CRCR Certification
PERP · RCRC
★ $ ★
CRCR Certified Revenue Cycle Representative
EST. 2005
EXCELLENCE IN REVENUE CYCLE MANAGEMENT
CRCR Exam Prep — HFMA Certification
R E V E N U E CYC L E M A N AG E M E N T — CO M P R E H E N S I V E R E V I E W
INSTITUTION CRCR Certification COURSE CODE CRCR Prep
PROGRAM Revenue Cycle Certification ACADEMIC YEAR
EXAM TITLE HFMA Certification Prep TOTAL QUESTIONS 71 Questions
COURSE TITLE Revenue Cycle Management FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover revenue cycle management principles and regulations.
▸ Topics include Medicare, Medicaid, HIPAA, and financial management.
▸ Correct answers and detailed rationales appear below each question.
▸ All content reflects current HFMA and healthcare finance standards.
, SECTION I — REVENUE CYCLE MANAGEMENT Questions 1 – 71
1. In what situation(s) should a provider NOT use a modifier?
A. CPT already indicates 2-4 lesions
B. CPT indicates multiple extremities
C. Both A and B
D. When services are performed on separate days
CORRECT ANSWER C — Both A and B
RATIONALE Modifiers should not be used when the CPT code already indicates 2-4 lesions or
multiple extremities. The CPT code itself already provides the specificity needed
for billing.
2. What are other names for the Three-Day Payment Window?
A. 72-hour rule
B. DRG window
C. Three-Day Window
D. All of the above
CORRECT ANSWER D — All of the above
RATIONALE The Three-Day Payment Window is also known as the 72-hour rule, DRG window,
Three-Day Window, and in some cases the 1-day window or 24-hour rule.
,3. What happens during the post-service stage?
A. Final coding, preparation and submission of claims, payment processing, balance billing
and resolution
B. Patient registration and insurance verification
C. Clinical treatment and patient care
D. Scheduling and pre-registration
CORRECT ANSWER A — Final coding, preparation and submission of claims, payment
processing, balance billing and resolution
RATIONALE The post-service stage includes final coding, claim preparation and submission,
payment processing, and balance billing and resolution activities.
4. The following tasks are part of what initiative? - Educate patients - Coordinate to avoid
duplicate patient contacts - Be consistent in key aspects of account resolution - Follow
best practices for communication
A. Medical Debt Task Force Best Practices
B. HFMA Patient Financial Communications
C. OIG Compliance Work Plan
D. CMS Conditions of Participation
CORRECT ANSWER A — Medical Debt Task Force Best Practices
RATIONALE These tasks are part of the Medical Debt Task Force best practices, which focus on
patient education, coordination, consistency, and communication in account
resolution.
, 5. Which option is NOT a main HFMA Healthcare Dollars & Sense® revenue cycle initiative?
A. Patient Financial Communications
B. Price Transparency
C. Medical Account Resolution
D. Process Compliance
CORRECT ANSWER D — Process Compliance
RATIONALE Process Compliance is NOT a main HFMA Healthcare Dollars & Sense revenue
cycle initiative. The main initiatives are Patient Financial Communications, Price
Transparency, and Medical Account Resolution.
6. Which option is NOT a continuum of care provider?
A. Physician
B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
CORRECT ANSWER B — Health Plan Contracting
RATIONALE Health Plan Contracting is NOT a continuum of care provider. Physicians,
hospices, and skilled nursing facilities are providers within the continuum of care.
Health Plan Contracting is an administrative function.
7. What is "implied certification"?
A. When it is implied that a provider met all compliance standards before submitting a claim
B. When a provider certifies compliance after claim submission
C. When a payer assumes compliance without verification
D. When a patient certifies the services received
CORRECT ANSWER A — When it is implied that a provider met all compliance standards before
submitting a claim
RATIONALE Implied certification means that by submitting a claim, the provider implicitly
certifies that they have met all compliance standards and regulations.
