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Certified RevenueCycle Specialist(CRCS) ExamStudy Outline 2020January 202011240 Waples Mill Road, Suite 200, Fairfax, VA 22030Phone: 703-281-4043 Fax: 703-359-7562 www.aaham.org
Copyright 2020American Association of Healthcare Administrative Management(AAHAM)All Rights ReservedNo part of this publication may be reproduced or transmitted in anyform or by any means, electronic or mechanical, including photocopy, recording or any information storage or retrieval system, without writtenpermission from the AAHAM National Office in Fairfax, VA.
AcknowledgmentsThis guide is the work of the following committed and creative group of individuals:AAHAM CRCS CommitteeOfficerLori Sickelbaugh, CRCE, National First Vice PresidentCommittee MembersCarrie Kuennen, CRCP, CRCE, Iowa Hawkeye ChapterSandra Peffer, CRCS, Ohio Western Reserve ChapterColleen Wentz, CRCS, CCT, CRCP, CRIP, Washington Inland Empire ChapterInstructional DesignerDebra Halsey, Training Consultant, Halsey & Co., Phoenix, AZ
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ContentsContents1IntroductionOverview of this Outline . 1-1Knowledge and Skill Requirements for Certification . 1-1Deposit Collection Program . 1-2Glossary . 1-2An Alternative to this Outline . 1-3AAHAM Certification Programs . 1-3Overview of CRCS Exam . 1-4Eligibility. 1-4Applications, Fees, and Deadlines . 1-5Applications . 1-5Fees . 1-5Deadlines . 1-5Exam Format and Grading . 1-6Retake Criteria . 1-6Suggested Preparation . 1-7Exam Logistics . 1-8Recertification . 1-82Federal Agencies and RegulationsKnowledge and Skill Requirements . 2-13Patient Access / Front OfficeKnowledge and Skill Requirements . 3-14BillingKnowledge and Skill Requirements . 4-15Credit and CollectionsKnowledge and Skill Requirements . 5-1Glossary . 6-1 AAHAMi
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Certified Revenue Cycle Specialist (CRCS) Exam Study Outline 2020Introduction1 IntroductionOverview of this OutlineAAHAM offers this Certified Revenue Cycle Specialist (CRCS) Exam StudyOutline 2020 to help you prepare for the CRCS examination.Knowledge and Skill Requirements forCertificationThis outline lists the requirements for each broad topic covered in the exam. Most of the exam questions apply to both facilities and provider practices. When a requirement applies to only one environment, it is shown ina box with a unique border and an icon on the left.NOTE: The boxes and icons (“F” for facilities and “P” for provider practices)clarify requirements that typically apply to either a facility or provider practice,but not both. But remember that all the information in this study manual couldappear on your exam, regardless of whether it is flagged for facilities or providerpractices. The certification you are testing for and its exam are no longerseparated by facility versus provider practice distinction. AAHAM (Rev. 1/15/2020)Confidential and Proprietary1-1
Certified Revenue Cycle Specialist (CRCS) Exam Study Outline 2020IntroductionThe text below typically applies to the facility environment only.FIDeposit Collection ProgramA deposit is the estimated portion of the patient’s bill not covered by insurance. Payment can be made in one installment or financed over time,and can be collected prior to admission, at admission, or at discharge. Advantages of a deposit collection program, when combined with a goodpreregistration and insurance verification program, include: Increased hospital cash collections Reduced amount due at discharge Reduced overall accounts receivable Reduced financial risk and bad debtDisadvantages of this type of program include the possibility of creating apublic relations issue between the hospital and the doctor, the patient andthe hospital, or the patient and the doctor.This text typically applies to provider practices only.PThe primary duty of the Front Office personnel is to act as a liaison between the physician and the patient. Front Office personnel are critical tothe physician office — from billing to collections to quality patient care.GlossaryThere is an extensive glossary at the back of this outline.TIP: It will be extremely helpful when taking the exam if you are very familiarwith the terms and definitions in the glossary.1-2 AAHAM (Rev. 1/15/2020)Confidential and Proprietary
Certified Revenue Cycle Specialist (CRCS) Exam Study Outline 2020IntroductionAn Alternative to this OutlineShould you want a more comprehensive and robust study aid, considerpurchasing the Certified Revenue Cycle Specialist (CRCS) Exam Study Manual2020 to help you prepare for the examination. Like this outline, the studymanual lists the specific skill and knowledge requirements you must meetto achieve certification. However, the study manual also includes extensive information you can review to prepare for the exam. In addition, thestudy manual has Knowledge Checks where you can test your ability toapply what you have learned, with answer keys so you can assess yourprogress.To purchase the Certified Revenue Cycle Specialist (CRCS) Exam Study Manual 2020, please visit our website athttp://www.aaham.org/Certification.aspx.AAHAM Certification ProgramsHealthcare revenue cycle professionals across the nation and around theglobe are looking for an edge a way to work smarter, build a career, stayinformed, and make the right contacts; an AAHAM certification helps youachieve all of these goals.AAHAM is the premier association of healthcare revenue cycle professionals. AAHAM members have committed to the highest standards ofprofessionalism, integrity, and competence. They are dedicated to the exchange of knowledge about changes in technology and concepts in the delivery of healthcare.AAHAM certification is an investment in your personal growth and yourprofessional future, regardless of where you are in your career. AvailableAAHAM certifications include: Certified Revenue Cycle Executive (CRCE) - for all senior/executiveleaders and directors in the healthcare revenue cycle, to assist in critical thinking, communication, and strategic management skills Certified Revenue Cycle Professional (CRCP) - for all managers andsupervisors in the healthcare revenue cycle, to help in effectively managing key aspects of the revenue cycle AAHAM (Rev. 1/15/2020)Confidential and Proprietary1-3
