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HFMA CRCR 2025 BRAND NEW ACTUAL
EXAM WITH ANSWERS.
1. If the insurance verification response reports that a subscriber
has a single policy, what is the status of the subscriber's
spouse? - correct answers -Neither enrolled not entitled to
benefits
2. Regulation Z of the consumer Credit Protection Act, also known
as the Truth in lending Act establishes what? - correct answers
-Disclosure rules for consumer credit sales and consumer
loans
3. What is a principle diagnosis? - correct answers -Primary
reason for the patients admission
4. Collecting patient liability dollars after service leads to what? -
correct answers -Lower accounts receivable levels
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5. What is the daily out-of-pocket amount for each lifetime reserve
day used? - correct answers -50% of the current deductible
amount
6. What service provided to a Medicare beneficiary in a rural
health clinic(RHC) is not billable as an RHC service? - correct
answers -Inpatient care
7. What code indicates the disposition of the patient at the
conclusion of service? - correct answers -Patient discharge
status code
8. What are hospitals required to do for Medicare credit balance
accounts? - correct answers -They result in lost reimbursement
and additional cost to collect.
9. When an undue delay of payment results from a dispute
between the patient and the third party payer, who is
responsible for payment? - correct answers -Patient
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10. With advances in internet security and encryption, revenue-
cycle processes are expanding to allow patients to do what? -
correct answers -Access their information and perform
functions on-line
11. What date is required on all CMS 1500 claim forms? -
correct answers -onset date of current illness
12. What code is used to report the provider's most common
semiprivate room rate? - correct answers -Condition code
13. Regulations and requirements for coding accountable care
organizations which allows providers to begin creating these
organizations were finalized in - correct answers -2012
14. What is a primary responsibility of the recover audit
contractor? - correct answers -To correctly identify proper
payments for Medicare part A and B claims
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15. How must providers handle credit balances? - correct
answers -Comply with state statutes concerning reporting credit
balance
16. What activities are completed when a scheduled pre-
registered patient arrives for service? - correct answers -
Registering the patient and directing the patient to the service
area
17. In addition to being supported by information found in the
patients chart, a CMS 1500 claim must be coded using what? -
correct answers -HCPCS
18. What results from a denied claim? - correct answers -The
provider incurs rework and appeal costs
19. Through what document does a hospital establish
compliance standards? - correct answers -code of conduct
HFMA CRCR 2025 BRAND NEW ACTUAL
EXAM WITH ANSWERS.
1. If the insurance verification response reports that a subscriber
has a single policy, what is the status of the subscriber's
spouse? - correct answers -Neither enrolled not entitled to
benefits
2. Regulation Z of the consumer Credit Protection Act, also known
as the Truth in lending Act establishes what? - correct answers
-Disclosure rules for consumer credit sales and consumer
loans
3. What is a principle diagnosis? - correct answers -Primary
reason for the patients admission
4. Collecting patient liability dollars after service leads to what? -
correct answers -Lower accounts receivable levels
, Page | 2
5. What is the daily out-of-pocket amount for each lifetime reserve
day used? - correct answers -50% of the current deductible
amount
6. What service provided to a Medicare beneficiary in a rural
health clinic(RHC) is not billable as an RHC service? - correct
answers -Inpatient care
7. What code indicates the disposition of the patient at the
conclusion of service? - correct answers -Patient discharge
status code
8. What are hospitals required to do for Medicare credit balance
accounts? - correct answers -They result in lost reimbursement
and additional cost to collect.
9. When an undue delay of payment results from a dispute
between the patient and the third party payer, who is
responsible for payment? - correct answers -Patient
, Page | 3
10. With advances in internet security and encryption, revenue-
cycle processes are expanding to allow patients to do what? -
correct answers -Access their information and perform
functions on-line
11. What date is required on all CMS 1500 claim forms? -
correct answers -onset date of current illness
12. What code is used to report the provider's most common
semiprivate room rate? - correct answers -Condition code
13. Regulations and requirements for coding accountable care
organizations which allows providers to begin creating these
organizations were finalized in - correct answers -2012
14. What is a primary responsibility of the recover audit
contractor? - correct answers -To correctly identify proper
payments for Medicare part A and B claims
, Page | 4
15. How must providers handle credit balances? - correct
answers -Comply with state statutes concerning reporting credit
balance
16. What activities are completed when a scheduled pre-
registered patient arrives for service? - correct answers -
Registering the patient and directing the patient to the service
area
17. In addition to being supported by information found in the
patients chart, a CMS 1500 claim must be coded using what? -
correct answers -HCPCS
18. What results from a denied claim? - correct answers -The
provider incurs rework and appeal costs
19. Through what document does a hospital establish
compliance standards? - correct answers -code of conduct
