HFMA CRCR EXAM--REAL ACTUAL
EXAM-LATEST UPDATE 2025 |
COMPLETE QUESTIONS WITH
CORRECT DETAILED ANSWERS |
RATED 100% CORRECT!! ALREADY
GRADED A+
What,are,collection,agency,fees,based,on?,-,ans-✔✔A,percentage,of,dollars,collected
Self-
funded,benefit,plans,may,choose,to,coordinate,benefits,using,the,gender,rule,or,what,othe
r,rule?,-,ans-✔✔Birthday
In,what,type,of,payment,methodology,is,a,lump,sum,or,bundled,payment,negotiated,betwe
en,the,payer,and,some,or,all,providers?,-,ans-✔✔Case,rates
What,customer,service,improvements,might,improve,the,patient,accounts,department?,-,a
ns-✔✔Holding,staff,accountable,for,customer,service,during,performance,reviews
What,is,an,ABN,(Advance,Beneficiary,Notice,of,Non-coverage),required,to,do?,-,ans-
✔✔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?,-,ans-✔✔Bad,debt,adjustment
What,is,the,initial,hospice,benefit?,-,ans-✔✔Two,90-
day,periods,and,an,unlimited,number,of,subsequent,periods
When,does,a,hospital,add,ambulance,charges,to,the,Medicare,inpatient,claim?,-,ans-
✔✔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?,-,ans-
✔✔Post,a,late-charge,adjustment,to,the,account
,an,increase,in,the,dollars,aged,greater,than,90,days,from,date,of,service,indicate,what,abo
ut,accounts,-,ans-✔✔They,are,not,being,processed,in,a,timely,manner
What,is,an,advantage,of,a,preregistration,program?,-,ans-
✔✔It,reduces,processing,times,at,the,time,of,service
What,are,the,two,statutory,exclusions,from,hospice,coverage?,-,ans-
✔✔Medically,unnecessary,services,and,custodial,care
What,core,financial,activities,are,resolved,within,patient,access?,-,ans-
✔✔Scheduling,,insurance,verification,,discharge,processing,,and,payment,of,point-of-
service,receipts
What,statement,applies,to,the,scheduled,outpatient?,-,ans-
✔✔The,services,do,not,involve,an,overnight,stay
How,is,a,mis-posted,contractual,allowance,resolved?,-,ans-
✔✔Comparing,the,contract,reimbursement,rates,with,the,contract,on,the,admittance,advic
e,to,identify,the,correct,amount
What,type,of,patient,status,is,used,to,evaluate,the,patient's,need,for,inpatient,care?,-,ans-
✔✔Observation
Coverage,rules,for,Medicare,beneficiaries,receiving,skilled,nursing,care,require,that,the,be
neficiary,has,received,what?,-,ans-
✔✔Medically,necessary,inpatient,hospital,services,for,at,least,3,consecutive,days,before,t
he,skilled,nursing,care,admission
When,is,the,word,"SAME",entered,on,the,CMS,1500,billing,form,in,Field,0$?,-,ans-
✔✔When,the,patient,is,the,insured
What,are,non-
emergency,patients,who,come,for,service,without,prior,notification,to,the,provider,called?,-,
ans-✔✔Unscheduled,patients
If,the,insurance,verification,response,reports,that,a,subscriber,has,a,single,policy,,what,is,t
he,status,of,the,subscriber's,spouse?,-,ans-✔✔Neither,enrolled,not,entitled,to,benefits
Regulation,Z,of,the,Consumer,Credit,Protection,Act,,also,known,as,the,Truth,in,Lending,Ac
t,,establishes,what?,-,ans-
✔✔Disclosure,rules,for,consumer,credit,sales,and,consumer,loans
What,is,a,principal,diagnosis?,-,ans-✔✔Primary,reason,for,the,patient's,admission
Collecting,patient,liability,dollars,after,service,leads,to,what?,-,ans-
✔✔Lower,accounts,receivable,levels
