CRCR EXAM PREP, MULTIPLE
CHOICE, - MATERIALS FROM
HFMA ACTUAL EXAM 2026 WITH
VERIFIED ANSWERS
When was Health Information Technology for Economic and Clinical Health (HITECH) Act signed
into law?
FEB 17, 2009
When did HITECH Act become effective?
2013
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. Payments to Physicians for Co-Surgery Procedures
B. Denials and Appeals in Medicare Part D
C. Medicare Hospital Payments for Claims Involving the Acute- and Post-Acute-Care Transfer
Policies
D. Standard Unique Employer Identifier
D. Standard Unique Employer Identifier
What Plan are the tasks below a part of?
- Medicare Payments Made Outside of the Hospice Benefit
,- Denials and Appeals in Medicare Part C and Part D
- Medicare Part B Payments for End-Stage Renal Disease Dialysis Services
- Review of Home Health Claims for Services With 5 to 10 Skilled Visits
The 2020 OIG Work Plan
When was the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act
signed into law?
JUNE 25 2010
In what situation(s) should a provider NOT use a modifier?
- CPT already indicates 2-4 lesions
- CPT indicates multiple extremities
What are other names for Three-Day Payment Window?
ALL OF THE ABOVE
72-hour rule, DRG window, Three-Day Window, 1 day window or 24-hour rule
What happens during the post-service stage?
Final coding, preparation and submission of claims, payment processing, balance billing and
resolution.
What are the below tasks part of?
- Educate patients
- Coordinate to avoid duplicate patient contacts
- Be consistent in key aspects of account resolution
- Follow best practices for communication
Best practices created by the Medical Debt Task Force
Which option is NOT a main HFMA Healthcare Dollars & Sense® revenue cycle initiative?
Process Compliance
,Which option is NOT a continuum of care provider?
A. Physician
B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
B. Health Plan Contracting
What is "implied certification"?
When it is implied that a provider met all compliance standards before submitting a claim
Which of the following are essential elements of an effective compliance program?
A. Established compliance standards and procedures.
B. Designation of a compliance officer employed within the Billing Department.
C. Oversight of personnel by high-level personnel.
D. Automatic dismissal of any employee excluded from participation in a federal healthcare
program.
E. Reasonable methods to achieve compliance with standards, including monitoring systems
and hotlines.
A. Established compliance standards and procedures.
C. Oversight of personnel by high-level personnel.
E. Reasonable methods to achieve compliance with standards, including monitoring systems
and hotlines.
What is the Medicare DRG Three-Day Payment Window?
All Diagnostic services provided to a Medicare patient by a hospital on the Date of the patient's
Inpatient admission or during the 3 calendar days (or in the case of a non-IPPS hospital: 1
, calendar day) immediately BEFORE the Date of Admission are REQUIRED to be included on the
bill for the IP stay (unless there is no Part A coverage)
Do Outpatient Non-Diagnostic Services qualify for separate payments if provided with the
Three-Day Payment Window?
No
What is modifier 59?
Used to identify CPTs OTHER THAN E&M services, NOT normally reported together, but are
appropriate under the circumstances.
Documentation must support a different session, different procedure or surgery, different site or
organ system, separate.
What is condition code 51?
Code noted on the separate UB-04 OP claim, thus indicating the charge is unrelated to the
admission.
What kind of hospitals are the following:
Cancer treatment facilities, psychiatric, IP rehabilitation, LTC and children's hospitals for
examples
Non-IPPS hospitals
What are the 3 types of medical necessity screenings and noncoverage notifications required in
the Medicare program?
1. Advanced Beneficiary Notice of Noncoverage (ABN) for Part B services.
2. SNF ABN for Part A SNF services.
3. HINN - Hospital-Issued Notice of Non-Coverage (Part A)
What is Medicare Part B ABN?
CHOICE, - MATERIALS FROM
HFMA ACTUAL EXAM 2026 WITH
VERIFIED ANSWERS
When was Health Information Technology for Economic and Clinical Health (HITECH) Act signed
into law?
FEB 17, 2009
When did HITECH Act become effective?
2013
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. Payments to Physicians for Co-Surgery Procedures
B. Denials and Appeals in Medicare Part D
C. Medicare Hospital Payments for Claims Involving the Acute- and Post-Acute-Care Transfer
Policies
D. Standard Unique Employer Identifier
D. Standard Unique Employer Identifier
What Plan are the tasks below a part of?
- Medicare Payments Made Outside of the Hospice Benefit
,- Denials and Appeals in Medicare Part C and Part D
- Medicare Part B Payments for End-Stage Renal Disease Dialysis Services
- Review of Home Health Claims for Services With 5 to 10 Skilled Visits
The 2020 OIG Work Plan
When was the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act
signed into law?
JUNE 25 2010
In what situation(s) should a provider NOT use a modifier?
- CPT already indicates 2-4 lesions
- CPT indicates multiple extremities
What are other names for Three-Day Payment Window?
ALL OF THE ABOVE
72-hour rule, DRG window, Three-Day Window, 1 day window or 24-hour rule
What happens during the post-service stage?
Final coding, preparation and submission of claims, payment processing, balance billing and
resolution.
What are the below tasks part of?
- Educate patients
- Coordinate to avoid duplicate patient contacts
- Be consistent in key aspects of account resolution
- Follow best practices for communication
Best practices created by the Medical Debt Task Force
Which option is NOT a main HFMA Healthcare Dollars & Sense® revenue cycle initiative?
Process Compliance
,Which option is NOT a continuum of care provider?
A. Physician
B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
B. Health Plan Contracting
What is "implied certification"?
When it is implied that a provider met all compliance standards before submitting a claim
Which of the following are essential elements of an effective compliance program?
A. Established compliance standards and procedures.
B. Designation of a compliance officer employed within the Billing Department.
C. Oversight of personnel by high-level personnel.
D. Automatic dismissal of any employee excluded from participation in a federal healthcare
program.
E. Reasonable methods to achieve compliance with standards, including monitoring systems
and hotlines.
A. Established compliance standards and procedures.
C. Oversight of personnel by high-level personnel.
E. Reasonable methods to achieve compliance with standards, including monitoring systems
and hotlines.
What is the Medicare DRG Three-Day Payment Window?
All Diagnostic services provided to a Medicare patient by a hospital on the Date of the patient's
Inpatient admission or during the 3 calendar days (or in the case of a non-IPPS hospital: 1
, calendar day) immediately BEFORE the Date of Admission are REQUIRED to be included on the
bill for the IP stay (unless there is no Part A coverage)
Do Outpatient Non-Diagnostic Services qualify for separate payments if provided with the
Three-Day Payment Window?
No
What is modifier 59?
Used to identify CPTs OTHER THAN E&M services, NOT normally reported together, but are
appropriate under the circumstances.
Documentation must support a different session, different procedure or surgery, different site or
organ system, separate.
What is condition code 51?
Code noted on the separate UB-04 OP claim, thus indicating the charge is unrelated to the
admission.
What kind of hospitals are the following:
Cancer treatment facilities, psychiatric, IP rehabilitation, LTC and children's hospitals for
examples
Non-IPPS hospitals
What are the 3 types of medical necessity screenings and noncoverage notifications required in
the Medicare program?
1. Advanced Beneficiary Notice of Noncoverage (ABN) for Part B services.
2. SNF ABN for Part A SNF services.
3. HINN - Hospital-Issued Notice of Non-Coverage (Part A)
What is Medicare Part B ABN?
