CRCR study kit
Cheatsheet, term cards, never-miss list, and a seven-day plan. Original study material.
The rule
Clear the visit, capture the charge, post the remittance, and route the exception. You do not decide what the payer pays.
If a line will not balance or a required element is missing, hold and name the owner. Do not invent the field.
Never miss
- Pre-service is identity, eligibility, authorization, and estimates.
- A clean claim has the required data elements. It is not a payment promise.
- MSP asks whether another payer is primary to Medicare.
- An ABN is for expected Medicare noncoverage of a usually covered service, before the service.
- A remittance must balance: charge equals paid plus adjustments plus patient responsibility.
- Authorization denials go to access, not to a silent diagnosis rewrite.
Traps
- Changing a diagnosis so the claim pays.
- Blind contractual write-offs that hide underpayments.
- Treating a generic waiver as an ABN.
- Leaving patient class wrong after a status change.
Shortcuts
- Route by remittance reason, not by who emailed last.
- Age the AR by payer reason.
- Status change means recapture charges under the new class.
Memory hooks
- PRE-TOS-POST. Pre-service, time of service, post-service HFMA's CRCR unit order.
- ID-ELIG-AUTH-EST. Identity, eligibility, authorization, estimate Financial clearance checklist.
Best recognition-to-effort ratio in billing for a VA who is not sitting CPC yet. Not required by PH agencies.
- Day 1Revenue cycle overviewRead the Revenue cycle overview terms, then the never-miss lines that touch this domain.
- Day 2Pre-service financial careRead the Pre-service financial care terms, then the never-miss lines that touch this domain.
- Day 3Time-of-service financial careRead the Time-of-service financial care terms, then the never-miss lines that touch this domain.
- Day 4Post-service claims and ARRead the Post-service claims and AR terms, then the never-miss lines that touch this domain.
- Day 5Compliance checkpointsRead the Compliance checkpoints terms, then the never-miss lines that touch this domain.
- Day 6Mixed recallRun the term cards, then a short drill. Restate the one-line rule out loud.
- Day 7Full drillSit the 15-question exam and review every miss against this kit.