,What,is,the,daily,out-of-pocket,amount,for,each,lifetime,reserve,day,used?,-,ans-
✔✔50%,of,the,current,deductible,amount
What,service,provided,to,a,Medicare,beneficiary,in,a,rural,health,clinic,
(RHC),is,not,billable,as,an,RHC,services?,-,ans-✔✔Inpatient,care
What,code,indicates,the,disposition,of,the,patient,at,the,conclusion,of,service?,-,ans-
✔✔Patient,discharge,status,code
What,are,hospitals,required,to,do,for,Medicare,credit,balance,accounts?,-,ans-
✔✔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?,-,ans-✔✔Patient
Medicare,guidelines,require,that,when,a,test,is,ordered,for,a,LCD,or,NCD,exists,,the,inform
ation,provided,on,the,order,must,include:,-,ans-✔✔A,valid,CPT,or,HCPCS,code
With,advances,in,internet,security,and,encryption,,revenue-
cycle,processes,are,expanding,to,allow,patients,to,do,what?,-,ans-
✔✔Access,their,information,and,perform,functions,on-line
What,date,is,required,on,all,CMS,1500,claim,forms?,-,ans-✔✔onset,date,of,current,illness
What,does,scheduling,allow,provider,staff,to,do,-,ans-
✔✔Review,appropriateness,of,the,service,request
What,code,is,used,to,report,the,provider's,most,common,semiprivate,room,rate?,-,ans-
✔✔Condition,code
Regulations,and,requirements,for,coding,accountable,care,organizations,,which,allows,pr
oviders,to,begin,creating,these,organizations,,were,finalized,in:,-,ans-✔✔2012
What,is,a,primary,responsibility,of,the,Recover,Audit,Contractor?,-,ans-
✔✔To,correctly,identify,proper,payments,for,Medicare,Part,A,&,B,claims
How,must,providers,handle,credit,balances?,-,ans-
✔✔Comply,with,state,statutes,concerning,reporting,credit,balance
Insurance,verification,results,in,what?,-,ans-
✔✔The,accurate,identification,of,the,patient's,eligibility,and,benefits
What,form,is,used,to,bill,Medicare,for,rural,health,clinics?,-,ans-✔✔CMS,1500
, What,activities,are,completed,when,a,scheduled,pre-
registered,patient,arrives,for,service?,-,ans-
✔✔Registering,the,patient,and,directing,the,patient,to,the,service,area
In,addition,to,being,supported,by,information,found,in,the,patient's,chart,,a,CMS,1500,clai
m,must,be,coded,using,what?,-,ans-✔✔HCPCS,
(Healthcare,Common,Procedure,Coding,system)
What,results,from,a,denied,claim?,-,ans-✔✔The,provider,incurs,rework,and,appeal,costs
Why,does,the,financial,counselor,need,pricing,for,services?,-,ans-
✔✔To,calculate,the,patient's,financial,responsibility
What,type,of,provider,bills,third-party,payers,using,CMS,1500,form,-,ans-✔✔Hospital-
based,mammography,centers
How,are,disputes,with,nongovernmental,payers,resolved?,-,ans-
✔✔Appeal,conditions,specified,in,the,individual,payer's,contract
The,important,message,from,Medicare,provides,beneficiaries,with,information,concerning,
what?,-,ans-
✔✔Right,to,appeal,a,discharge,decision,if,the,patient,disagrees,with,the,services
Why,do,managed,care,plans,have,agreements,with,hospitals,,physicians,,and,other,health
care,providers,to,offer,a,range,of,services,to,plan,members?,-,ans-
✔✔To,improve,access,to,quality,healthcare
If,a,patient,remains,an,inpatient,of,an,SNF,
(skilled,nursing,facility,for,more,than,30,days,,what,is,the,SNF,permitted,to,do?,-,ans-
✔✔Submit,interim,bills,to,the,Medicare,program.
