CRCR CERTIFICATION PRACTICE TEST PAPER
2026 QUESTIONS AND DETAILED SOLUTIONS
100% CORRECT
◉ 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). Answer:
b) Judicial review by a federal district court
◉ 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. Answer: a) The principles and
standards by which organizations operate
,◉ 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. Answer: a) Charitable
pledges
◉ 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.
Answer: c) Which diagnoses, signs, or symptoms are reimbursable
◉ 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. Answer: c) The time it takes to collect
anticipated revenue
◉ 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. Answer: b) The fact
that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
◉ 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 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. Answer: c) Support that choice, providing that the
discussion does not interfere with patient care or disrupt patient flow
◉ A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of regulations
imposed by a government
agency are being met
d) The development of operational policies that correspond to
regulations. Answer: c) Systematic procedures to ensure that the
provisions of regulations imposed by a government
◉ 10. Case Management requires that a case manager be assigned
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
2026 QUESTIONS AND DETAILED SOLUTIONS
100% CORRECT
◉ 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). Answer:
b) Judicial review by a federal district court
◉ 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. Answer: a) The principles and
standards by which organizations operate
,◉ 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. Answer: a) Charitable
pledges
◉ 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.
Answer: c) Which diagnoses, signs, or symptoms are reimbursable
◉ 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. Answer: c) The time it takes to collect
anticipated revenue
◉ 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. Answer: b) The fact
that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
◉ 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 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. Answer: c) Support that choice, providing that the
discussion does not interfere with patient care or disrupt patient flow
◉ A comprehensive "Compliance Program" is defined as
a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of regulations
imposed by a government
agency are being met
d) The development of operational policies that correspond to
regulations. Answer: c) Systematic procedures to ensure that the
provisions of regulations imposed by a government
◉ 10. Case Management requires that a case manager be assigned
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
