CRCR Questions and Answers Latest 2022 Graded A

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CRCR Questions and Answers Latest 2022 Graded A What do Case Managers do? ✔✔Monitor high resource cases to ensure effective utilization What is HIM responsible for? ✔✔all pt medical records ... : transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? ✔✔manage cases: services correct, on time What are the three types of utilization review? ✔✔Prospective, Concurrent, Retrospective Where can home health services be offered? ✔✔Home, Assist Living, neighbors: just not SNF nor Hospital To receive -Care payments, what must a SNF have when receiving a pt from a hosp? ✔✔A transfer agreement approved by -Care. Can a home health agency employ another agency to provide services? ✔✔Yes, so long as at least one employee of the original agency provides care. What is the Net Collection Rate? ✔✔how much cash was collected as a % of available to collect? What is the Net Collection Rate benchmark? ✔✔95% What is the benchmark for denials ✔✔<2% on first submission Formual for cost to collect ✔✔total PFS expenses/gross pt care collections What is the benchmark for cost to collect ✔✔2.25% What % of the UB-04 source of data is from pt access? ✔✔40% What % of the UB-04 source of data is from service depts? ✔✔11% What % of the UB-04 source of data is from HIM? ✔✔20% What % of the UB-04 source of data is from billing? ✔✔20% What % of the UB-04 source of data is not used? ✔✔9% What % of the CMS 1500 source of data is from pt access? ✔✔53% What % of the CMS 1500 source of data is from service? ✔✔14% What % of the CMS 1500 source of data is from HIM ✔✔7% What % of the CMS 1500 source of data is from billing? ✔✔26% From whom is the UB-04 directed? ✔✔institutional: hospitals, SNF, hospice From whom is the CMS 1500? ✔ [Show More]

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