Certified Revenue Cycle Representative (CRCR) Practice Exam

Which component is NOT required in a Financial Assistance Policy (FAP)?

1. Eligibility criteria

2. Application process

3. Application assistance

4. Out-of-network providers

The correct answer is: Out-of-network providers

A Financial Assistance Policy (FAP) is designed to provide guidelines and support for individuals seeking financial help with medical expenses. One key aspect of a FAP is to ensure that patients understand how to apply for assistance and what services are covered. The policy typically includes several essential components such as eligibility criteria, application processes, and resources for application assistance. Eligibility criteria are crucial because they define who qualifies for financial assistance and under what circumstances. The application process outlines the steps patients must take to apply for the assistance. Application assistance is also vital, as it ensures that patients have support while navigating the process, making it more accessible to those in need. In contrast, the inclusion of out-of-network providers in the FAP is generally not a requirement. Financial Assistance Policies primarily focus on providing assistance for services rendered by the healthcare entity that issues the FAP. Out-of-network providers often have their own billing policies and financial assistance options, which may not fall under the purview of the institution’s FAP. Therefore, this component is not mandated as part of the essential structure of a Financial Assistance Policy.