HFMA CRCR EXAM|| MOST RECENT EXAM 2026/2027
ACTUAL COMPLETE REAL VERIFIED EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED
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How is a mis-posted contractual allowance resolved? -
Answer-Comparing the contract reimbursement rates with
the contract on the admittance advice to identify the
correct amount
What type of patient status is used to evaluate the
patient's need for inpatient care? - Answer-Observation
Coverage rules for Medicare beneficiaries receiving skilled
nursing care require that the beneficiary has received
what? - Answer-Medically necessary inpatient hospital
services for at least 3 consecutive days before the skilled
nursing care admission
When is the word "SAME" entered on the CMS 1500
billing form in Field 0$? - Answer-When the patient is the
insured
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What are non-emergency patients who come for service
without prior notification to the provider called? - Answer-
Unscheduled patients
If the insurance verification response reports that a
subscriber has a single policy, what is the status of the
subscriber's spouse? - Answer-Neither enrolled not
entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also
known as the Truth in Lending Act, establishes what? -
Answer-Disclosure rules for consumer credit sales and
consumer loans
What is a principal diagnosis? - Answer-Primary reason for
the patient's admission
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
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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
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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