CRCR Exam Prep: NEWEST 2023-2024 ACTUAL
TEST 140 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
What are collection agency fees based on? - Selected Answer-A percentage of dollars
collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule? - Selected Answer-Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers? - Selected Answer-Case rates
What customer service improvements might improve the patient accounts department?
- Selected Answer-Holding staff accountable for customer service during performance
reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -
Selected 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? - Selected Answer-Bad debt adjustment
What is the initial hospice benefit? - Selected Answer-Two 90-day periods and an
unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? -
Selected 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? -
Selected Answer-Post a late-charge adjustment to the account
,Certified Revenue Cycle Representative - CRCR
an increase in the dollars aged greater than 90 days from date of service indicate what
about accounts - Selected Answer-They are not being processed in a timely manner
What is an advantage of a preregistration program? - Selected Answer-It reduces
processing times at the time of service
What are the two statutory exclusions from hospice coverage? - Selected Answer-
Medically unnecessary services and custodial care
,Certified Revenue Cycle Representative - CRCR
What core financial activities are resolved within patient access? - Selected Answer-
Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
What statement applies to the scheduled outpatient? - Selected Answer-The services do
not involve an overnight stay
How is a mis-posted contractual allowance resolved? - Selected 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? -
Selected Answer-Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what? - Selected 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$? -
Selected Answer-When the patient is the insured
What are non-emergency patients who come for service without prior notification to the
provider called? - Selected Answer-Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what
is the status of the subscriber's spouse? - Selected Answer-Neither enrolled not entitled
to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending
Act, establishes what? - Selected Answer-Disclosure rules for consumer credit sales and
consumer loans
What is a principal diagnosis? - Selected Answer-Primary reason for the patient's
admission
Collecting patient liability dollars after service leads to what? - Selected Answer-Lower
accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? -
Selected Answer-50% of the current deductible amount
What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not
, Certified Revenue Cycle Representative - CRCR
billable as an RHC services? - Selected Answer-Inpatient care
What code indicates the disposition of the patient at the conclusion of service? -
Selected Answer-Patient discharge status code
What are hospitals required to do for Medicare credit balance accounts? -
Selected Answer-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? - Selected Answer-Patient
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the
information provided on the order must include: - Selected Answer-A valid CPT or
HCPCS code
With advances in internet security and encryption, revenue-cycle processes are
expanding to allow patients to do what? - Selected Answer-Access their information
and perform functions on-line
What date is required on all CMS 1500 claim forms? - Selected Answer-onset date of
current illness
What does scheduling allow provider staff to do - Selected Answer-Review
appropriateness of the service request
What code is used to report the provider's most common semiprivate room rate? -
Selected Answer-Condition code
Regulations and requirements for coding accountable care organizations, which allows
providers to begin creating these organizations, were finalized in: - Selected Answer-2012
What is a primary responsibility of the Recover Audit Contractor? - Selected Answer-To
correctly identify proper payments for Medicare Part A & B claims
How must providers handle credit balances? - Selected Answer-Comply with state
statutes concerning reporting credit balance
Insurance verification results in what? - Selected Answer-The accurate identification of
the patient's eligibility and benefits
What form is used to bill Medicare for rural health clinics? - Selected Answer-CMS 1500
TEST 140 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
What are collection agency fees based on? - Selected Answer-A percentage of dollars
collected
Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule? - Selected Answer-Birthday
In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers? - Selected Answer-Case rates
What customer service improvements might improve the patient accounts department?
- Selected Answer-Holding staff accountable for customer service during performance
reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? -
Selected 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? - Selected Answer-Bad debt adjustment
What is the initial hospice benefit? - Selected Answer-Two 90-day periods and an
unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? -
Selected 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? -
Selected Answer-Post a late-charge adjustment to the account
,Certified Revenue Cycle Representative - CRCR
an increase in the dollars aged greater than 90 days from date of service indicate what
about accounts - Selected Answer-They are not being processed in a timely manner
What is an advantage of a preregistration program? - Selected Answer-It reduces
processing times at the time of service
What are the two statutory exclusions from hospice coverage? - Selected Answer-
Medically unnecessary services and custodial care
,Certified Revenue Cycle Representative - CRCR
What core financial activities are resolved within patient access? - Selected Answer-
Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
What statement applies to the scheduled outpatient? - Selected Answer-The services do
not involve an overnight stay
How is a mis-posted contractual allowance resolved? - Selected 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? -
Selected Answer-Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what? - Selected 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$? -
Selected Answer-When the patient is the insured
What are non-emergency patients who come for service without prior notification to the
provider called? - Selected Answer-Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what
is the status of the subscriber's spouse? - Selected Answer-Neither enrolled not entitled
to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending
Act, establishes what? - Selected Answer-Disclosure rules for consumer credit sales and
consumer loans
What is a principal diagnosis? - Selected Answer-Primary reason for the patient's
admission
Collecting patient liability dollars after service leads to what? - Selected Answer-Lower
accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used? -
Selected Answer-50% of the current deductible amount
What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not
, Certified Revenue Cycle Representative - CRCR
billable as an RHC services? - Selected Answer-Inpatient care
What code indicates the disposition of the patient at the conclusion of service? -
Selected Answer-Patient discharge status code
What are hospitals required to do for Medicare credit balance accounts? -
Selected Answer-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? - Selected Answer-Patient
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the
information provided on the order must include: - Selected Answer-A valid CPT or
HCPCS code
With advances in internet security and encryption, revenue-cycle processes are
expanding to allow patients to do what? - Selected Answer-Access their information
and perform functions on-line
What date is required on all CMS 1500 claim forms? - Selected Answer-onset date of
current illness
What does scheduling allow provider staff to do - Selected Answer-Review
appropriateness of the service request
What code is used to report the provider's most common semiprivate room rate? -
Selected Answer-Condition code
Regulations and requirements for coding accountable care organizations, which allows
providers to begin creating these organizations, were finalized in: - Selected Answer-2012
What is a primary responsibility of the Recover Audit Contractor? - Selected Answer-To
correctly identify proper payments for Medicare Part A & B claims
How must providers handle credit balances? - Selected Answer-Comply with state
statutes concerning reporting credit balance
Insurance verification results in what? - Selected Answer-The accurate identification of
the patient's eligibility and benefits
What form is used to bill Medicare for rural health clinics? - Selected Answer-CMS 1500
