CRCR Certification Test Answers Questions from Actual Exam with 100% correct Answers, Exams of Nursing

Download CRCR Certification Test Answers Questions from Actual Exam with 100% correct Answers and more Exams Nursing in PDF only on Docsity! CRCR Certification Test Answers Questions from Actual Exam with 100% correct Answers Updated 2023-2024 The 501(r) regulations require not-for-profit providers 501(c) (3) to do which of the following activities? A. Complete a community needs assessment and develop a discount program for patient balances after insurance payment. B. Pursue extraordinary collection activities with all patients eligible for financial assistance. C. Implement a financial assistance program for uninsured and underinsured patients. D. Discount all charges to self-pay patients to an amount generally billed to all other patients. - ANSWER-A. Complete a community needs assessment and develop a discount program for patient balances after insurance payment The accurate capture of charges remains critically important because: A. Of the potential of fraud and abuse charges from erroneous billing. B. Charges remain one of the few consistent indicators available to monitor resource use. C. Charges are means of measuring physician productivity. D. Charges provide the data used in activity based costing. - ANSWER-B. Charges remain one of the few consistent indicators available to monitor resource use The ACO investment model will test the use of pre-paid shared savings to: A. Invest in treatment protocols that reduce costs to Medicare B. Attract physicians to participate in the ACO payment system. C. Raise quality ratings in designated hospitals. D. Encourage new ACOs to form in rural and underserved areas. - ANSWER-D. Encourage new ACOs to form in rural and underserved areas 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: A. Have a patient financial responsibilities kit ready for the patient, containing all of the required registration forms and instructions. B. Make sure that the attending staff can answer questions and assist in obtaining required patient financial data. C. Support that choice, providing that the discussion does not interfere with patient care or disrupt patient flow. D. Decline such request as finance discussions can disrupt patient care and patient flow. - ANSWER-C. Support that choice, providing that the discussion does not interfere with patient care or disrupt patient flow Activities completed when the scheduled, pre-registered patient arrives for service includes: A. Verifying insurance, activating the record and directing the patient to the service area. B. Scanning the driver's license or other phot identification and directing the patient to the financial counselor. C. Activating the record, obtaining signatures and finalizing financial issues. D. Registering the patient and directing the patient to the service area. - ANSWER-C. Activating the record, obtaining signatures and The activity which results in the accurate recording of patient bed and level of care assessment, patient transfer and patient discharge status on a real-time basis is known as: A. Utilization review B. Case Management C. Census Management D. Patient through-put - ANSWER-A. Utilization review or B. Case Management An advantage of a pre-registration program is: A. The markets value of such a program B. The ability to eliminate no-show appointments. C. The opportunity to reduce processing times at the time of service. B. Financial assistance policies C. Documenting the conversation in the medical record D. Available patient financing options - ANSWER-C. Documenting the conversation in the medical record The basis for qualification in Medicaid is typically: A. The Federal Poverty Guidelines B. Financial need as demonstrated by the prior two-years federal income tax fillings C. The patient's score on the Internal Revenue Service's Personal Wealth and Spending indicator D. Bank statements for the previous 18 months - ANSWER-A. The Federal Poverty Guidelines Because 501(r) regulations focus on identifying potentially eligible financial assistance patients, hospitals must: A. Capture their experience with such patients to properly budget B. Hold financial conversations with patients as soon as possible C. Build the necessary processes to handle the potentially lengthy payment schedules D. Expedite payment processing of normal accounts receivables to protect cash flow - ANSWER-B. Hold financial conversations with patients as soon as possible Before classifying and subsequently writing off an account to financial assistance or bad debt, the hospital must establish policy, define appropriate criteria, implementation, identifying and processing accounts and: A. Obtain the patients income tax statements from the prior 2 years B. Having the account triaged for any partial payment possibilities C. Monitor compliance D. Assist in arranging for a commercial bank loan - ANSWER-C. Monitor compliance The benefit of a Medicare Advantage Plan is: A. It is a less costly plan compared to traditional Medicare B. Patients may retain a primary care physician and see another physician for a second opinion at no charge C. Patients generally have their entire Medicare-covered healthcare through the plan and do not need to worry about "Part A" or "Part B' benefits D. Patients receive significant discounting on services contracted by the federal government - ANSWER-C. Patients generally have their entire Medicare-covered healthcare through the plan and do not need to worry about "Part A" or "Part B" benefits A benefit