90.,MSP,
(Medicare,Secondary,Payer),rules,allow,providers,to,bill,Medicare,for,liability,claims,after,
what,happens?,-,ans-
✔✔120,days,passes,,but,the,claim,then,be,withdrawn,from,the,liability,carrier
What,data,are,required,to,establish,a,new,MPI,entry?,-,ans-
✔✔The,patient's,full,legal,name,,date,of,birth,,and,sex
What,should,the,provider,do,if,both,of,the,patient's,insurance,plans,pay,as,primary?,-,ans-
✔✔Determine,the,correct,payer,and,notify,the,incorrect,payer,of,the,processing,error
What,do,EMTALA,regulations,require,on-call,physicians,to,do?,-,ans-
✔✔Personally,appear,in,the,emergency,department,and,attend,to,the,patient,within,a,reas
onable,time
EXAM-LATEST UPDATE 2025 |
COMPLETE QUESTIONS WITH
CORRECT DETAILED ANSWERS |
RATED 100% CORRECT!! ALREADY
GRADED A+
What,are,collection,agency,fees,based,on?,-,ans-✔✔A,percentage,of,dollars,collected
Self-
funded,benefit,plans,may,choose,to,coordinate,benefits,using,the,gender,rule,or,what,othe
r,rule?,-,ans-✔✔Birthday
In,what,type,of,payment,methodology,is,a,lump,sum,or,bundled,payment,negotiated,betwe
en,the,payer,and,some,or,all,providers?,-,ans-✔✔Case,rates
What,customer,service,improvements,might,improve,the,patient,accounts,department?,-,a
ns-✔✔Holding,staff,accountable,for,customer,service,during,performance,reviews
What,is,an,ABN,(Advance,Beneficiary,Notice,of,Non-coverage),required,to,do?,-,ans-
✔✔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?,-,ans-✔✔Bad,debt,adjustment
What,is,the,initial,hospice,benefit?,-,ans-✔✔Two,90-
day,periods,and,an,unlimited,number,of,subsequent,periods
When,does,a,hospital,add,ambulance,charges,to,the,Medicare,inpatient,claim?,-,ans-
✔✔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?,-,ans-
✔✔Post,a,late-charge,adjustment,to,the,account
,an,increase,in,the,dollars,aged,greater,than,90,days,from,date,of,service,indicate,what,abo
ut,accounts,-,ans-✔✔They,are,not,being,processed,in,a,timely,manner
What,is,an,advantage,of,a,preregistration,program?,-,ans-
✔✔It,reduces,processing,times,at,the,time,of,service
What,are,the,two,statutory,exclusions,from,hospice,coverage?,-,ans-
✔✔Medically,unnecessary,services,and,custodial,care
What,core,financial,activities,are,resolved,within,patient,access?,-,ans-
✔✔Scheduling,,insurance,verification,,discharge,processing,,and,payment,of,point-of-
service,receipts
What,statement,applies,to,the,scheduled,outpatient?,-,ans-
✔✔The,services,do,not,involve,an,overnight,stay
How,is,a,mis-posted,contractual,allowance,resolved?,-,ans-
✔✔Comparing,the,contract,reimbursement,rates,with,the,contract,on,the,admittance,advic
e,to,identify,the,correct,amount
What,type,of,patient,status,is,used,to,evaluate,the,patient's,need,for,inpatient,care?,-,ans-
✔✔Observation
Coverage,rules,for,Medicare,beneficiaries,receiving,skilled,nursing,care,require,that,the,be
neficiary,has,received,what?,-,ans-
✔✔Medically,necessary,inpatient,hospital,services,for,at,least,3,consecutive,days,before,t
he,skilled,nursing,care,admission
When,is,the,word,"SAME",entered,on,the,CMS,1500,billing,form,in,Field,0$?,-,ans-
✔✔When,the,patient,is,the,insured
What,are,non-
emergency,patients,who,come,for,service,without,prior,notification,to,the,provider,called?,-,
ans-✔✔Unscheduled,patients
If,the,insurance,verification,response,reports,that,a,subscriber,has,a,single,policy,,what,is,t
he,status,of,the,subscriber's,spouse?,-,ans-✔✔Neither,enrolled,not,entitled,to,benefits
Regulation,Z,of,the,Consumer,Credit,Protection,Act,,also,known,as,the,Truth,in,Lending,Ac
t,,establishes,what?,-,ans-
✔✔Disclosure,rules,for,consumer,credit,sales,and,consumer,loans
What,is,a,principal,diagnosis?,-,ans-✔✔Primary,reason,for,the,patient's,admission
Collecting,patient,liability,dollars,after,service,leads,to,what?,-,ans-
✔✔Lower,accounts,receivable,levels
