HFMA CRCR Exam Prep 2026 (Multiple Choice) | Certified
Revenue Cycle Representative | Latest Update 2026 |
100% Correct Answers | Actual Exam Prep
1. What is the purpose of modifier 59 in medical coding?
To indicate that two procedures were performed on the same day
but are distinct and separate.
To indicate a repeat procedure.
To denote a bilateral procedure.
To signify that a procedure was performed on a different body part.
2. If a healthcare provider mistakenly applies a modifier to a service that does
not warrant it, what potential consequences could arise?
The provider will be audited for compliance violations.
The claim may be denied or delayed due to incorrect coding.
The provider will receive a higher reimbursement.
The claim will automatically be approved without review.
3. If a healthcare provider fails to issue an advance beneficiary notice (ABN)
when required, what potential consequence could they face?
Financial liability for the services provided
No impact on the provider's compliance status
Automatic approval of all claims submitted
Increased reimbursement rates from Medicare
4. What are price concessions in the context of revenue cycle management?
Price concessions are discounts offered to uninsured patients.
, Price concessions are penalties imposed for late payments.
Price concessions are reductions in the amount billed to a patient or
payer.
Price concessions are additional fees charged for services rendered.
5. This Health care act was signed into law by President Obama, March 23rd,
2010:
COBRA (Consolidated Omnibus Budget Reconciliation Act)
OBRA (Omnibus Budget Reconciliation Act)
PPACA (Patient Protection Affordable Care Act)
OSHA (Occupational Safety & Health Administration)
6. Describe one way the Affordable Care Act enhances the quality of care in
healthcare settings.
The Affordable Care Act enhances quality of care by limiting patient
access to specialists.
The Affordable Care Act enhances quality of care by reducing funding
for public health initiatives.
The Affordable Care Act enhances quality of care by increasing the
number of healthcare providers available.
The Affordable Care Act enhances quality of care by implementing
measures that promote preventive services and reduce healthcare
disparities.
7. What is the definition of the 'suspense' period in revenue cycle management?
The suspense period indicates the time allowed for patient billing
inquiries.
, The suspense period refers to the time taken to process patient
admissions.
The suspense period is the time frame during which claims are
pending for payment or resolution.
The suspense period is the duration for which financial audits are
conducted.
8. If a healthcare provider increases their Point of Service (POS) Cash collection
rate, what potential impact could this have on their financial management?
Increased administrative costs due to more billing staff.
Higher rates of patient dissatisfaction due to upfront payments.
Improved cash flow and reduced reliance on accounts receivable.
Decreased revenue from insurance reimbursements.
9. What change was brought by the implementation of ASC 606?
Method to manage categories of net assets to ensure compliance
with the restrictions on those funds
A report of net income or loss over an accounting period
2 types of adjustment to incurred charges: Explicit price
concessions & Implicit price concessions
Care provided to a patient who does not have the ability to pay for
the services or portion of the services received
10. Describe the implications of Medicare being a Secondary Payer for
healthcare providers.
Medicare will automatically cover all services provided.
, Healthcare providers must bill the primary insurer before
submitting claims to Medicare.
Medicare pays all costs regardless of other insurance.
Providers can only bill Medicare directly without considering other
insurances.
11. If a healthcare organization implements only 3 out of the 5 MAP Keys, what
potential impact could this have on their revenue cycle management?
Enhanced patient satisfaction and care quality.
Improved financial performance and streamlined operations.
No significant impact on revenue cycle management.
Increased risk of compliance issues and inefficiencies in revenue
collection.
12. If a healthcare organization has a 'Cash Collected as a Percentage of Net
Revenue' of 75%, what does this imply about their revenue cycle
management practices?
It implies that the organization has high operational costs.
It implies that the organization is experiencing a decline in patient
volume.
It implies that the organization is effectively collecting a significant
portion of its expected revenue.
It implies that the organization is not complying with Medicare
policies.