period begins: A. With admission as an inpatient B. Upon the day the coverage premium is paid C. The first day in which a patient is furnished extended care services in the period the patient is entitled to hospital insurance D. Immediately once authorization for treatment is provided by the health plan - ANSWER-C. The first day in which a patient is furnished extended care services in the period the patient is entitled to hospital insurance The best practice in billing is to generate bills and financial information that is: A. Timely and specifies the patient's next steps B. Clear, concise, correct and patient-friendly C. Comprehensive and all-inclusive D. Direct in summarizing charges and in requesting prompt payment - ANSWER-B. Clear, concise, correct and patient-friendly Case management requires that a case manager be assigned: A. To a select group of resource intensive patient cases B. To every patient C. To specific cases designated by third-party contractual agreement D. To patients of any physician requesting case management - ANSWER-B. To every patient Claims edits are: A. Rules developed to verify the accuracy of claims based on each health plan's policies B. The specific reimbursement areas of a claim that are denied by the health plan C. Special addendums to the claim allowing the provider to submit additional documentation D. Triggers in the health plan claim adjudication system that disallows reimbursement - ANSWER-A. Rules developed to verify the accuracy of claims based on each health plan's policies Claims with dates of service received later than one year beyond the date of service, will be: A. Denied by Medicare B. The full responsibility of the patient C. The provider's responsibility but can be deemed charity care D. Fully paid with interest - ANSWER-A. Denied by Medicare A "Compliance Program" is defined as: A. Educating staff on regulations B. The development of operational policies that correspond to regulations C. Systematic procedures to ensure that the provisions of regulations imposed by a government agency are being met D. Annual legal audit and review for adherence to regulations - ANSWER-C. Systematic procedures to ensure that provisions of regulations imposed by government agency are being met The concept encompasses all activities required to send a request for payment to a third-party health plan for payment of benefits: A. Billing B. Account resolution C. Claims Processing D. Third-party invoicing - ANSWER-C. Claims processing Concurrent review and discharge planning: A. Occurs during service B. Is performed by the health plan during the time of service C. Is a significant part of quality and is performed by the clinical treatment team D. Is performed at discharge with the patient - ANSWER-C. Is a significant part of quality and is preformed by the clinical treatment team A decision of 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 medical history B. The safe-guarding against medical error C. Current medical needs D. The Medical predictability of something adverse happening - ANSWER-B. The safe- guarding against medical error The disadvantages of outsourcing include all the following EXCEPT: A. Increased costs due to vendor ineffectiveness B. Possible staff job cuts due to vendor efficiencies C. The impact of customer service or patient relations D. The impact of direct control of accounts receivable - ANSWER-B. Possible staff job cuts due to vendor efficiencies During the pre-registration, a search for the patient's MPI is initiated using which of the following data sets? A. Patient's full legal name and address B. Patient's full legal name and health plan group numbers C. Patient's full legal name and date of birth or the patient's Social security number D. Patient's Social Security number and home address - ANSWER-C. Patient's full legal name and date of birth or the patient's Social Security number Each time a patient is transferred: A. Any additional charges must be explained to the patient B. The attending physician must sign-off on the transfer request C. The patient must give consent D. A transfer request must be made to staff responsible for bed assignments - ANSWER-D. A transfer request must be made to staff responsible for bed assignments The enhanced data-mining opportunities that results from the more detailed coding under ICD-10 allow senior leadership to work with physicians to do all of the following EXCEPT: A. Improve outcomes HFMA best practice specify that, In an Emergency Department setting: A. Financial conversations are inappropriate B. Financial conversations be brief and focused on obtaining third-party payer information C. Financial conversations be focused on obtaining basic demographic data needed to create the patient account D. No patient financial discussions should occur before a patient is screened and stabilized - ANSWER-D. No patient financial discussions should occur before a patient is screened and stabilized HFMA best practices stipulate that a reasonable attempt should be made to have the financial responsibilities discussion: A. As early as possible, before a financial obligation is Incurred B. During the registration process C> Before scheduling of services D. No later than the evening of the day of admission - ANSWER-A. As early as possible, before a financial obligation is incurred HFMA patient financial communications best practices call for annual training for all staff EXCEPT: A. Staff who engage in patient financial communications discussions B. Patient access C. Nursing D. Customer service representatives - ANSWER-C. Nursing HIPPA contains all of the following goals EXCEPT: A. To expand health coverage by improving the portability and continuity of health insurance coverage in group and individual markets B. To ensure proper coding across the continuum of care C. To give patients access to their health files and the right to request amendments or make corrections D. To facilitate the electronic exchange of medical information with respect to financial and administrative transactions carried out by health plans, healthcare clearing houses, and healthcare providers - ANSWER-B. To ensure proper coding across the continuum of care HIPAA has adopted Employer Identification Numbers (EINs) to be used in standard transactions to identify the employer of an individual described transaction. EINs are created and assigned by: A. The Social Security Administration B. The United States Department of the Treasury C. The United States Department of Labor D. The Internal Revenue Service - ANSWER-D. The Internal Revenue Service HIPAA privacy rules require covered entitles to take all of the following actions EXCEPT: A. Develop written policies and procedures including a description of staff who have access to protected information B. Define protected health information and access thereto by individuals, health plans, and business associates C. Ensure that a privacy officer is hired/designated D. Use only designated software platforms to secure patient data - ANSWER-D. Use only designated software platforms to secure patient data Hospitals can only convert an inpatient case to observation if the hospital utilization review committee determines this status before the patient is discharged and: A. With the consent of the third-party payer's medical director that and observation setting will be more appropriate B. After any billing C. Before closing the patient's account D. Prior to billing, that an observation setting will be more appropriate - ANSWER-D. Prior to billing, that an observation setting will be more appropriate Hospitals can only convert to an inpatient case to observation if: A. The patient's health plan approves B. The hospital utilization review committee determines before the patient is discharged and prior to billing, that an observation setting would be more appropriate C. The level of intensity of treatment does not warrant an admission D. The patient in consultation with the attending and before billing requests the change - ANSWER-B. The hospital utilization review determines before the patient is discharged and prior to billing, that an observation setting would be more appropriate Hospitals need which of the following information sets to assess a patient's financial status? A. Income, Expenses, Debt B. Demographic, Income, Assets, Expenses C. Income, Expenses, and Capacity to take on more debt D. Asset liquidity, Income, Expenses, Credit worthiness - ANSWER-B. Demographic, Income, Assets, Expenses ICD-10-CM and ICD-10-PCD code sets are modifications of: A. The international ICD-10 codes as developed by the WHO (World Health Organization) B. ICD 9 codes C. CPT codes D. DRGs - ANSWER-B. ICD 9 codes Identifying the patient in the MPI, creating the registration record, completing medical necessity screening, determining insurance eligibility, obtaining insurance benefits, resolving managed care requirements, and completing financial education/resolution are all: A. The data collection steps for scheduling and pre-registering a patient B. Registration steps that must be completed before an medical services are provided C. The steps mandated for billing Medicare Part A D. The process of closing an account - ANSWER-A. The data collection steps for scheduling and pre-registering a patient If further treatment can only be provided in a hospital setting, the patient's condition cannot be evaluated and/or treated within 24 hours, or if there is not an anticipation of improvement in the patient's condition within 24 hours, the patient: A. Will be admitted as an inpatient B. Will remain in observation for up to 72 hours after which the patient is admitted as an inpatient C. Will be discharged and if needed, designated to a priority one outpatient status D. Will have his/her case reviewed by the attending physician and the primary care physician and a future course of care will then be determined - ANSWER-A. Will be admitted as an inpatient The impact of denials on the revenue cycle includes all of the following EXCEPT: A. Loss of revenue B. Increased collection fees C. Staff productivity D. Quality reputation - ANSWER-D. Quality reputation The importance of medical records being maintained by HIM is that the patient records: A. Are evidence used in assessing the quality of care B. Are the primary source for clinical data required for reimbursement by health plans and liability payers C. Are the strongest evidence and defense in the event of a Medicare audit D. Are the evidence cited in quality review - ANSWER-B. Are the primary source for clinical data required for reimbursement by health plans and liability payers The Important Message from Medicare provides beneficiaries information concerning their: A. Obligation to reimburse the hospital for any services not covered by the Medicare program B. Right to refuse to use lifetime reserve days for the current stay C. Right to appeal a discharge decision if the patient disagrees with the plan D. Understanding of billing issues and the deductible and/or co-insurance due for the current visit - ANSWER-C. Right to appeal a discharge decision if the patient disagrees with the