ACTUAL FINAL EXAM PREP WITH CERTIFIED
QUESTIONS AND 100% CORRECT VERIFIED
ANSWERS ASSURED A+ GRADE BRAND NEW!!!
1. The primary purpose of the HFMA Certified Revenue Cycle
Representative (CRCR)
credential is to:
A) Validate clinical nursing skills
B) Demonstrate foundational knowledge of healthcare revenue cycle
processes
C) Certify hospital administrators for executive leadership
D) Replace state licensure for billing professionals
Answer: B
Rationale: CRCR certifies understanding of end-to-end revenue cycle
functions from registration to payment.
2. Which federal law prohibits knowingly and willfully soliciting or
receiving remuneration
for patient referrals?
A) HIPAA
B) Stark Law
C) Anti-Kickback Statute
,D) False Claims Act
Answer: C
Rationale: The Anti-Kickback Statute prohibits offering or receiving
anything of value to induce referrals.
3. The Stark Law prohibits physician referrals for certain designated
health services if the
physician has a:
A) Prior authorization denial
B) Financial relationship with the entity
C) Malpractice claim
D) Employment contract elsewhere
Answer: B
Rationale: Stark Law addresses self-referral when a physician has an
ownership or compensation relationship.
4. Which of the following is a key element of the False Claims Act?
A) Requires providers to report all payments over $10,000
B) Imposes liability on those who knowingly submit false claims to the
government
C) Mandates electronic health records
D) Establishes Medicare Advantage plans
Answer: B
,Rationale: The False Claims Act penalizes knowing submission of false or
fraudulent
government claims.
5. In healthcare revenue cycle, "front-end" processes typically include:
A) Coding and billing
B) Registration, eligibility verification, and authorization
C) Denial management and appeals
D) Accounts receivable follow-up
Answer: B
Rationale: Front-end revenue cycle occurs before or at service delivery,
including patient access functions.
6. Which document must be signed by the patient before non-
emergency services to
confirm financial responsibility?
A) Advance directive
B) Notice of Privacy Practices
C) Financial consent and insurance assignment
D) Clinical treatment plan
Answer: C
Rationale: Financial consent acknowledges patient responsibility for
charges not covered by insurance.
, 7. The process of verifying a patient's insurance coverage and benefits
before services is
called:
A) Utilization review
B) Eligibility verification
C) Claims adjudication
D) Precertification
Answer: B
Rationale: Eligibility verification confirms active coverage and benefit
details.
8. Which type of authorization is required by some payers before
certain procedures to
confirm medical necessity?
A) Retrospective authorization
B) Preauthorization or prior authorization
C) Concurrent review
D) Post-service certification
Answer: B
Rationale: Prior authorization is obtained before service to ensure
coverage based on medical necessity.
9. The HITECH Act strengthened which existing law's privacy and
security requirements?