CERTIFIED REVENUE CYCLE REPRESENTATIVE EXAM 2 CERTIFICATION EVALUATION TESTED QUESTIONS FULL SOLUTION GUIDE

CERTIFIED REVENUE CYCLE REPRESENTATIVE EXAM 2 CERTIFICATION EVALUATION
TESTED QUESTIONS FULL SOLUTION GUIDE
Certified Revenue Cycle Representative EXAM 2
Final Preparation Questions and Answers Verified
Solutions Latest Update 2026/2027

Question:
What will cause a CMS 1500 claim to be rejected?

Answer:
The provider is billing with a future date of service



Question:
Under Medicare regulations, which of the following is not included on a valid physician's order for
services?

Answer:
The cost of the test



Question:
how are HCPCS codes and the appropriate modifiers used?

Answer:
To report the level 1, 2, or 3 code that correctly describes the service provided



Question:
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window
rule?

Answer:
Diagnostic and clinically-related non-diagnostic charges provided on the Tuesday, Wednesday,
Thursday, and Friday before admission

,Question:
What is a benefit of pre-registering patient's for service?

Answer:
Patient arrival processing is expedited, reducing wait times and delays



Question:
What is a characteristic of a managed contracting methodology?

Answer:
Prospectively set rates for inpatient and outpatient services



Question:
What do the MSP disability rules require?

Answer:
That the patient's spouse's employer must have less than 20 employees in the group health plan



Question:
what organization originated the concept of insuring prepaid health care services?

Answer:
Blue Cross and blue Shield



Question:
What is true about screening a beneficiary for possible MSP situations?

Answer:
It is acceptable to complete the screening form after the patient has completed the registration
process and been sent to the service department



Question:

,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



Question:
In services lines such as cardiology or orthopedics, what does the case-rate payment methodology
allow providers to do?

Answer:
Receive a fixed for specific procedures



Question:
What will comprehensive patient access processing accomplish?

Answer:
Minimize the need for follow-up on insurance accounts



Question:
Through what document does a hospital establish compliance standards?

Answer:
Code of conduct



Question:
How does utilization review staff use correct insurance information?

Answer:
To obtain approval for inpatient days and coordinate services



Question:
When is it not appropriate to use observation status?

, Answer:
As a substitute for an inpatient admission



Question:
What is a serious consequence of misidentifying a patient in the MPI?

Answer:
The services will be documented in the wrong record



Question:
When a patient reports directly to a clinical department for service, what will the clinical department
staff do?

Answer:
Redirect the patient to the patient access department for registration



Question:
What process can be used to shorten claim turnaround time?

Answer:
Send high-dollar hard-copy claims with required attachments by overnight mail or registered mail



Question:
How are patient reminder calls used?

Answer:
To make sure the patient follows the prep instructions and arrives at the scheduled time for service



Question:
If a patient declares a straight bankruptcy, what must the provider do?

Answer: