Page 1 of 63
CRCR CERTIFICATION EXAM FOR ENSEMBLE
HEALTH PARTNERS STUDY GUIDE***
QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS |DOWNLOAD AND
PASS | LATEST EXAM UPDATE 2026/2027
Which of the following is NOT a factor in self-pay follow-
up?
❖The type of patient (inpatient, out-patient)
When billing Rural Health Clinic services on a UB-04/837-I,
specific CPT codes are collapsed into a single revenue
code (520 or 521). Although codes are collapsed into a
single revenue code, it is still important to list the
appropriate CPT codes as part
❖These codes will be used to determine medical
necessity and useful in determining what happened
during the encounter
,Page 2 of 63
What is likely to occur if credit balances are not identified
separately from debit balances in accounts receivable?
❖The accounts receivable level would be understated
The process of verifying health insurance coverage,
identifying contract terms, and obtaining total charges is
known as
❖insurance verification and reimbursable charges
Unless the patient encounter is an emergency, it is more
efficient and effective to
❖Collect all information after the patient has been
discharged
,Page 3 of 63
Applying the contracted payment amount to the amount
of total charges yields
❖A pricing agreement
"Hard-coded" is the term used to refer to
❖Codes for services, procedures, and drugs
automatically assigned by the charge master
The advantages to using a third-party collection agency
include all of the following EXCEPT
❖Providers pay pennies on each dollar collected
Which of the following is usually covered on a Conditions
of Admission form
❖Release of information
, Page 4 of 63
The 501(r) regulations require not-for-profit providers
(501(c)(3) organizations) to do which of the following
activities.
❖Complete a community needs assessment and
develop a discount program for patient balances after
insurance payment
To be eligible for Medicaid, an individual must
❖meet income and asset requirements
Eliminating mail time and reducing data entry time,
electronically monitoring the receipt of claims and online
claim adjudication, more prompt payment are all benefits
achieved by
❖The electronic submission of claims using electronic
transfers
CRCR CERTIFICATION EXAM FOR ENSEMBLE
HEALTH PARTNERS STUDY GUIDE***
QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS |DOWNLOAD AND
PASS | LATEST EXAM UPDATE 2026/2027
Which of the following is NOT a factor in self-pay follow-
up?
❖The type of patient (inpatient, out-patient)
When billing Rural Health Clinic services on a UB-04/837-I,
specific CPT codes are collapsed into a single revenue
code (520 or 521). Although codes are collapsed into a
single revenue code, it is still important to list the
appropriate CPT codes as part
❖These codes will be used to determine medical
necessity and useful in determining what happened
during the encounter
,Page 2 of 63
What is likely to occur if credit balances are not identified
separately from debit balances in accounts receivable?
❖The accounts receivable level would be understated
The process of verifying health insurance coverage,
identifying contract terms, and obtaining total charges is
known as
❖insurance verification and reimbursable charges
Unless the patient encounter is an emergency, it is more
efficient and effective to
❖Collect all information after the patient has been
discharged
,Page 3 of 63
Applying the contracted payment amount to the amount
of total charges yields
❖A pricing agreement
"Hard-coded" is the term used to refer to
❖Codes for services, procedures, and drugs
automatically assigned by the charge master
The advantages to using a third-party collection agency
include all of the following EXCEPT
❖Providers pay pennies on each dollar collected
Which of the following is usually covered on a Conditions
of Admission form
❖Release of information
, Page 4 of 63
The 501(r) regulations require not-for-profit providers
(501(c)(3) organizations) to do which of the following
activities.
❖Complete a community needs assessment and
develop a discount program for patient balances after
insurance payment
To be eligible for Medicaid, an individual must
❖meet income and asset requirements
Eliminating mail time and reducing data entry time,
electronically monitoring the receipt of claims and online
claim adjudication, more prompt payment are all benefits
achieved by
❖The electronic submission of claims using electronic
transfers
