Page 1 of 108
HFMA CRCR EXAM TEST | CONTAINS 4 DIFFERENT
ALREADY TESTED VERSIONS WITH EXPERT VERIFIED
QUESTIONS AND ANSWERS | GUARANTEED PASS|
ALREADY GRADED A | LATEST UPDATE 2025 |
INCLUDES A STUDY GUIDE AND ANSWER KEY AT THE
END
What are collection agency fees based on? ......ANSWER........A
percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits
using the gender rule or what other rule?
......ANSWER........Birthday
In what type of payment methodology is a lump sum or bundled
coverage? ......ANSWER........Medically unnecessary services and
custodial care payment negotiated between the payer and some
or all providers? ......ANSWER........Case rates
What customer service improvements might improve the patient
accounts department? ......ANSWER........Holding staff accountable
for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage)
required to do? ......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?
......ANSWER........Bad debt adjustment
,Page 2 of 108
What is the initial hospice benefit? ......ANSWER........Two 90-day
periods and an unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare
inpatient claim? ......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? ......ANSWER........Post a late-charge
adjustment to the account
an increase in the dollars aged greater than 90 days from date
of service indicate what about accounts ......ANSWER........They
are not being processed in a timely manner
What is an advantage of a preregistration program?
......ANSWER........It reduces processing times at the time of service
What are the two statutory exclusions from hospice
What core financial activities are resolved within patient access?
......ANSWER........Scheduling, insurance verification, discharge
processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient?
......ANSWER........The services do not involve an overnight stay
How is a mis-posted contractual allowance resolved?
......ANSWER........Comparing the contract reimbursement rates
with the contract on the admittance advice to identify the correct
amount
,Page 3 of 108
What type of patient status is used to evaluate the patient's
need for inpatient care? ......ANSWER........Observation
Coverage rules for Medicare beneficiaries receiving skilled
nursing care require that the beneficiary has received what?
......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$? ......ANSWER........When the patient is the insured
What are non-emergency patients who come for service without
prior notification to the provider called?
......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?
......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?
......ANSWER........Disclosure rules for consumer credit sales and
consumer loans
What is a principal diagnosis? ......ANSWER........Primary reason
for the patient's admission
Collecting patient liability dollars after service leads to what?
......ANSWER........Lower accounts receivable levels
, Page 4 of 108
What is the daily out-of-pocket amount for each lifetime reserve
day used? ......ANSWER........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?
......ANSWER........Inpatient care
What code indicates the disposition of the patient at the
conclusion of service? ......ANSWER........Patient discharge status
code
What are hospitals required to do for Medicare credit balance
accounts? ......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? ......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: ......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?
......ANSWER........Access their information and perform functions
on-line
What date is required on all CMS 1500 claim forms?
......ANSWER........onset date of current illness
HFMA CRCR EXAM TEST | CONTAINS 4 DIFFERENT
ALREADY TESTED VERSIONS WITH EXPERT VERIFIED
QUESTIONS AND ANSWERS | GUARANTEED PASS|
ALREADY GRADED A | LATEST UPDATE 2025 |
INCLUDES A STUDY GUIDE AND ANSWER KEY AT THE
END
What are collection agency fees based on? ......ANSWER........A
percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits
using the gender rule or what other rule?
......ANSWER........Birthday
In what type of payment methodology is a lump sum or bundled
coverage? ......ANSWER........Medically unnecessary services and
custodial care payment negotiated between the payer and some
or all providers? ......ANSWER........Case rates
What customer service improvements might improve the patient
accounts department? ......ANSWER........Holding staff accountable
for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage)
required to do? ......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?
......ANSWER........Bad debt adjustment
,Page 2 of 108
What is the initial hospice benefit? ......ANSWER........Two 90-day
periods and an unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare
inpatient claim? ......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? ......ANSWER........Post a late-charge
adjustment to the account
an increase in the dollars aged greater than 90 days from date
of service indicate what about accounts ......ANSWER........They
are not being processed in a timely manner
What is an advantage of a preregistration program?
......ANSWER........It reduces processing times at the time of service
What are the two statutory exclusions from hospice
What core financial activities are resolved within patient access?
......ANSWER........Scheduling, insurance verification, discharge
processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient?
......ANSWER........The services do not involve an overnight stay
How is a mis-posted contractual allowance resolved?
......ANSWER........Comparing the contract reimbursement rates
with the contract on the admittance advice to identify the correct
amount
,Page 3 of 108
What type of patient status is used to evaluate the patient's
need for inpatient care? ......ANSWER........Observation
Coverage rules for Medicare beneficiaries receiving skilled
nursing care require that the beneficiary has received what?
......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$? ......ANSWER........When the patient is the insured
What are non-emergency patients who come for service without
prior notification to the provider called?
......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?
......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?
......ANSWER........Disclosure rules for consumer credit sales and
consumer loans
What is a principal diagnosis? ......ANSWER........Primary reason
for the patient's admission
Collecting patient liability dollars after service leads to what?
......ANSWER........Lower accounts receivable levels
, Page 4 of 108
What is the daily out-of-pocket amount for each lifetime reserve
day used? ......ANSWER........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?
......ANSWER........Inpatient care
What code indicates the disposition of the patient at the
conclusion of service? ......ANSWER........Patient discharge status
code
What are hospitals required to do for Medicare credit balance
accounts? ......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? ......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: ......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?
......ANSWER........Access their information and perform functions
on-line
What date is required on all CMS 1500 claim forms?
......ANSWER........onset date of current illness
