with Answers 2023

The liens types - CORRECT ANSWERSagreement, judicial process, statue The third party payer follow up and account resolution activities include - CORRECT ANSWERSelectronic work list after untimely non payments, comparison of actual and expected reimbursement, adjustment posts, submitting secondary claims if necessary liability payers - CORRECT ANSWERSworkers' compensation, auto insurance, premises medical coverage for property cases home owners based on policy what can be done with unpaid clean third party claims - CORRECT ANSWERSbecome the patient responsibility after some days work flow payment cycle - CORRECT ANSWERSclean claim cycle should be determined for all major health plans if timely payments not received a electronic work list should be maded What is Medicares work flow payment cycle for clean claims - CORRECT ANSWERS14 days impact payment turn around techniques for third party include - CORRECT ANSWERSuse electronic claims submission, send hard copy claims via over night mail, send high dollar hard copy claims via registered mail with attachments, closely monitor payment timeliness and back logs of major health plans Name the statutory liens - CORRECT ANSWERSemployee, landlord, material-man & mechanic, tax subrogation - CORRECT ANSWERSupon being billed the healthcare plan may process the claim for reimbursement and subsequently pursue payment from the liability payer

financial assistance policy key elements - CORRECT ANSWERSstatement of mission & financial assistance, payment, in & out patient deposit requirements, payment methods, payment arrangements & bad debt guidelines What is done with a remaining open balanced after all insurance payments have been received and posted - CORRECT ANSWERSpatient responsibility what can be an open balance - CORRECT ANSWERSdeductible, co-payment, co- insurance what is fundamental requirement for correctly identifying charity and bad debt accounts - CORRECT ANSWERSa board approved financial assistance policy inability to pay - CORRECT ANSWERSfinancial assistance unwillingness to pay the entire account - CORRECT ANSWERSbad debt the Affordable Care Act requires the IRS - CORRECT ANSWERSto issues rules to implement the FAP section of the ACA The IRS rules for the FAP sections of the ACA are called - CORRECT ANSWERSIRS 501 (r) The 501 (r) rules apply to - CORRECT ANSWERSnon-profit providers as made the 501 (c) 3 status What are the activities when initiating self-pay follow up and account resolution - CORRECT ANSWERSpresumptive financial assistance determination, financial profile, poverty guidelines HFMA's Best practices - CORRECT ANSWERSmake bills patient friendly, establish policies & ensure that they are followed, be consistent, coordinate account resolution activities with business affiliates, exercise sound business judgement when choosing account resolution methods, start the account resolution when the first statement is sent, report back to credit bureaus when account is resolved, track consumer complaints

evaluation criteria demonstrates reputation expectations - CORRECT ANSWERSdocumented experience working in financial areas of health care agency fees - CORRECT ANSWERSthe cost to the provider for collection agency monies offset by the return on bad debt accounts how to handle the retention and payment of agency fees - CORRECT ANSWERSfollow contractual agreement between agency and provider as to how monies sent to the agency will be handled patient relations include - CORRECT ANSWERSto sensitively deal with patients or individuals while managing collection efficiency Collection agencies should include - CORRECT ANSWERSat least 2 formats regarding accounts assigned on a routine basis collection results are - CORRECT ANSWERSaccurately calculated to demonstrate the actual recovery percentage rate What are the advantages in using a third party collection agency - CORRECT ANSWERShave tools and technologies that are good in payment of self pay accounts, collect faster, complete documentation record may be critical in litigation activities, provide additional benefits to the provider through feedback eval of accounts and staff training, incentive to patients to pay accounts timely to provider to avoid agency transfer What is the selection of the collection agency similar to - CORRECT ANSWERSa business partner or the hiring of a vendor for specific services Consumer credit protection Act Title I - CORRECT ANSWERSTruth in Lending Act Consumer credit protection Act Title III - CORRECT ANSWERSRestrictions on Garnishment Consumer credit protection Act Title VI - CORRECT ANSWERSFair Credit Reporting Act

Consumer credit protection Act Title VIII - CORRECT ANSWERSFair Debt Collection Practices Act The 1979 key chapters - CORRECT ANSWERSChapter 7, 11 and 13 Chapter 7 - CORRECT ANSWERSstraight bankruptcy or liquidation Chapter 11 - CORRECT ANSWERSDebtor reorganization Chapter 13 - CORRECT ANSWERSdebtor rehabilitation Governs the types of bankruptcy and its impact on patient's financial responsibility to the hospital - CORRECT ANSWERSThe 1979 Bankruptcy Act Federal Acts have been passed - CORRECT ANSWERSto ensure consumers are treated fairly in the credit and debt collection transactions Failure to follow these various acts could - CORRECT ANSWERSresult in large fines and bad publicity Advantages to outsourcing - CORRECT ANSWERScapitalizes on the economies of scale, limits internal staffing requirements, access to qualified staff, absorbs some financial risk based on "efficiency factor Disadvantages to outsourcing - CORRECT ANSWERSineffective vendor results in increased costs, impact on customer service, legal impact if vendor represents themselves as provider employees, impact on direct control of accounts receivable