Certified Revenue Cycle Specialist (CRCS) Exam Study Outline 2020Introduction Certified Revenue Cycle Specialist (CRCS) - for frontline revenue cycle staff with responsibilities in the revenue cycle with a focus on specific knowledge required in registration, billing, and credit, and collections Certified Revenue Integrity Professional (CRIP) - for anyone in therevenue cycle industry to help ensure that facilities effectively managetheir chargemaster, and bill and document appropriately for all services rendered to a patient Certified Compliance Technician (CCT) - for all revenue cycle staffwho must meet employers' annual compliance training requirementsIn addition to bolstering your resume, earning an AAHAM certification isan essential, proactive step in maximizing your knowledge, income potential, and networking opportunities in the healthcare revenue cycle industry. In particular, many AAHAM members use the CRCS, CRCP, andCRCE certifications as a career ladder to help achieve their professionalgoals.Overview of CRCS ExamIntroduced in 1992 as the Certified Patient Accounts Technician (CPAT) orCertified Clinic Accounts Technician (CCAT) certification, this exam testsstaff proficiency and provides a resource for patient account managers toensure staffing competence. The exam tests overall understanding ofhealthcare patient accounting in the areas of admitting, billing, and collections, along with the knowledge of industry-standard abbreviations.Successful completion will establish individuals as being proficient andcompetent. Further, the designation, sponsored by AAHAM, will providerecognition from your peers and healthcare executives nationally. In manyinstances, certification can help you get the job or promotion you reallywant.EligibilityAny person involved in the admitting, billing, or collection of patient accounts in healthcare is eligible for the CRCS exam. Membership inAAHAM is not a requirement, although it is encouraged. One year of experience in clinical or hospital patient accounting is recommended.1-4 AAHAM (Rev. 1/15/2020)Confidential and Proprietary
Certified Revenue Cycle Specialist (CRCS) Exam Study Outline 2020IntroductionApplications, Fees, and DeadlinesApplicationsThere are two ways to apply for an exam: Online — go to www.aaham.org; use the online application link onthe Certification page; and pay with a credit card (amount describedunder Fees below). Mail in — obtain an application from www.aaham.org, Certificationtab. Complete and mail the application with a check or money order(amount described under Fees below), payable to AAHAM, to:National AAHAM11240 Waples Mill Rd., Ste. 200Fairfax, VA 22030If you have any further questions or would like to request a copy of thecertification brochure, contact the AAHAM National Office at 703-2814043, ext. 2 or send an email to julia@aaham.org.FeesExamination fees are: Full examination:– 100Section retake (described under Retake Criteria below):– 50DeadlinesThe application and fee must be received by: December 15 for the March exam April 15 for the July exam August 15 for the November exam AAHAM (Rev. 1/15/2020)Confidential and Proprietary1-5
Certified Revenue Cycle Specialist (CRCS) Exam Study Outline 2020IntroductionExam Format and GradingThe examination has three sections: Patient Access / Front Desk Billing Credit and CollectionsEach section also includes relevant regulations and acronyms and consistsof a mix of 40 multiple-choice and true/false questions, for a total of 120questions.A grading report will appear after you submit your results at the completion of your exam. If a printer is available, you may print your scores.These scores will also be sent to you via email to the email address youprovide on your application.You must attain a score of at least 70% in each section to pass that section,and you must pass all three sections to pass the exam.Certificates are mailed directly to the examinees, with the address thatwas listed on their exam application. Examinees receive their certificate bythe end of the month following the exam period.Retake CriteriaIf you pass at least two of the sections but fail the third, you can retake theremaining section within 12 months of the initial exam month. In order to retake a section, you must:1. Check the exam schedule at aaham.org, Certification page. Be sure toregister in time to complete the retake exam within 12 months of theinitial exam month.1-6 AAHAM (Rev. 1/15/2020)Confidential and Proprietary
Certified Revenue Cycle Specialist (CRCS) Exam Study Outline 2020Introduction2. Register for the section you need to retake by one of these methods:–Online — go to www.aaham.org; use the online application linkon the Certification page; and pay with a credit card.–Mail in — obtain an application from www.aaham.org, Certification page. Complete and mail the application with a check ormoney order, payable to AAHAM, to:National AAHAM11240 Waples Mill Rd., Ste. 200Fairfax, VA 22030Suggested PreparationIndependent research and hands-on experience will be necessary in orderto successfully complete the exam. Be sure to allow enough time for all thepreparation you want to do. Finding a "study-buddy" can be very helpful;try to pair up with another person in your chapter and take the exam together.Many chapters of
Certified Revenue Cycle Professional (CRCP) - for all managers and supervisors in the healthcare revenue cycle, to help in effectively man-aging key aspects of the revenue cycle . Certified Revenue Cycle Specialist (CRCS) Exam Study Outline 2020 Introduction 1-4 AAHAM (Rev. 1/15/2020) Confidential and Proprietary Certified Revenue Cycle Specialist (CRCS) - for frontline revenue cy .
