HFMA CRCR Complete Exam Practice
Questions with Correct Expert Graded
A+ Answers | Latest Version
1. HFMA Certification - ANSWER Programs enhancing knowledge in
healthcare finance.
2. CRCR Certification - ANSWER National-level certification for revenue
cycle professionals.
3. Through what document does a hospital establish compliance standards? -
ANSWER code of conduct
4. What is the purpose OIG work plant? - ANSWER Identify Acceptable
compliance programs in various provider setting
5. Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance information
if it would delay what? - ANSWER Medical screening and stabilizing
treatment
6. Which of the following is a step in the discharge process? - ANSWER Have
a case management service complete the discharge plan
7. 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
,8. 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
9. 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.
10.What patient assets are considered in the financial assistance application? -
ANSWER Sources of readily available funds , vehicles, campers, boats and
saving accounts
11.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
12.What core financial activities are resolved within patient access? -
ANSWER scheduling , pre-registration, insurance verification and managed
care processing
13.What is an unscheduled direct admission? - ANSWER A patient who
arrives at the hospital via ambulance for treatment in the emergency
department
14.When is it not appropriate to use observation status? - ANSWER As a
substitute for an inpatient admission
, 15.Patients who require periodic skilled nursing or therapeutic care receive
services from what type of program? - ANSWER Home health agency
16.Every patient who is new to the healthcare provider must be offered what? -
ANSWER A printed copy of the provider privacy notice
17.Which of the following statements apples to self insured insurance plans? -
ANSWER The employer provides a traditional HMO health plan
18.In addition to the member's identification number, what information is
recorded in a 270 transaction - ANSWER Name
19.If a Medicare patient is admitted on Friday, what services fall within the
three-day DRG window rule? - ANSWER Non-diagnostic service provided
on Tuesday through Friday
20.What does a modifier allow a provider to do? - ANSWER Report a specific
circumstance that affected a procedure or service without changing the code
or its definition
21.IF outpatient diagnostic services are provided within three days of the
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective
Payment System) hospital, what must happen to these charges - ANSWER
They must be billed separately to the part B Carrier
22.what is a recurring or series registration? - ANSWER One registration
record is created for multiple days of service
23.What are nonemergency patients who come for service without prior
notification to the provider called? - ANSWER Unscheduled patients
Questions with Correct Expert Graded
A+ Answers | Latest Version
1. HFMA Certification - ANSWER Programs enhancing knowledge in
healthcare finance.
2. CRCR Certification - ANSWER National-level certification for revenue
cycle professionals.
3. Through what document does a hospital establish compliance standards? -
ANSWER code of conduct
4. What is the purpose OIG work plant? - ANSWER Identify Acceptable
compliance programs in various provider setting
5. Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance information
if it would delay what? - ANSWER Medical screening and stabilizing
treatment
6. Which of the following is a step in the discharge process? - ANSWER Have
a case management service complete the discharge plan
7. 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
,8. 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
9. 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.
10.What patient assets are considered in the financial assistance application? -
ANSWER Sources of readily available funds , vehicles, campers, boats and
saving accounts
11.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
12.What core financial activities are resolved within patient access? -
ANSWER scheduling , pre-registration, insurance verification and managed
care processing
13.What is an unscheduled direct admission? - ANSWER A patient who
arrives at the hospital via ambulance for treatment in the emergency
department
14.When is it not appropriate to use observation status? - ANSWER As a
substitute for an inpatient admission
, 15.Patients who require periodic skilled nursing or therapeutic care receive
services from what type of program? - ANSWER Home health agency
16.Every patient who is new to the healthcare provider must be offered what? -
ANSWER A printed copy of the provider privacy notice
17.Which of the following statements apples to self insured insurance plans? -
ANSWER The employer provides a traditional HMO health plan
18.In addition to the member's identification number, what information is
recorded in a 270 transaction - ANSWER Name
19.If a Medicare patient is admitted on Friday, what services fall within the
three-day DRG window rule? - ANSWER Non-diagnostic service provided
on Tuesday through Friday
20.What does a modifier allow a provider to do? - ANSWER Report a specific
circumstance that affected a procedure or service without changing the code
or its definition
21.IF outpatient diagnostic services are provided within three days of the
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective
Payment System) hospital, what must happen to these charges - ANSWER
They must be billed separately to the part B Carrier
22.what is a recurring or series registration? - ANSWER One registration
record is created for multiple days of service
23.What are nonemergency patients who come for service without prior
notification to the provider called? - ANSWER Unscheduled patients