plan Improving the overall patient experience requires revenue cycle leadership and staff to simultaneously be: A. Clear on policies and firm and consistent in applying the policies B. Careful in screening patient demands C. Monitoring cost and charges the patient incurs B. All health plans C. The Office of the U.S. Inspector General (OIC) D. State Insurance Commissioners - ANSWER-A. Recovery Audit Contractors (RAC) Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) are Medicare established guideline(s) used to determine: A. What Medicare reimburses and what should be referred to Medicaid B. Medicare outpatient reimbursement rates C. Which diagnoses, signs, or symptoms are reimbursable D. Medicare and Medicaid provider eligibility - ANSWER-C. Which diagnoses, signs, or symptoms are reimbursable Maintaining routine contact with the health plan or liability 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. Case Management C. HIM staff D. Managed Care Contract Staff - ANSWER-B. Case Management Medicare beneficiaries remain in the same "benefit period": A. Up to 60 days B. Up to hospitalization discharge C. Until the beneficiary is "hospitalization-free" for 60 consecutive days D. Each calendar year - ANSWER-C. Until the beneficiary is "Hospitalization-free" for 60 consecutive days The Medicare Bundled Payments for Care Initiative (BCPI) is designated to: A. Prevent duplicate billing B. Drive down cost as one payment is shared by all care givers in a s single episode of care C. "Stretch" the impact of patient self-pay by squeezing costs down through a lump-sum payment to providers D. Align incentives between hospitals, physicians, and non-physician providers in order to better coordinate patient care - ANSWER-D. Align incentives between hospitals, physicians, and non-physician providers in order to better coordinate patient care The Medicare fee-for-service appeal process for both beneficiaries and providers includes all of the following levels EXCEPT: A. Redetermination by the company that handles claims for Medicare B. review by the Medicare Appeals Council (Appeals Council) C. Judicial review by a federal district court D. Medical Necessity review by an independent physicians panel - ANSWER-D. Medical Necessity review by an independent physicians panel Medicare has established guidelines called Local Coverage Determinations (LCD) and National Coverage Determinations (NCD that establish: A. Reasonable and customary prices for services in a given area B. Prospective Medicare patient financial responsibilities for a given diagnosis C. Provider and physician reimbursement for specific diagnoses and tests D. What services or healthcare items are covered under Medicare - ANSWER-D. What services or healthcare items are covered uder Medicare Medicare Part B has an annual deductible, and the beneficiary is responsible for: A. A co-insurance payment for all Part B covered services B. Physician's office fees C. Tests outside of an inpatient setting D. Prescrirptions - ANSWER-A. A co-insurance payment for all Part B covered services Medicare patients are NOT required to produce a physician's order to receive which of the services? A. Diagnostic mammography, flu vaccine or B-12 shots B. Diagnostic mammography, flu vaccine or pneumonia vaccine C. Screening mammography, flu vaccine or pneumonia vaccine D. Screening mammography, flu vaccine or B-12 shots - ANSWER-C. Screening mammography, flu vaccine or pneumonia vaccine The most effective payment plan programs: A. Screen patients to determine if they are capable of paying B. Are rigorous in patient follow-up C. Do not allow missed payments D. Are turned over to a collection agency - ANSWER-A. Screen patients to determine if they are capable of paying Most major health insurance payers, including Medicare and Medicaid, offer: A. Hard-copy documentation of insurance coverage B. Insurance verification through agents who are available during normal business hours C. Electronic verification of insurance coverage D. Provider "self-service" web portal accessible through the policy holder's plan ID number - ANSWER-C. Electronic verification of insurance coverage Most major health plans including Medicare and Medicaid, offer: A. Toll free verification hot lines, staffed around the clock B. Electronic and/or web portal verification C. Patient "verification of benefits" cards D. A grace period for obtaining verification within 72 hours of treatment - ANSWER-B. Electronic and/or web portal verification A nightly room charge will be incorrect if the patient's: A. Transfer from the ICU (Intensive care unit) to the Medical/Surgical floor is not reflected in the registration system B. Pharmacy orders have not been entered into the pharmacy system C. Condition has not been discussed during the shift change report meeting D. Discharge for the next day has not been charted - ANSWER-A. Transfer from the ICU (intensive care unit) to the Medical/Surgical floor is not reflected in the registration system Once the EMTALA requirements are satisfied: A. Third-party payer information should be collected from the patient and payer be notified of the ED visit B. An initial registration record is completed so that the proper coding can be initiated C. The patients then assume full liability for services unless a third-party payer is notified or the patient applies for financial assistance within the first 48 hours D. The remaining registration processing is initiated either at the bedside or in a registration area - ANSWER-D. The remaining registration processing in initiated either at