13. What are price concessions?
Strategic KPIs that set the standard for patient-centric revenue cycle
excellence in the healthcare industry
Revenue Cycle Representative | Latest Update 2026 |
100% Correct Answers | Actual Exam Prep
1. What is the purpose of modifier 59 in medical coding?
To indicate that two procedures were performed on the same day
but are distinct and separate.
To indicate a repeat procedure.
To denote a bilateral procedure.
To signify that a procedure was performed on a different body part.
2. If a healthcare provider mistakenly applies a modifier to a service that does
not warrant it, what potential consequences could arise?
The provider will be audited for compliance violations.
The claim may be denied or delayed due to incorrect coding.
The provider will receive a higher reimbursement.
The claim will automatically be approved without review.
3. If a healthcare provider fails to issue an advance beneficiary notice (ABN)
when required, what potential consequence could they face?
Financial liability for the services provided
No impact on the provider's compliance status
Automatic approval of all claims submitted
Increased reimbursement rates from Medicare
4. What are price concessions in the context of revenue cycle management?
Price concessions are discounts offered to uninsured patients.
, Price concessions are penalties imposed for late payments.
Price concessions are reductions in the amount billed to a patient or
payer.
Price concessions are additional fees charged for services rendered.
5. This Health care act was signed into law by President Obama, March 23rd,
2010:
COBRA (Consolidated Omnibus Budget Reconciliation Act)
OBRA (Omnibus Budget Reconciliation Act)
PPACA (Patient Protection Affordable Care Act)
OSHA (Occupational Safety & Health Administration)
6. Describe one way the Affordable Care Act enhances the quality of care in
healthcare settings.
The Affordable Care Act enhances quality of care by limiting patient
access to specialists.
The Affordable Care Act enhances quality of care by reducing funding
for public health initiatives.
The Affordable Care Act enhances quality of care by increasing the
number of healthcare providers available.
The Affordable Care Act enhances quality of care by implementing
measures that promote preventive services and reduce healthcare
disparities.
7. What is the definition of the 'suspense' period in revenue cycle management?
The suspense period indicates the time allowed for patient billing
inquiries.
, The suspense period refers to the time taken to process patient
admissions.
The suspense period is the time frame during which claims are
pending for payment or resolution.
The suspense period is the duration for which financial audits are
conducted.
8. If a healthcare provider increases their Point of Service (POS) Cash collection
rate, what potential impact could this have on their financial management?
Increased administrative costs due to more billing staff.
Higher rates of patient dissatisfaction due to upfront payments.
Improved cash flow and reduced reliance on accounts receivable.
Decreased revenue from insurance reimbursements.
9. What change was brought by the implementation of ASC 606?
Method to manage categories of net assets to ensure compliance
with the restrictions on those funds
A report of net income or loss over an accounting period
2 types of adjustment to incurred charges: Explicit price
concessions & Implicit price concessions
Care provided to a patient who does not have the ability to pay for
the services or portion of the services received
10. Describe the implications of Medicare being a Secondary Payer for
healthcare providers.
Medicare will automatically cover all services provided.
, Healthcare providers must bill the primary insurer before
submitting claims to Medicare.
Medicare pays all costs regardless of other insurance.
Providers can only bill Medicare directly without considering other
insurances.
11. If a healthcare organization implements only 3 out of the 5 MAP Keys, what
potential impact could this have on their revenue cycle management?
Enhanced patient satisfaction and care quality.
Improved financial performance and streamlined operations.
No significant impact on revenue cycle management.
Increased risk of compliance issues and inefficiencies in revenue
collection.
12. If a healthcare organization has a 'Cash Collected as a Percentage of Net
Revenue' of 75%, what does this imply about their revenue cycle
management practices?
It implies that the organization has high operational costs.
It implies that the organization is experiencing a decline in patient
volume.
It implies that the organization is effectively collecting a significant
portion of its expected revenue.
It implies that the organization is not complying with Medicare
policies.
13. What are price concessions?
Strategic KPIs that set the standard for patient-centric revenue cycle
excellence in the healthcare industry
