CRCR Certification - Revenue Cycle
Management Examination
1. How are overall aggregate payments made to a hospice regulated?
A. They are subject to a fixed annual fee set by the state.
B. They are subject to a computed "cap amount" acalculated by Each state's Medicaid plan
C. They are determined by the hospice's annual cost report.
D. They are negotiated directly with the Medicare Administrative Contractor (MAC).
Correct Answer: B
Rationale: The content states that overall aggregate payments to a hospice are subject to a
computed "cap amount" calculated by each state's Medicaid plan.
2. Which of the following is a fundamental requirement for an individual to participate in
Medicaid?
A. Hold private insurance concurrently.
B. Be over the age of 65.
C. Meet income and assets requirements
D. Have a qualifying permanent disability.
Correct Answer: C
Rationale: The content explicitly lists "Meet Income and Assets Requirements" as a requirement
for participation in Medicaid.
3. What is the primary consideration when choosing a setting for patient financial
discussions?
A. The convenience of the hospital staff.
,B. The availability of financial documents.
C. Respect the patients privacy
D. The proximity to the clinical treatment area.
Correct Answer: C
Rationale: The content specifies that organizations should first and foremost respect the patient's
privacy when choosing a setting for these discussions.
4. A nightly room charge will be incorrect if which of the following occurs?
A. The patient's diet order is not updated.
B. The patient's transfer from ICU to the Medical/Surgical floor is not reflected in the
registration system
C. The patient receives visitors after hours.
D. The patient is prescribed a new medication.
Correct Answer: B
Rationale: The content directly states that a nightly room charge will be incorrect if a transfer
from the ICU is not reflected in the registration system.
5. What was a key development legislated by the Affordable Care Act?
A. The creation of a single-payer health system.
B. The development of Health Insurance Exchanges, where individuals and small businesses can
purchase qualified health benefit plans regardless of insured's health status
C. The mandatory enrollment of all citizens in a health plan.
D. The direct provision of insurance by the federal government.
,Correct Answer: B
Rationale: The content describes the development of Health Insurance Exchanges by the ACA
for the purpose of purchasing plans regardless of health status.
6. Which of the following represents a portion of the accounts receivable inventory that has
NOT qualified for billing?
A. Insurance claims awaiting adjudication.
B. Patient payment plans.
C. Charitable pledges
D. Secondary insurance claims.
Correct Answer: C
Rationale: The content identifies "Charitable pledges" as a part of accounts receivable that has
not qualified for billing.
7. What is required for the UB-04/837-I to generate payment from Medicare for Rural
Health Clinics?
A. CPT codes.
B. Revenue codes
C. Place of Service codes.
D. Modifiers.
Correct Answer: B
Rationale: The content states that revenue codes are required on the UB-04/837-I for Rural
Health Clinics to generate Medicare payment.
, 8. Which directive was developed to promote healthcare quality, value, and to protect
consumers and workers?
A. The Healthcare Compliance Directive.
B. Patient bill of rights
C. The Affordable Care Act.
D. The HIPAA Privacy Rule.
Correct Answer: B
Rationale: The content defines the "Patient bill of rights" as the directive developed for these
purposes.
9. What is the activity that involves the real-time recording of patient bed status, level of
care, and discharge?
A. Patient registration.
B. Case management
C. Clinical documentation.
D. Utilization review.
Correct Answer: B
Rationale: The content defines this real-time activity as "case management."
10. Which of the following scenarios is a violation of EMTALA?
A. Asking for insurance information after a medical screening exam.
B. Registration staff may routinely contact managed care plans for prior authorizations before
the patient is seen by the on-duty physician
Management Examination
1. How are overall aggregate payments made to a hospice regulated?
A. They are subject to a fixed annual fee set by the state.
B. They are subject to a computed "cap amount" acalculated by Each state's Medicaid plan
C. They are determined by the hospice's annual cost report.
D. They are negotiated directly with the Medicare Administrative Contractor (MAC).
Correct Answer: B
Rationale: The content states that overall aggregate payments to a hospice are subject to a
computed "cap amount" calculated by each state's Medicaid plan.
2. Which of the following is a fundamental requirement for an individual to participate in
Medicaid?
A. Hold private insurance concurrently.
B. Be over the age of 65.
C. Meet income and assets requirements
D. Have a qualifying permanent disability.
Correct Answer: C
Rationale: The content explicitly lists "Meet Income and Assets Requirements" as a requirement
for participation in Medicaid.
3. What is the primary consideration when choosing a setting for patient financial
discussions?
A. The convenience of the hospital staff.
,B. The availability of financial documents.
C. Respect the patients privacy
D. The proximity to the clinical treatment area.
Correct Answer: C
Rationale: The content specifies that organizations should first and foremost respect the patient's
privacy when choosing a setting for these discussions.
4. A nightly room charge will be incorrect if which of the following occurs?
A. The patient's diet order is not updated.
B. The patient's transfer from ICU to the Medical/Surgical floor is not reflected in the
registration system
C. The patient receives visitors after hours.
D. The patient is prescribed a new medication.
Correct Answer: B
Rationale: The content directly states that a nightly room charge will be incorrect if a transfer
from the ICU is not reflected in the registration system.
5. What was a key development legislated by the Affordable Care Act?
A. The creation of a single-payer health system.
B. The development of Health Insurance Exchanges, where individuals and small businesses can
purchase qualified health benefit plans regardless of insured's health status
C. The mandatory enrollment of all citizens in a health plan.
D. The direct provision of insurance by the federal government.
,Correct Answer: B
Rationale: The content describes the development of Health Insurance Exchanges by the ACA
for the purpose of purchasing plans regardless of health status.
6. Which of the following represents a portion of the accounts receivable inventory that has
NOT qualified for billing?
A. Insurance claims awaiting adjudication.
B. Patient payment plans.
C. Charitable pledges
D. Secondary insurance claims.
Correct Answer: C
Rationale: The content identifies "Charitable pledges" as a part of accounts receivable that has
not qualified for billing.
7. What is required for the UB-04/837-I to generate payment from Medicare for Rural
Health Clinics?
A. CPT codes.
B. Revenue codes
C. Place of Service codes.
D. Modifiers.
Correct Answer: B
Rationale: The content states that revenue codes are required on the UB-04/837-I for Rural
Health Clinics to generate Medicare payment.
, 8. Which directive was developed to promote healthcare quality, value, and to protect
consumers and workers?
A. The Healthcare Compliance Directive.
B. Patient bill of rights
C. The Affordable Care Act.
D. The HIPAA Privacy Rule.
Correct Answer: B
Rationale: The content defines the "Patient bill of rights" as the directive developed for these
purposes.
9. What is the activity that involves the real-time recording of patient bed status, level of
care, and discharge?
A. Patient registration.
B. Case management
C. Clinical documentation.
D. Utilization review.
Correct Answer: B
Rationale: The content defines this real-time activity as "case management."
10. Which of the following scenarios is a violation of EMTALA?
A. Asking for insurance information after a medical screening exam.
B. Registration staff may routinely contact managed care plans for prior authorizations before
the patient is seen by the on-duty physician