PERP · RCRC
★ $ ★
CRCR Certified Revenue Cycle Representative
EST. 2005
EXCELLENCE IN REVENUE CYCLE MANAGEMENT
CRCR Exam Prep — HFMA Certification
R E V E N U E CYC L E M A N AG E M E N T — CO M P R E H E N S I V E R E V I E W
INSTITUTION CRCR Certification COURSE CODE CRCR Prep
PROGRAM Revenue Cycle Certification ACADEMIC YEAR
EXAM TITLE HFMA Certification Prep TOTAL QUESTIONS 71 Questions
COURSE TITLE Revenue Cycle Management FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover revenue cycle management principles and regulations.
▸ Topics include Medicare, Medicaid, HIPAA, and financial management.
▸ Correct answers and detailed rationales appear below each question.
▸ All content reflects current HFMA and healthcare finance standards.
, SECTION I — REVENUE CYCLE MANAGEMENT Questions 1 – 71
1. In what situation(s) should a provider NOT use a modifier?
A. CPT already indicates 2-4 lesions
B. CPT indicates multiple extremities
C. Both A and B
D. When services are performed on separate days
CORRECT ANSWER C — Both A and B
RATIONALE Modifiers should not be used when the CPT code already indicates 2-4 lesions or
multiple extremities. The CPT code itself already provides the specificity needed
for billing.
2. What are other names for the Three-Day Payment Window?
A. 72-hour rule
B. DRG window
C. Three-Day Window
D. All of the above
CORRECT ANSWER D — All of the above
RATIONALE The Three-Day Payment Window is also known as the 72-hour rule, DRG window,
Three-Day Window, and in some cases the 1-day window or 24-hour rule.
,3. What happens during the post-service stage?
A. Final coding, preparation and submission of claims, payment processing, balance billing
and resolution
B. Patient registration and insurance verification
C. Clinical treatment and patient care
D. Scheduling and pre-registration
CORRECT ANSWER A — Final coding, preparation and submission of claims, payment
processing, balance billing and resolution
RATIONALE The post-service stage includes final coding, claim preparation and submission,
payment processing, and balance billing and resolution activities.
4. The following tasks are part of what initiative? - Educate patients - Coordinate to avoid
duplicate patient contacts - Be consistent in key aspects of account resolution - Follow
best practices for communication
A. Medical Debt Task Force Best Practices
B. HFMA Patient Financial Communications
C. OIG Compliance Work Plan
D. CMS Conditions of Participation
CORRECT ANSWER A — Medical Debt Task Force Best Practices
RATIONALE These tasks are part of the Medical Debt Task Force best practices, which focus on
patient education, coordination, consistency, and communication in account
resolution.
, 5. Which option is NOT a main HFMA Healthcare Dollars & Sense® revenue cycle initiative?
A. Patient Financial Communications
B. Price Transparency
C. Medical Account Resolution
D. Process Compliance
CORRECT ANSWER D — Process Compliance
RATIONALE Process Compliance is NOT a main HFMA Healthcare Dollars & Sense revenue
cycle initiative. The main initiatives are Patient Financial Communications, Price
Transparency, and Medical Account Resolution.
6. Which option is NOT a continuum of care provider?
A. Physician
B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
CORRECT ANSWER B — Health Plan Contracting
RATIONALE Health Plan Contracting is NOT a continuum of care provider. Physicians,
hospices, and skilled nursing facilities are providers within the continuum of care.
Health Plan Contracting is an administrative function.
7. What is "implied certification"?
A. When it is implied that a provider met all compliance standards before submitting a claim
B. When a provider certifies compliance after claim submission
C. When a payer assumes compliance without verification
D. When a patient certifies the services received
CORRECT ANSWER A — When it is implied that a provider met all compliance standards before
submitting a claim
RATIONALE Implied certification means that by submitting a claim, the provider implicitly
certifies that they have met all compliance standards and regulations.
