CRCR Exam Review Questions and Answers
Question 1
Name the guideline that Medicare established to determine which diagnoses, signs,
or symptoms are payable.
A) Scheduling Instructions
B) Patient Identifiers
C) Local Coverage Determinations
D) Advance Beneficiary Notice
Correct Answer
C) Local Coverage Determinations
Question 2
What is the first component of a pricing determination?
A) Use a worksheet or other tool for guidance in determining an estimate
B) Verification of the patient's insurance eligibility and benefits.
C) Identify the service or test involved
D) Inform the patient that physician services are or are not included.
Correct Answer
B) Verification of the patient's insurance eligibility and benefits.
Question 3
Which option is a federally-aided, state-operated program to provide health and
long-term care coverage?
A) Self-Insured Plans
B) Medicaid
C) Medicare
D) Liability Coverage
Correct Answer
B) Medicaid
Page 1 of 108
,Question 4
What is the objective of the HCAHPS initiative?
A) To conduct evaluations concerning patients' perspective on hospital care.
B) To provide a standardization method for evaluating patients' perspective on
hospital care.
C) To provide clear communication and good customer service, which will give the
provider a competitive edge.
D) To make certain that during registration key information is verified by means of a
picture ID and insurance card.
Correct Answer
B) To provide a standardization method for evaluating patients' perspective on
hospital care.
Question 5
Why is it critical that a chargemaster is reviewed and updated regularly?
A) So the CPT databases can have the most current and accurate information.
B) To ensure it supports and represents the services provided within the organization.
C) Because charge descriptions can vary greatly between providers.
D) To ensure the most appropriate measure of the utilization of resources.
Correct Answer
B) To ensure it supports and represents the services provided within the
organization.
Question 6
For which levels of hospice care is only one rate applied to each day? (select all that
apply)
A) Routine Home Care
B) Continuous Home Care
C) Inpatient Respite Care
D) General Inpatient Care
Correct Answer
A, C, and D. - Home care is determined by the number of furnished hours.
Page 2 of 108
,Question 7
Which option is NOT a department that supports and collaborates with the revenue
cycle?
A) Finance
B) Clinical Services
C) Information Technology
D) Assisted Living Services
Correct Answer
D) Assisted Living Services
Question 8
Which option is NOT a reserve amount on a providers' financial statement?
A) Bad Debts
B) Contractual Allowance Accounts
C) Contra-Account Amounts
D) Charity Care
Correct Answer
C) Contra-Account Amounts
Question 9
Which statement is NOT a unique billing requirement for different provider types?
A) Overall aggregate payments made to a hospice are subject to a "cap amount",
calculated by the MAC at the end of the hospice cap period.
B) a patient may be balance billed for whatever amount the non-contractiting
physician charges above the health plan's reimbursement amount.
C) When billing services on a UB04/837-I, specific CPT codes are collapsed into a
single revenue code (520 or 521)
D) With the exception of physician services, Medicare reimbursement for hospice care
is made at one of four pre-determined rates for each day of hospice care.
Correct Answer
B) a patient may be balance billed for whatever amount the non-contractiting
physician charges above the health plan's reimbursement amount.
Page 3 of 108
, Question 10
Annually, the OIG publishes a work plan of compliance issues and objectives that will
be focused on throughout the following year. Identify which option is NOT a work
plan task mentioned in this course.
A) Standard Unique Employer Identifier
B) Provider-based status
C) Medical devices
D) Reconciliation of outlier payments
Correct Answer
A) Standard Unique Employer Identifier
Question 11
What are KPIs?
A) Days in A/R is calculated based on the value of the total accounts receivable into
30, 60, 90, 120 days and over categories, based on the date of service/discharge.
C) Benchmarks which are used to compete Key Performance indicators is an
organization to an agreed upon average expected standard within the same industry.
D) Key Performance Indicators which set standards for accounts receivables (A/R) and
provide a method for measuring the collection and control of A/R.
Correct Answer
D) Key Performance Indicators which set standards for accounts receivables (A/R)
and provide a method for measuring the collection and control of A/R.
Question 12
What is the purpose of insurance verification?
A) To identify information that does not have to be collected from the patient.
B) To ensure accuracy of the health plan information.
C) To complete guarantor information if the guarantor is not the patient.
D) To effectively complete the MSP screening process.
Correct Answer
B) To ensure accuracy of the health plan information.
