CRCR Certification Real Exam (Questionbank) Testbank
(2025–2026), Complete Verified Question & Answer
Collection
Introduction
This document contains a comprehensive question bank for the CRCR
(Certified Revenue Cycle Representative) certification exam, covering
verified exam-style questions with precise, validated answers. It
includes a wide range of revenue cycle management topics such as
Medicare rules, billing processes, reimbursement methodologies,
patient access, compliance, and healthcare regulations. The material
is structured to mirror real exam content, making it suitable for
complete exam preparation and self-assessment.
Exam Questions and Answers
The Medicare fee-for service appeal process for both beneficiaries
and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for
Medicare
d) Review by the Medicare Appeals Council (Appeals Council) ---
correct precise answer ---B
,Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct --- correct precise answer ---A
A portion of the accounts receivable inventory which has NOT
qualified for billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency --- correct precise
answer ---A
Local Coverage Determinations (LCD) and National Coverage
Determinations (NCD) are
Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
,b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred to
Medicaid --- correct precise answer ---C
Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date --- correct precise answer ---C
Patients are contacting hospitals to proactively inquire about costs
and fees prior to
agreeing to service. The problem for hospitals in providing such
information is:
a) That hospitals don't want to establish a price without knowing if
the patient has insurance and how much reimbursement can be
expected
b) The fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
, c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information --- correct
precise answer ---B
Across all care settings, if a patient consents to a financial
discussion during a medical
encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer questions and
assist in obtaining required patient financial data
b) Have a patient financial responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt patient
care and patient flow --- correct precise answer ---C
A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
(2025–2026), Complete Verified Question & Answer
Collection
Introduction
This document contains a comprehensive question bank for the CRCR
(Certified Revenue Cycle Representative) certification exam, covering
verified exam-style questions with precise, validated answers. It
includes a wide range of revenue cycle management topics such as
Medicare rules, billing processes, reimbursement methodologies,
patient access, compliance, and healthcare regulations. The material
is structured to mirror real exam content, making it suitable for
complete exam preparation and self-assessment.
Exam Questions and Answers
The Medicare fee-for service appeal process for both beneficiaries
and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for
Medicare
d) Review by the Medicare Appeals Council (Appeals Council) ---
correct precise answer ---B
,Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct --- correct precise answer ---A
A portion of the accounts receivable inventory which has NOT
qualified for billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency --- correct precise
answer ---A
Local Coverage Determinations (LCD) and National Coverage
Determinations (NCD) are
Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
,b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred to
Medicaid --- correct precise answer ---C
Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date --- correct precise answer ---C
Patients are contacting hospitals to proactively inquire about costs
and fees prior to
agreeing to service. The problem for hospitals in providing such
information is:
a) That hospitals don't want to establish a price without knowing if
the patient has insurance and how much reimbursement can be
expected
b) The fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
, c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information --- correct
precise answer ---B
Across all care settings, if a patient consents to a financial
discussion during a medical
encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer questions and
assist in obtaining required patient financial data
b) Have a patient financial responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt patient
care and patient flow --- correct precise answer ---C
A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
