HFMA CRCR NEWEST EXAM LATEST EXAM 200+ QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS) 2026/2027
UPDATE | INSTANT PDF DOWNLOAD
What the CRCR Exam Covers
The HFMA CRCR certification focuses on end-to-end healthcare revenue cycle knowledge,
including how hospitals and providers get paid correctly and compliantly.
Core domains:
Patient access (registration, eligibility, financial clearance)
Charge capture and clinical documentation
Medical coding (ICD-10, CPT basics)
Claims submission and billing
Insurance follow-up and denial management
Payment posting and reconciliation
Patient collections and financial counseling
Compliance (HIPAA, billing regulations, payer rules)
Revenue cycle performance improvement
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 package be applied? - ANSWER👀 To the approved
APC payment rate
A patient has met the $200 individual deductible and $900 of the $1000 co-insurance
responsibility. The co-insurance rate is 20%. The estimated insurance plan
responsibility is $1975.00. What amount of coinsurance is due from the patient? -
ANSWER👀 $100.00
,When is a patient considered to be medically indigent? - ANSWER👀 The patient's
outstanding medical bills exceed a defined dollar amount or percentage of assets.
What patient assets are considered in the financial assistance application? -
ANSWER👀 Sources of readily available funds , vehicles, campers, boats and saving
accounts
If the patient cannot agree to payment arrangements, What is the next option? -
ANSWER👀 Warn the patient that unpaid accounts are placed with collection
agencies for further processing
What core financial activities are resolved within patient access? - ANSWER👀
scheduling , pre-registration, insurance verification and managed care processing
What is an unscheduled direct admission? - ANSWER👀 A patient who arrives at the
hospital via ambulance for treatment in the emergency department
When is it not appropriate to use observation status? - ANSWER👀 As a substitute
for an inpatient admission
Patients who require periodic skilled nursing or therapeutic care receive services
from what type of program? - ANSWER👀 Home health agency
Every patient who is new to the healthcare provider must be offered what? -
ANSWER👀 A printed copy of the provider privacy notice
Which of the following statements apples to self insured insurance plans? -
ANSWER👀 The employer provides a traditional HMO health plan
, In addition to the member's identification number, what information is recorded in a
270 transaction - ANSWER👀 Name
What process does a patient's health plan use to retroactively collect payments from
liability automobile or worker's compensation plan? - ANSWER👀 Subrogation
In what type of payment methodology is a lump sum of bundled payment negotiated
between the payer and some or all providers? - ANSWER👀 DRG/Case rate
What Restriction does a managed care plan place on locations that must be used if
the plan is to pay for the service provided? - ANSWER👀 Site of service limitation
Which of the following statements applies to private rooms? - ANSWER👀 If the
medical necessity for a private room is documented in the chart. The patients
insurance will be billed for the differential
Which of the following is true about screening a beneficiary of possible
MSP(Medicare secondary payer) situations? - ANSWER👀 It is necessary to ask the
patient each of the MSP questions
Through what document does a hospital establish compliance standards? -
ANSWER👀 code of conduct
What is the purpose OIG work plant? - ANSWER👀 Identify Acceptable compliance
programs in various provider setting
AND CORRECT ANSWERS (VERIFIED ANSWERS) 2026/2027
UPDATE | INSTANT PDF DOWNLOAD
What the CRCR Exam Covers
The HFMA CRCR certification focuses on end-to-end healthcare revenue cycle knowledge,
including how hospitals and providers get paid correctly and compliantly.
Core domains:
Patient access (registration, eligibility, financial clearance)
Charge capture and clinical documentation
Medical coding (ICD-10, CPT basics)
Claims submission and billing
Insurance follow-up and denial management
Payment posting and reconciliation
Patient collections and financial counseling
Compliance (HIPAA, billing regulations, payer rules)
Revenue cycle performance improvement
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 package be applied? - ANSWER👀 To the approved
APC payment rate
A patient has met the $200 individual deductible and $900 of the $1000 co-insurance
responsibility. The co-insurance rate is 20%. The estimated insurance plan
responsibility is $1975.00. What amount of coinsurance is due from the patient? -
ANSWER👀 $100.00
,When is a patient considered to be medically indigent? - ANSWER👀 The patient's
outstanding medical bills exceed a defined dollar amount or percentage of assets.
What patient assets are considered in the financial assistance application? -
ANSWER👀 Sources of readily available funds , vehicles, campers, boats and saving
accounts
If the patient cannot agree to payment arrangements, What is the next option? -
ANSWER👀 Warn the patient that unpaid accounts are placed with collection
agencies for further processing
What core financial activities are resolved within patient access? - ANSWER👀
scheduling , pre-registration, insurance verification and managed care processing
What is an unscheduled direct admission? - ANSWER👀 A patient who arrives at the
hospital via ambulance for treatment in the emergency department
When is it not appropriate to use observation status? - ANSWER👀 As a substitute
for an inpatient admission
Patients who require periodic skilled nursing or therapeutic care receive services
from what type of program? - ANSWER👀 Home health agency
Every patient who is new to the healthcare provider must be offered what? -
ANSWER👀 A printed copy of the provider privacy notice
Which of the following statements apples to self insured insurance plans? -
ANSWER👀 The employer provides a traditional HMO health plan
, In addition to the member's identification number, what information is recorded in a
270 transaction - ANSWER👀 Name
What process does a patient's health plan use to retroactively collect payments from
liability automobile or worker's compensation plan? - ANSWER👀 Subrogation
In what type of payment methodology is a lump sum of bundled payment negotiated
between the payer and some or all providers? - ANSWER👀 DRG/Case rate
What Restriction does a managed care plan place on locations that must be used if
the plan is to pay for the service provided? - ANSWER👀 Site of service limitation
Which of the following statements applies to private rooms? - ANSWER👀 If the
medical necessity for a private room is documented in the chart. The patients
insurance will be billed for the differential
Which of the following is true about screening a beneficiary of possible
MSP(Medicare secondary payer) situations? - ANSWER👀 It is necessary to ask the
patient each of the MSP questions
Through what document does a hospital establish compliance standards? -
ANSWER👀 code of conduct
What is the purpose OIG work plant? - ANSWER👀 Identify Acceptable compliance
programs in various provider setting
