Certified Revenue Cycle Representative (CRCR) Practice Exam

What happens during the post-service stage?

1. A. Final coding of all services, preparation and submission of claims, payment processing and balance billing and resolution.

2. B. Orders are entered, results are reported, charges are generated, and diagnostic and procedural coding is initiated.

3. C. The encounter record is generated, and the patient and guarantor information is obtained and/or updated as required.

4. D. The focus is on the patient and his/her financial care, in addition to the clinical care provided for the patient.

The correct answer is: A. Final coding of all services, preparation and submission of claims, payment processing and balance billing and resolution.

During the post-service stage, the primary focus is on finalizing the details of the services provided to the patient. This includes final coding of all services rendered, which is crucial for accurate billing and reimbursement. Once the coding is complete, preparation and submission of claims to the appropriate payers take place, which ensures that healthcare providers are compensated for the services provided. Payment processing is another key component of this stage, where payments from insurance companies are received, and any necessary adjustments are made. In addition, the post-service stage involves balance billing, which refers to the practice of billing the patient for any outstanding balances after insurance payments have been applied. Resolving these balances is essential for the financial health of healthcare institutions and for maintaining clear communication with patients regarding their financial obligations. This stage plays a vital role in the overall revenue cycle management, as it ensures that all billing processes are completed effectively and efficiently, ultimately impacting the facility's cash flow. Therefore, the answer accurately encapsulates the comprehensive activities that occur following the provision of healthcare services.