the bedside or in a registration area Once the price is estimated in the pre-service stage, a provider's financial best practice is to: A. Allow the patient time to compare prices with other providers B. Have another employee double check the price estimate C. Lock-in prices D. Explain to the patient their financial responsibility and to determine the plan for payment - ANSWER-D. Explain to the patient their financial responsibility and to determine the plan for payment An originating site is: A. The location where the patient's bill is generated B. The location of the patient at the time the service is provided C. The site that generates reimbursement of a claim D. The location of the medical treatment provider - ANSWER-B. The location of the patient at the time the service is provided Outside the emergency department setting, patient financial discussions may take place during the registration or discharge process in a location that: A. Doesn't disrupt patient flow B. Meets patient's needs C. Is clearly identifiable as a patient financial services location D. Contains technology dedicated to patient accounts - ANSWER-A. Doesn't disrupt patient flow 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. Medicare A. The creation of one registration record for multiple days of service B. The creation of multiple registrations for multiple services C. The creation of one registration record per diagnosis per visit D. The creation of multiple patient types for one date of service - ANSWER-A. The creation of one registration record for multiple days of service Reimbursement and budget personnel actively model coding and reimbursement changes that result from the coding are put in place to guard against: A. Underpayments B. Denials C. Compliance fraud by "upcoding" D. Chargemaster error - ANSWER-C. Compliance fraud by "upcoding" The result of accurate census balancing on a daily basis is: A. The overall accuracy of resource planning B. The correct recording of room charges C. The increased efficiency in treatment D. Improved ability to plan nursing staff support services - ANSWER-B. The correct recording of room charges Revenue cycle activities occurring at the point-of-service include all of the following EXCEPT: A. The provision of case management and discharge planning services B. Providing charges to the third-party payer as they are incurred C. The generation of charges D. The monitoring of charges - ANSWER-A. The provision of case management and discharge planning services Scheduled procedures routinely include: A. Physician notification that scheduling is complete B. Patient preparation instructions C. Information on financial obligations D. The scheduler's name and contact information - ANSWER-B. Patient preparation instructions The soft cost of a dissatisfied customer is: A. The "cost" of staff providing extra attention in trying to perform service recovery B. The customer passing on information about their negative experience to potential patients or through social media channels C. A potentially negative treatment environment due to patient hostility D. Lowered quality outcomes for the dissatisfied patient - ANSWER-B. The customer passing on information about their negative experience to potential patients or through social media channels Successful account resolution beings with: A. Educating patients on their estimated financial responsibility B. Collecting all deductibles and copayments during the pre-service stage C. Accurate documentation of services D. Patient compliance with the course of treatment - ANSWER-A. Educating patients on their estimated financial responsibility A successful pre-registration program: A. Helps the patient feel welcome B. Identifies clearly what information must be gathered including demographic data, insurance data, and financial information C. Thoroughly discusses the patient's financial obligation D. Collects patient deductibles and co-pays - ANSWER-B. Identifies clearly what information must be gathered including demographic data, insurance data, and financial information Telemed seeks to improve a patient's health by: A. Permitting two-way, real time interactive communication between the patient, and the clinical professional B. Using high-compression fiber optics to transmit medical data C. Providing relevant, on-demand consumer medical education D. Providing physician access to the most current medical research - ANSWER-A. Permitting two-way, real time interactive communication between the patient, and the clinical professional Tests and services can only be provided: A. As inpatient services B. Once the patient agrees to meet their financial responsibilities C. With valid physician orders D. After any authorizations are obtained - ANSWER-C. With valid physician orders This directive was developed to promote and ensure healthcare quality and value and also to protect consumers and workers in the healthcare system. Theis directive is called: A. Payer quality monitoring B. Patient bill of rights C. Medicare patient and staff safety standards D. Joint Commission for Accreditation of Healthcare Organization(JCAHO) safety standards - ANSWER-B. Patient bill of rights The three types of utilization reviews used to ensure that resources and services are provided in the most efficient and effective ways are: A. Prospective review, Retrospective review and payment review B. Retrospective review, Systemic review and testing review C. Concurrent review, Discharge review and Placement review D. Prospective review, Concurrent review and Retrospective review - ANSWER-D. Prospective