CMSRN FOUNDATIONS EXAM STUDY GUIDE
2026 FULL QUESTIONS AND ANSWERS
GRADED A+
◉ Collecting patient liability dollars after service leads to what?
Answer: Lower accounts receivable levels
◉ What is the daily out-of-pocket amount for each lifetime reserve
day used? Answer: 50% of the current deductible amount
◉ What service provided to a Medicare beneficiary in a rural health
clinic (RHC) is not billable as an RHC services? Answer: Inpatient
care
◉ What code indicates the disposition of the patient at the
conclusion of service? Answer: Patient discharge status code
◉ What are hospitals required to do for Medicare credit balance
accounts? Answer: They result in lost reimbursement and additional
cost to collect
,◉ When an undue delay of payment results from a dispute between
the patient and the third party payer, who is responsible for
payment? Answer: Patient
◉ Medicare guidelines require that when a test is ordered for a LCD
or NCD exists, the information provided on the order must include:
Answer: A valid CPT or HCPCS code
◉ With advances in internet security and encryption, revenue-cycle
processes are expanding to allow patients to do what? Answer:
Access their information and perform functions on-line
◉ What date is required on all CMS 1500 claim forms? Answer:
onset date of current illness
◉ What does scheduling allow provider staff to do Answer: Review
appropriateness of the service request
◉ What code is used to report the provider's most common
semiprivate room rate? Answer: Condition code
◉ Regulations and requirements for coding accountable care
organizations, which allows providers to begin creating these
organizations, were finalized in: Answer: 2012
, ◉ What is a primary responsibility of the Recover Audit Contractor?
Answer: To correctly identify proper payments for Medicare Part A
& B claims
◉ How must providers handle credit balances? Answer: Comply
with state statutes concerning reporting credit balance
◉ Insurance verification results in what? Answer: The accurate
identification of the patient's eligibility and benefits
◉ What form is used to bill Medicare for rural health clinics?
Answer: CMS 1500
◉ What activities are completed when a scheduled pre-registered
patient arrives for service? Answer: Registering the patient and
directing the patient to the service area
◉ In addition to being supported by information found in the
patient's chart, a CMS 1500 claim must be coded using what?
Answer: HCPCS (Healthcare Common Procedure Coding system)
◉ What results from a denied claim? Answer: The provider incurs
rework and appeal costs
2026 FULL QUESTIONS AND ANSWERS
GRADED A+
◉ Collecting patient liability dollars after service leads to what?
Answer: Lower accounts receivable levels
◉ What is the daily out-of-pocket amount for each lifetime reserve
day used? Answer: 50% of the current deductible amount
◉ What service provided to a Medicare beneficiary in a rural health
clinic (RHC) is not billable as an RHC services? Answer: Inpatient
care
◉ What code indicates the disposition of the patient at the
conclusion of service? Answer: Patient discharge status code
◉ What are hospitals required to do for Medicare credit balance
accounts? Answer: They result in lost reimbursement and additional
cost to collect
,◉ When an undue delay of payment results from a dispute between
the patient and the third party payer, who is responsible for
payment? Answer: Patient
◉ Medicare guidelines require that when a test is ordered for a LCD
or NCD exists, the information provided on the order must include:
Answer: A valid CPT or HCPCS code
◉ With advances in internet security and encryption, revenue-cycle
processes are expanding to allow patients to do what? Answer:
Access their information and perform functions on-line
◉ What date is required on all CMS 1500 claim forms? Answer:
onset date of current illness
◉ What does scheduling allow provider staff to do Answer: Review
appropriateness of the service request
◉ What code is used to report the provider's most common
semiprivate room rate? Answer: Condition code
◉ Regulations and requirements for coding accountable care
organizations, which allows providers to begin creating these
organizations, were finalized in: Answer: 2012
, ◉ What is a primary responsibility of the Recover Audit Contractor?
Answer: To correctly identify proper payments for Medicare Part A
& B claims
◉ How must providers handle credit balances? Answer: Comply
with state statutes concerning reporting credit balance
◉ Insurance verification results in what? Answer: The accurate
identification of the patient's eligibility and benefits
◉ What form is used to bill Medicare for rural health clinics?
Answer: CMS 1500
◉ What activities are completed when a scheduled pre-registered
patient arrives for service? Answer: Registering the patient and
directing the patient to the service area
◉ In addition to being supported by information found in the
patient's chart, a CMS 1500 claim must be coded using what?
Answer: HCPCS (Healthcare Common Procedure Coding system)
◉ What results from a denied claim? Answer: The provider incurs
rework and appeal costs
