HFMA CRCR Final and Practice Exam Test Bank
Questions with 100% Correct Verified Detailed
Answers 2025/2026 Edition
Introduction:
This document provides the complete collection of HFMA CRCR
(Certified Revenue Cycle Representative) final and practice exam
test bank questions with 100% verified and detailed answers for
the 2025-2026 edition. It covers compliance, Medicare and
Medicaid rules, billing processes, insurance verification, coding
standards, revenue cycle best practices, and patient financial
communication guidelines. The material is designed to help
students and professionals prepare thoroughly for the HFMA CRCR
exam.
Exam Questions and Answers:
Through what document does a hospital establish compliance
standards? --- correct answer ---code of conduct
What is the purpose OIG work plant? --- correct answer ---Identify
Acceptable compliance programs in various provider setting
,If a Medicare patient is admitted on Friday, what services fall
within the three-day DRG window rule? --- correct answer ---Non-
diagnostic service provided on Tuesday through Friday
What does a modifier allow a provider to do? --- correct answer ---
Report a specific circumstance that affected a procedure or service
without changing the code or its definition
IF outpatient diagnostic services are provided within three days of
the admission of a Medicare beneficiary to an IPPS (Inpatient
Prospective Payment System) hospital, what must happen to these
charges --- correct answer ---They must be billed separately to the
part B Carrier
what is a recurring or series registration? --- correct answer ---One
registration record is created for multiple days of service
What are nonemergency patients who come for service without
prior notification to the provider called? --- correct answer ---
Unscheduled patients
Which of the following statement apply to the observation patient
type? --- correct answer ---It is used to evaluate the need for an
inpatient admission
,which services are hospice programs required to provide around
the clock patient --- correct answer ---Physician, Nursing,
Pharmacy
Scheduler instructions are used to prompt the scheduler to do
what? --- correct answer ---Complete the scheduling process
correctly based on service requeste
The Time needed to prepare the patient before service is the
difference between the patients arrival time and which of the
following? --- correct answer ---Procedure time
Medicare guidelines require that when a test is ordered for a LCD
or NCD exists, the information provided on the order must include:
--- correct answer ---Documentation of the medical necessity for
the test
What is the advantage of a pre-registration program --- correct
answer ---It reduces processing times at the time of service
What date are required to establish a new MPI(Master patient
Index) entry --- correct answer ---The responsible party's full legal
name, date of birth, and social security number
, Which of the following statements is true about third-party
payments? --- correct answer ---The payments are received by the
provider from the payer responsible for reimbursing the provider
for the patient's covered services.
Which provision protects the patient from medical expenses that
exceed the pre-set level --- correct answer ---stop loss
what documentation must a primary care physician send to HMO
patient to authorize a visit to a specialist for additional testing or
care? --- correct answer ---Referral
Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance
information if it would delay what? --- correct answer ---Medical
screening and stabilizing treatment
Which of the following is a step in the discharge process? ---
correct answer ---Have a case management service complete the
discharge plan
The hospital has a APC based contract for the payment of outpatient
services. Total anticipated charges for the visit are $2,380. The
approved APC payment rate is $780. Where will the patients benefit
Questions with 100% Correct Verified Detailed
Answers 2025/2026 Edition
Introduction:
This document provides the complete collection of HFMA CRCR
(Certified Revenue Cycle Representative) final and practice exam
test bank questions with 100% verified and detailed answers for
the 2025-2026 edition. It covers compliance, Medicare and
Medicaid rules, billing processes, insurance verification, coding
standards, revenue cycle best practices, and patient financial
communication guidelines. The material is designed to help
students and professionals prepare thoroughly for the HFMA CRCR
exam.
Exam Questions and Answers:
Through what document does a hospital establish compliance
standards? --- correct answer ---code of conduct
What is the purpose OIG work plant? --- correct answer ---Identify
Acceptable compliance programs in various provider setting
,If a Medicare patient is admitted on Friday, what services fall
within the three-day DRG window rule? --- correct answer ---Non-
diagnostic service provided on Tuesday through Friday
What does a modifier allow a provider to do? --- correct answer ---
Report a specific circumstance that affected a procedure or service
without changing the code or its definition
IF outpatient diagnostic services are provided within three days of
the admission of a Medicare beneficiary to an IPPS (Inpatient
Prospective Payment System) hospital, what must happen to these
charges --- correct answer ---They must be billed separately to the
part B Carrier
what is a recurring or series registration? --- correct answer ---One
registration record is created for multiple days of service
What are nonemergency patients who come for service without
prior notification to the provider called? --- correct answer ---
Unscheduled patients
Which of the following statement apply to the observation patient
type? --- correct answer ---It is used to evaluate the need for an
inpatient admission
,which services are hospice programs required to provide around
the clock patient --- correct answer ---Physician, Nursing,
Pharmacy
Scheduler instructions are used to prompt the scheduler to do
what? --- correct answer ---Complete the scheduling process
correctly based on service requeste
The Time needed to prepare the patient before service is the
difference between the patients arrival time and which of the
following? --- correct answer ---Procedure time
Medicare guidelines require that when a test is ordered for a LCD
or NCD exists, the information provided on the order must include:
--- correct answer ---Documentation of the medical necessity for
the test
What is the advantage of a pre-registration program --- correct
answer ---It reduces processing times at the time of service
What date are required to establish a new MPI(Master patient
Index) entry --- correct answer ---The responsible party's full legal
name, date of birth, and social security number
, Which of the following statements is true about third-party
payments? --- correct answer ---The payments are received by the
provider from the payer responsible for reimbursing the provider
for the patient's covered services.
Which provision protects the patient from medical expenses that
exceed the pre-set level --- correct answer ---stop loss
what documentation must a primary care physician send to HMO
patient to authorize a visit to a specialist for additional testing or
care? --- correct answer ---Referral
Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance
information if it would delay what? --- correct answer ---Medical
screening and stabilizing treatment
Which of the following is a step in the discharge process? ---
correct answer ---Have a case management service complete the
discharge plan
The hospital has a APC based contract for the payment of outpatient
services. Total anticipated charges for the visit are $2,380. The
approved APC payment rate is $780. Where will the patients benefit
