Certified Revenue Cycle Representative (CRCR) Practice Exam

What identifiers are used to achieve accurate patient identification?

1. Patient’s address, insurance policy number, and phone number.

2. Full legal name, date of birth, sex and social security number.

3. Emergency contact information and medical history.

4. Employment information and insurance coverage type.

The correct answer is: Full legal name, date of birth, sex and social security number.

Accurate patient identification is critical in the healthcare revenue cycle to ensure that the right patient receives the correct care and that all billing and insurance claims are processed correctly. The combination of full legal name, date of birth, sex, and social security number provides a comprehensive identification framework that minimizes the risk of misidentification. The full legal name establishes a clear identity, while the date of birth distinguishes individuals with similar names. The sex of the patient provides additional demographic context, which can be vital for certain medical procedures and treatment plans. Finally, the social security number acts as a unique identifier that is less common among the population, thus reducing the potential for overlap with other patients. While other identifiers such as the patient's address or insurance information can be relevant, they are not as effective in establishing unique patient identities across the board. Therefore, the elements highlighted in the correct answer together create a robust system for patient identification that is essential for maintaining accuracy and efficiency in healthcare operations.