CRS PA BOARD FINAL STUDY GUIDE 2026
QUESTIONS WITH SOLUTIONS GRADED A+
⩥ Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule?
Answer: Birthday
⩥ In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all providers?
Answer: Case rates
⩥ What customer service improvements might improve the patient
accounts department?
Answer: Holding staff accountable for customer service during
performance reviews
⩥ What is an ABN (Advance Beneficiary Notice of Non-coverage)
required to do?
Answer: Inform a Medicare beneficiary that Medicare may not pay for
the order or service
⩥ What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance?
,Answer: Bad debt adjustment
⩥ What is the initial hospice benefit?
Answer: Two 90-day periods and an unlimited number of subsequent
periods
⩥ When does a hospital add ambulance charges to the Medicare
inpatient claim?
Answer: If the patient requires ambulance transportation to a skilled
nursing facility
⩥ How should a provider resolve a late-charge credit posted after an
account is billed?
Answer: Post a late-charge adjustment to the account
⩥ an increase in the dollars aged greater than 90 days from date of
service indicate what about accounts
Answer: They are not being processed in a timely manner
⩥ What is an advantage of a preregistration program?
Answer: It reduces processing times at the time of service
⩥ What are the two statutory exclusions from hospice coverage?
, Answer: Medically unnecessary services and custodial care
⩥ What core financial activities are resolved within patient access?
Answer: Scheduling, insurance verification, discharge processing, and
payment of point-of-service receipts
⩥ What statement applies to the scheduled outpatient?
Answer: The services do not involve an overnight stay
⩥ 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$?
QUESTIONS WITH SOLUTIONS GRADED A+
⩥ Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule?
Answer: Birthday
⩥ In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all providers?
Answer: Case rates
⩥ What customer service improvements might improve the patient
accounts department?
Answer: Holding staff accountable for customer service during
performance reviews
⩥ What is an ABN (Advance Beneficiary Notice of Non-coverage)
required to do?
Answer: Inform a Medicare beneficiary that Medicare may not pay for
the order or service
⩥ What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance?
,Answer: Bad debt adjustment
⩥ What is the initial hospice benefit?
Answer: Two 90-day periods and an unlimited number of subsequent
periods
⩥ When does a hospital add ambulance charges to the Medicare
inpatient claim?
Answer: If the patient requires ambulance transportation to a skilled
nursing facility
⩥ How should a provider resolve a late-charge credit posted after an
account is billed?
Answer: Post a late-charge adjustment to the account
⩥ an increase in the dollars aged greater than 90 days from date of
service indicate what about accounts
Answer: They are not being processed in a timely manner
⩥ What is an advantage of a preregistration program?
Answer: It reduces processing times at the time of service
⩥ What are the two statutory exclusions from hospice coverage?
, Answer: Medically unnecessary services and custodial care
⩥ What core financial activities are resolved within patient access?
Answer: Scheduling, insurance verification, discharge processing, and
payment of point-of-service receipts
⩥ What statement applies to the scheduled outpatient?
Answer: The services do not involve an overnight stay
⩥ 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$?