,What,is,the,daily,out-of-pocket,amount,for,each,lifetime,reserve,day,used?,-,ans-
✔✔50%,of,the,current,deductible,amount
What,service,provided,to,a,Medicare,beneficiary,in,a,rural,health,clinic,
(RHC),is,not,billable,as,an,RHC,services?,-,ans-✔✔Inpatient,care
What,code,indicates,the,disposition,of,the,patient,at,the,conclusion,of,service?,-,ans-
✔✔Patient,discharge,status,code
What,are,hospitals,required,to,do,for,Medicare,credit,balance,accounts?,-,ans-
✔✔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?,-,ans-✔✔Patient
Medicare,guidelines,require,that,when,a,test,is,ordered,for,a,LCD,or,NCD,exists,,the,inform
ation,provided,on,the,order,must,include:,-,ans-✔✔A,valid,CPT,or,HCPCS,code
With,advances,in,internet,security,and,encryption,,revenue-
cycle,processes,are,expanding,to,allow,patients,to,do,what?,-,ans-
✔✔Access,their,information,and,perform,functions,on-line
What,date,is,required,on,all,CMS,1500,claim,forms?,-,ans-✔✔onset,date,of,current,illness
What,does,scheduling,allow,provider,staff,to,do,-,ans-
✔✔Review,appropriateness,of,the,service,request
What,code,is,used,to,report,the,provider's,most,common,semiprivate,room,rate?,-,ans-
✔✔Condition,code
Regulations,and,requirements,for,coding,accountable,care,organizations,,which,allows,pr
oviders,to,begin,creating,these,organizations,,were,finalized,in:,-,ans-✔✔2012
What,is,a,primary,responsibility,of,the,Recover,Audit,Contractor?,-,ans-
✔✔To,correctly,identify,proper,payments,for,Medicare,Part,A,&,B,claims
How,must,providers,handle,credit,balances?,-,ans-
✔✔Comply,with,state,statutes,concerning,reporting,credit,balance
Insurance,verification,results,in,what?,-,ans-
✔✔The,accurate,identification,of,the,patient's,eligibility,and,benefits
What,form,is,used,to,bill,Medicare,for,rural,health,clinics?,-,ans-✔✔CMS,1500
, What,activities,are,completed,when,a,scheduled,pre-
registered,patient,arrives,for,service?,-,ans-
✔✔Registering,the,patient,and,directing,the,patient,to,the,service,area
In,addition,to,being,supported,by,information,found,in,the,patient's,chart,,a,CMS,1500,clai
m,must,be,coded,using,what?,-,ans-✔✔HCPCS,
(Healthcare,Common,Procedure,Coding,system)
What,results,from,a,denied,claim?,-,ans-✔✔The,provider,incurs,rework,and,appeal,costs
Why,does,the,financial,counselor,need,pricing,for,services?,-,ans-
✔✔To,calculate,the,patient's,financial,responsibility
What,type,of,provider,bills,third-party,payers,using,CMS,1500,form,-,ans-✔✔Hospital-
based,mammography,centers
How,are,disputes,with,nongovernmental,payers,resolved?,-,ans-
✔✔Appeal,conditions,specified,in,the,individual,payer's,contract
The,important,message,from,Medicare,provides,beneficiaries,with,information,concerning,
what?,-,ans-
✔✔Right,to,appeal,a,discharge,decision,if,the,patient,disagrees,with,the,services
Why,do,managed,care,plans,have,agreements,with,hospitals,,physicians,,and,other,health
care,providers,to,offer,a,range,of,services,to,plan,members?,-,ans-
✔✔To,improve,access,to,quality,healthcare
If,a,patient,remains,an,inpatient,of,an,SNF,
(skilled,nursing,facility,for,more,than,30,days,,what,is,the,SNF,permitted,to,do?,-,ans-
✔✔Submit,interim,bills,to,the,Medicare,program.
90.,MSP,
(Medicare,Secondary,Payer),rules,allow,providers,to,bill,Medicare,for,liability,claims,after,
what,happens?,-,ans-
✔✔120,days,passes,,but,the,claim,then,be,withdrawn,from,the,liability,carrier
What,data,are,required,to,establish,a,new,MPI,entry?,-,ans-
✔✔The,patient's,full,legal,name,,date,of,birth,,and,sex
What,should,the,provider,do,if,both,of,the,patient's,insurance,plans,pay,as,primary?,-,ans-
✔✔Determine,the,correct,payer,and,notify,the,incorrect,payer,of,the,processing,error
What,do,EMTALA,regulations,require,on-call,physicians,to,do?,-,ans-
✔✔Personally,appear,in,the,emergency,department,and,attend,to,the,patient,within,a,reas
onable,time