Page 4 of 108
Question 1
Name the guideline that Medicare established to determine which diagnoses, signs,
or symptoms are payable.
A) Scheduling Instructions
B) Patient Identifiers
C) Local Coverage Determinations
D) Advance Beneficiary Notice
Correct Answer
C) Local Coverage Determinations
Question 2
What is the first component of a pricing determination?
A) Use a worksheet or other tool for guidance in determining an estimate
B) Verification of the patient's insurance eligibility and benefits.
C) Identify the service or test involved
D) Inform the patient that physician services are or are not included.
Correct Answer
B) Verification of the patient's insurance eligibility and benefits.
Question 3
Which option is a federally-aided, state-operated program to provide health and
long-term care coverage?
A) Self-Insured Plans
B) Medicaid
C) Medicare
D) Liability Coverage
Correct Answer
B) Medicaid
Page 1 of 108
,Question 4
What is the objective of the HCAHPS initiative?
A) To conduct evaluations concerning patients' perspective on hospital care.
B) To provide a standardization method for evaluating patients' perspective on
hospital care.
C) To provide clear communication and good customer service, which will give the
provider a competitive edge.
D) To make certain that during registration key information is verified by means of a
picture ID and insurance card.
Correct Answer
B) To provide a standardization method for evaluating patients' perspective on
hospital care.
Question 5
Why is it critical that a chargemaster is reviewed and updated regularly?
A) So the CPT databases can have the most current and accurate information.
B) To ensure it supports and represents the services provided within the organization.
C) Because charge descriptions can vary greatly between providers.
D) To ensure the most appropriate measure of the utilization of resources.
Correct Answer
B) To ensure it supports and represents the services provided within the
organization.
Question 6
For which levels of hospice care is only one rate applied to each day? (select all that
apply)
A) Routine Home Care
B) Continuous Home Care
C) Inpatient Respite Care
D) General Inpatient Care
Correct Answer
A, C, and D. - Home care is determined by the number of furnished hours.
Page 2 of 108
,Question 7
Which option is NOT a department that supports and collaborates with the revenue
cycle?
A) Finance
B) Clinical Services
C) Information Technology
D) Assisted Living Services
Correct Answer
D) Assisted Living Services
Question 8
Which option is NOT a reserve amount on a providers' financial statement?
A) Bad Debts
B) Contractual Allowance Accounts
C) Contra-Account Amounts
D) Charity Care
Correct Answer
C) Contra-Account Amounts
Question 9
Which statement is NOT a unique billing requirement for different provider types?
A) Overall aggregate payments made to a hospice are subject to a "cap amount",
calculated by the MAC at the end of the hospice cap period.
B) a patient may be balance billed for whatever amount the non-contractiting
physician charges above the health plan's reimbursement amount.
C) When billing services on a UB04/837-I, specific CPT codes are collapsed into a
single revenue code (520 or 521)
D) With the exception of physician services, Medicare reimbursement for hospice care
is made at one of four pre-determined rates for each day of hospice care.
Correct Answer
B) a patient may be balance billed for whatever amount the non-contractiting
physician charges above the health plan's reimbursement amount.
Page 3 of 108
, Question 10
Annually, the OIG publishes a work plan of compliance issues and objectives that will
be focused on throughout the following year. Identify which option is NOT a work
plan task mentioned in this course.
A) Standard Unique Employer Identifier
B) Provider-based status
C) Medical devices
D) Reconciliation of outlier payments
Correct Answer
A) Standard Unique Employer Identifier
Question 11
What are KPIs?
A) Days in A/R is calculated based on the value of the total accounts receivable into
30, 60, 90, 120 days and over categories, based on the date of service/discharge.
C) Benchmarks which are used to compete Key Performance indicators is an
organization to an agreed upon average expected standard within the same industry.
D) Key Performance Indicators which set standards for accounts receivables (A/R) and
provide a method for measuring the collection and control of A/R.
Correct Answer
D) Key Performance Indicators which set standards for accounts receivables (A/R)
and provide a method for measuring the collection and control of A/R.
Question 12
What is the purpose of insurance verification?
A) To identify information that does not have to be collected from the patient.
B) To ensure accuracy of the health plan information.
C) To complete guarantor information if the guarantor is not the patient.
D) To effectively complete the MSP screening process.
Correct Answer
B) To ensure accuracy of the health plan information.
Page 4 of 108
