This CRCS-I and CRCS-P Practice Exam assesses knowledge of healthcare policies, including the Patient Bill of Rights and the PPACA. It evaluates understanding of Medicare quality oversight and the roles of healthcare assistance personnel in marketplaces.
True
False
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True
False
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True
False
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Intentional skip
Unintentional skip
False skip
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During pre-certification only
During admitting/registration only
During pre-certification and/or admitting/registration
After admitting/registration
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Definitive LCD/NCD
Non-definitive LCD/NCD
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True
False
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Place the focus on customer service so that the initial impression is a positive one.
Identify mechanisms to decrease wait times.
Free up staff time for training on new technology and regulations.
Make the process a positive and painless experience for the patient, guarantor, and/or family.
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Improves patient-hospital relations
Improves traffic flow
Reduces need for additional staff at peak discharge times
Allows for greater accuracy in billing
All of the above
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40% - 50%
50% - 70%
60% - 80%
70% - 90%
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CLIA
ACL
QIO
TJC
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Health Care Extension Action Team
Health Care Executive Assistance Team
Health Care Fraud Elimination Team
Health Care Fraud Prevention and Enforcement Action Team
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Initiation
Reduction
Cessation
Termination
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Check if a legitimate estate exists and file an appropriate caveat to the estate.
Check the register of wills for an estate.
Change the mailing address to "The Family of [Patient Name]."
If there is no estate and no one assumes financial responsibility, write off any remaining self-pay balance.
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Bill never received by payer
COB or MSP problems
Medical record/chart needed for review
Excessive number of staff working claims
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Intentional skip
Unintentional skip
False skip
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History of chief complaint
Patient demographics
Financial information
Socioeconomic information
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An invoice to document the services ordered or rendered during a patient visit.
Often referred to as an invoice of services.
A tool to eliminate the need for transcribing medical record notes from a patient chart.
All of the above.
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Until 2010, Medicare was the primary payer for nearly all Medicare-covered services.
Medicare considers it a fraudulent or abusive practice to regularly submit claims that are the responsibility of another insurer under the MSP provision.
Before becoming entitled to Medicare, beneficiaries receive an IEQ that asks about any other healthcare coverage.
The CWF is a CMS file that contains Medicare patient eligibility and utilization data from the IEQ and ongoing MSPs.
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True
False
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The ABN must contain a complete description of the test(s) in question and the reason(s) that denial is likely.
Patients sign and date the ABN to indicate they understand and agree to pay for the tests if they are deemed noncovered.
The ABN must be signed and faxed to Medicare no later than 24 hours after the test is performed.
A beneficiary should not be given an ABN unless there is genuine doubt of Medicare payment.
Entities that issue ABNs are known by CMS as "notifiers."
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Treating and/or attending physician
A physician extender (physician assistant, nurse practitioner, etc.)
A licensed, registered nurse
A financial counselor
A student from an accredited health profession program (under the supervision of his or her clinical instructor)
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Intentional skip
Unintentional skip
False skip
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The Health Care and Education Reconciliation Act
The Patient Protection and Affordable Care Act
The Health Insurance Portability and Accountability Act
The Hill-Burton Act
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Accreditation by TJC is a requirement of participation in the Medicare program.
TJC will conduct an audit of the hospital every five years.
TJC can audit without advance notice.
TJC requires hospitals to have facility-wide disaster plans.
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True
False
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Endorse checks immediately with "Payable to [Name of Office] Only."
Issue receipts on all cash payments and deposit them the same day as received.
Store payments before they are deposited and other valuables in a fireproof safe.
Maintain a payment log.
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Therapeutic medical screening
Pre-admission testing (PAT)
Pre-admission screening (PAS)
Diagnostic medical screening (DMS)
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Marketing for staff physicians
Telephone triage available to the community
Referral for physicians and/or services
Registration for in-house or hospital-sponsored medical education programs
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True
False
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True
False
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Top left margin of the form.
Top right margin of the form.
Bottom left margin of the form.
Bottom right margin of the form.
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Services covered by workers' compensation, including the Black Lung Benefits Act
Care related to an accident for which liability or no-fault coverage exists.
Patients 65 or older with group coverage from their own or their spouses' employment with an employer who has 20 or more employees.
Patients with ESRD who have completed their 30-month COB period.
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Code 7, item 22
Code 8, item 22
Code 2, item 23
Code 8, item 24
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It is also called "accepting assignment."
It is imperative that assignment be obtained prior to discharge, when applicable.
It enables providers to ask the beneficiary to pay the entire charge at the time of service.
It offers higher fee schedule payments and fewer collection efforts.
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The equivalent electronic transaction is the 5010A1, formerly the 837P.
Paper forms are printed in red ink for scanning.
No photocopies are allowed.
One claim can report up to 8 lines of service.
It releases the guarantor/patient from financial responsibility of any and all account balances listed on the bankruptcy petition.
The account balance is to be written off to the appropriate transaction code.
It covers any patient accounts that occur within six months following the notification.
It is usually entered within six months when a Chapter 7 bankruptcy is deemed to have no assets.
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It is a U.S. federal law passed in 1946.
It offered loans for hospital construction in exchange for future charity care.
The Act stopped providing funds in 1997, so hospitals are no longer obligated to offer charity care because of participation in the program.
It is also known as Title I.
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Mandatory and retroactive
Restrictive and permissive
Mandatory and permissive
Restrictive and retroactive
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True
False
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True
False
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Agents or brokers
Certified application counselors
Navigators
Non-Navigators
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Cosmetic surgery
Chiropractic services (limited)
Routine eye care and most eyeglasses
Kidney dialysis and kidney transplants
Hearing aids
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It is a court ruling whereby the bankruptcy is rejected.
The most common reason for dismissal is the debtor agreeing to pay each creditor a portion of the debt owed.
It means a creditor can bill the debtor directly, refer the account to a collection agency, or pursue litigation.
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Financial assistance
Filing deadlines
Charging limitations
Collections actions
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It must be established as safe and effective.
It must be consistent with the symptoms or diagnosis of the illness or injury.
It must be considered cost effective.
It must not be furnished primarily for convenience.
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True
False
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APC
ADDR
AR
ADRR
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