review, Concurrent review and Retrospective review To be eligible for Medicaid, and individual must: A. Have no unpaid income taxes B. Meet income and asset requirements C. Be employed at least 15 hours a week D. Be actively seeking employment if unemployed - ANSWER-B. Meet income and asset requirement To provide a patient with information that is meaningful to them, all the following factors must be included EXCEPT: A. The actual physician reimbursement B. The patient's benefit plan C. The type of hospital service based on CPT or MD-DRG code D. The patient's insurance carrier - ANSWER-A. The actual physician reimbursement The Two Midnight Rule allows hospitals to account for total hospital time including: A. Off site ancillary services B. Costs outside of what is regular and customary occurring within the first 48 hours of inpatient care C. Outpatient time directly preceding the inpatient admission D. Attending physician "on-call" time - ANSWER-C. Outpatient time directly preceding the inpatient admission Under EMTALA (Emergency Medial Treatment Labor Act) regulations, the provider may not ask about a patient's insurance information if it would delay what? A. Transfer to another facility B. Complete course of treatment C. Admission to observation status D. Medical screening and stabilizing treatment - ANSWER-D. Medical screening and stabilizing treatment Unless the patient encounter is an emergency, it is more efficient and effective to: A. Collect all information after the patient has been discharged B. Use historical information and contact the patient only if the claim is rejected C. Obtain the required demographic and insurance information before services are rendered D. Contact the patient's physician to obtain the necessary registration information after services are rendered - ANSWER-C. Obtain the required demographic and insurance information before services are rendered Unless the patient encounter is an emergency, it is more efficient and effective to: A. Collect all information after the patient has been discharged B. Use historical information and contact the patient only if the claim rejects C. Obtain the required demographic and insurance information before services are rendered D. Check if there is any patient balance due - ANSWER-B. Ensure that she/he accesses the correct information in the historical database Which department supports/collaborates with the revenue cycle? A. Information Technology B. Hospice C. Software Applications D. Continuum of Care - ANSWER-A. Information Technology Which level of HCPCS codes begin with a single letter followed by four numeric digits? A. Level I B. Level II C. Level III D. None of the above - ANSWER-B. Level II or C. Level III Which level of HCPCS modifiers consist of 5 digits and is approved by the American Medical Association? A. Level I B. Level II C. Level III D. None of the above - ANSWER-A. Level I Which of the following statements applies to the scheduled outpatient? A. The services meet inpatient acuity criteria B. The services never require preauthorization C. The services are provided on an ongoing basis D. The services do not involve an overnight stay - ANSWER-D. The services do not involve an overnight stay Which option is a benefit of pre-registering patients for service? A. The patient arrival processing is expedited, reducing wait times and delays B. The verification of insurance after completion of service C. Service departments having the ability to override schedules and block times to reduce testing volumes D. The patient receiving multiple calls from the provider - ANSWER-A. That patient arrival processing is expedited, reducing wait times and delays Which option is a federally-aided, state-operated program established to provide health and long-term care coverage for low-income individuals or families? A. Medicaid B. Medicare C. Insurance Exchange D. Social Security - ANSWER-A. Medicaid Which option is a government-sponsored program that is financed through taxes and general revenue funds? A. Medicaid B. Medicare C. Insurance Exchange D. Social Security - ANSWER-B. Medicare Which statement applies to the scheduled outpatient? A. Their services meet inpatient acuity criteria B. Their services never require pre-authorization C. Their services are provided on an ongoing basis D. Their services do not involve an overnight stay - ANSWER-D. Their services do not involve an overnight stay Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? A. Registration staff my routinely contact manage care plans for prior authorizations before the patient is seen by the on-duty physician B. Co-Payments may be collected at the time of service once the medical screening and stabilization activities are completed C. Signage must be posted where it can be easily seen and read by patients D. Initial registration activities may occur so long as these activities do not delay treatment or suggest that treatment will not be provided to uninsured individuals. - ANSWER-A. Registration staff my routinely contact manage care plans for prior authorizations before the patient is seen by the on-duty physician Which statement is a requirement of the important Message from Medicare notification process? A. Notification is required at admission and no later than 4 days before discharge B. Notification is required no earlier than 7 days prior to admission and no more than 2 days prior to discharge C. Notification is only required if the patient's discharge D. Notification is not required for beneficiaries enrolled in a Medicare Advantage plan - ANSWER-