HFMA CERTIFIED REVENUE CYCLE
REPRESENTATIVE (CRCR) EXAM PRACTICE
QUESTIONS, ANSWERS AND RATIONALES
LATEST UPDATE!!!
Domain 1: Patient Access / PreService Financial Care (Scheduling, Registration,
Insurance Verification, Authorization)
Question 1
The revenue cycle process begins with which of the following functions?
A) Charge Capture
B) Claim Submission
C) Scheduling
D) Payment Posting
Answer: C) Scheduling
Rationale: The revenue cycle starts before the patient arrives for care. Scheduling is
the initial point of patient access that triggers subsequent functions like registration,
insurance verification, and authorization.
Question 2
,A patient presents for a scheduled outpatient procedure. During registration, the
registrar discovers that the patient's insurance was terminated 3 days ago due to
nonpayment of premium. What is the MOST appropriate action?
A) Proceed with the service as scheduled and bill the patient later
B) Cancel the procedure immediately
C) Notify the clinical team and attempt to contact the patient to discuss financial
responsibility and options before service
D) Change the payer to Self-Pay and proceed
Answer: C) Notify the clinical team and attempt to contact the patient to discuss
financial responsibility and options before service
Rationale: The registrar must ensure financial clearance. Proceeding without
verifying coverage (A) leads to denials. Canceling (B) without notification is poor
customer service. Changing to SelfPay (D) without patient consent violates patient
rights. The correct action is to halt the financial clearance process, notify clinical
staff to avoid resource waste, and counsel the patient regarding their options.
Question 3
Which of the following is a critical component of the "No Surprises Act" regarding
patient estimates?
A) Providing a Good Faith Estimate (GFE) to uninsured or selfpay patients prior to
scheduled services
B) Waiving all deductibles for emergency services
C) Requiring patients to sign a blanket assignment of benefits
D) Eliminating the need for prior authorizations
Answer: A) Providing a Good Faith Estimate (GFE) to uninsured or selfpay patients
prior to scheduled services
,Rationale: The No Surprises Act mandates that uninsured and selfpay patients
receive a GFE of expected charges prior to scheduled services. It also protects
insured patients from surprise balance billing for emergency services or ancillary
care at in network facilities, but it does not eliminate prior authorizations or waive
deductibles.
Question 4
A patient schedules a knee MRI. The scheduler notices the order does not specify
"contrast" or "without contrast." What is the appropriate action?
A) Schedule the exam for "without contrast" by default
B) Ask the patient which they prefer
C) Contact the ordering physician to clarify the order
D) Schedule both to be safe
Answer: C) Contact the ordering physician to clarify the order
Rationale: Clinical ambiguity must be resolved with the ordering provider before
scheduling to ensure appropriate care and billing. Schedulers should not make
clinical determinations.
Question 5
What is the primary purpose of the Medicare Secondary Payer (MSP)
questionnaire?
A) To determine if the patient has a living will
B) To determine if another payer is primary to Medicare
C) To calculate the patient's IRMAA
, D) To verify the patient's primary care physician election
Answer: B) To determine if another payer is primary to Medicare
Rationale: The MSP questionnaire identifies whether Medicare or another insurer
has primary payment responsibility, which is essential for correct claim submission.
Question 6
What is the primary advantage of a preregistration program for the provider?
A) It guarantees payment in full at the time of service
B) Create one registration record for multiple days of service
C) Waive all insurance requirements
D) Eliminate the need for charge capture
Answer: B) Create one registration record for multiple days of service
Rationale: A recurring or series registration allows the provider to establish a single
registration record that covers multiple service dates, reducing redundant data
entry and streamlining the registration process for patients receiving ongoing care.
Question 7
Approximately what percentage of billing information is obtained during patient
registration?
A) 10%
B) 25%
C) 50%
REPRESENTATIVE (CRCR) EXAM PRACTICE
QUESTIONS, ANSWERS AND RATIONALES
LATEST UPDATE!!!
Domain 1: Patient Access / PreService Financial Care (Scheduling, Registration,
Insurance Verification, Authorization)
Question 1
The revenue cycle process begins with which of the following functions?
A) Charge Capture
B) Claim Submission
C) Scheduling
D) Payment Posting
Answer: C) Scheduling
Rationale: The revenue cycle starts before the patient arrives for care. Scheduling is
the initial point of patient access that triggers subsequent functions like registration,
insurance verification, and authorization.
Question 2
,A patient presents for a scheduled outpatient procedure. During registration, the
registrar discovers that the patient's insurance was terminated 3 days ago due to
nonpayment of premium. What is the MOST appropriate action?
A) Proceed with the service as scheduled and bill the patient later
B) Cancel the procedure immediately
C) Notify the clinical team and attempt to contact the patient to discuss financial
responsibility and options before service
D) Change the payer to Self-Pay and proceed
Answer: C) Notify the clinical team and attempt to contact the patient to discuss
financial responsibility and options before service
Rationale: The registrar must ensure financial clearance. Proceeding without
verifying coverage (A) leads to denials. Canceling (B) without notification is poor
customer service. Changing to SelfPay (D) without patient consent violates patient
rights. The correct action is to halt the financial clearance process, notify clinical
staff to avoid resource waste, and counsel the patient regarding their options.
Question 3
Which of the following is a critical component of the "No Surprises Act" regarding
patient estimates?
A) Providing a Good Faith Estimate (GFE) to uninsured or selfpay patients prior to
scheduled services
B) Waiving all deductibles for emergency services
C) Requiring patients to sign a blanket assignment of benefits
D) Eliminating the need for prior authorizations
Answer: A) Providing a Good Faith Estimate (GFE) to uninsured or selfpay patients
prior to scheduled services
,Rationale: The No Surprises Act mandates that uninsured and selfpay patients
receive a GFE of expected charges prior to scheduled services. It also protects
insured patients from surprise balance billing for emergency services or ancillary
care at in network facilities, but it does not eliminate prior authorizations or waive
deductibles.
Question 4
A patient schedules a knee MRI. The scheduler notices the order does not specify
"contrast" or "without contrast." What is the appropriate action?
A) Schedule the exam for "without contrast" by default
B) Ask the patient which they prefer
C) Contact the ordering physician to clarify the order
D) Schedule both to be safe
Answer: C) Contact the ordering physician to clarify the order
Rationale: Clinical ambiguity must be resolved with the ordering provider before
scheduling to ensure appropriate care and billing. Schedulers should not make
clinical determinations.
Question 5
What is the primary purpose of the Medicare Secondary Payer (MSP)
questionnaire?
A) To determine if the patient has a living will
B) To determine if another payer is primary to Medicare
C) To calculate the patient's IRMAA
, D) To verify the patient's primary care physician election
Answer: B) To determine if another payer is primary to Medicare
Rationale: The MSP questionnaire identifies whether Medicare or another insurer
has primary payment responsibility, which is essential for correct claim submission.
Question 6
What is the primary advantage of a preregistration program for the provider?
A) It guarantees payment in full at the time of service
B) Create one registration record for multiple days of service
C) Waive all insurance requirements
D) Eliminate the need for charge capture
Answer: B) Create one registration record for multiple days of service
Rationale: A recurring or series registration allows the provider to establish a single
registration record that covers multiple service dates, reducing redundant data
entry and streamlining the registration process for patients receiving ongoing care.
Question 7
Approximately what percentage of billing information is obtained during patient
registration?
A) 10%
B) 25%
C) 50%
