HFMA CRCR PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
A claim is denied for the following reasons EXCEPT: - ansThe submited claim does not have the physician
signature
A common billing issue with hospital-based physician's is - ansThey are not contracted with the pa�ent's
health plan to provide services
A decision on whether a pa�ent should be admited as an inpa�ent or become an outpa�ent
observa�on pa�ent requires medical judgement based on all of the following EXCEPT: - ansThe pa�ent's
home care coverage
A four-digit number code established by the Na�onal Uniform Billing Commitee (NUBC) that
categorizes/classifies a line in the charge master is known as: - ansRevenue codes
A pa�ent has met the $200 individual deduc�ble and $900 of the $1000 co-insurance responsibility. The
co-insurance rate is 20%. The es�mated insurance plan responsibility is $1975.00. What amount of
coinsurance is due from the pa�ent? - ans$100.00
A por�on of the accounts receivable inventory which has NOT qualified for billing includes: - ansAccounts
created during pre-registra�on but not ac�vated
A scheduled inpa�ent represents an opportunity for the provider to do which of the following? -
ansComplete registra�on and insurance approval before service
Account Receivable (A/R) aging reports - ansIden�fy past due accounts likely to become bad debit
Across all care se�ngs, if a pa�ent consents to a financial discussion during a medical encounter to
expedite discharge, the HFMA best prac�ce is to: - ansSupport that choice, providing that the discussion
does not interfere with pa�ent care or disrupt pa�ent flow.
All Hospitals are required to establish a writen financial assistance policy that applies to: - ansAll
emergency and medically necessary care
,HFMA CRCR PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
All of following are steps in safeguarding collec�ons EXCEPT: - ansPlacing collec�ons in a lock-box for
pos�ng review the next business day
All of the following are poten�al causes of credit balances EXCEPT: - ansA pa�ent's choice to build up a
credit against future medical bills
Ambulance services are billed directly to the health plan for: - ansServices provided before a pa�ent is
admited and for ambulance rides arranged to pick up the pa�ent from the hospital a�er discharge to
take him/her home or to another facility.
An advantage of a pre-registra�on program in - ansThe opportunity to reduce processing �mes at the
�me of service
an increase in the dollars aged greater than 90 days from date of service indicate what about accounts -
ansThey are not being processed in a �mely manner
Any healthcare insurance plan that providers or insures comprehensive health maintenance and services
for an enrolled group of persons based on a monthly fee is known as a - ansHMO
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and
treatment services for an enrolled group of persons on a monthly fee is known as: - ansHMO
Any provider that has filed a �mely cost report may appeal in an adverse final decision received from the
Medicare Administra�ve Contractor (MAC), the appeal may be filed with: - ansThe Provider
Reimbursement Review Board.
Applying the contracted payment amount to the amount of total charges yields: - ansAn es�mated price
for the pa�ent's responsibility
, HFMA CRCR PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
Applying the contracted payment methodology to the total charges yields: - ansAn es�mate price
Appropriate training for pa�ent financial counseling staff must cover all of the following EXCEPT: -
ansDocumen�ng the conversa�on in the medical records
Before classifying and subsequently wri�ng off an account to financial assistance or bad debit, the
hospital must establish policy define appropriate criteria, implement procedures for iden�fying accounts
and: - ansMonitor compliance
Chapter 11 Bankruptcy permits a debtor to: - ansWork out a court-supervised plan with creditors
Charges, as the most appropriate measurement of u�liza�on, enables: - ansGenera�on of �mely and
accurate billing
Claims with the dates of service received later than one calendar year beyond the date of service will be:
- ansDenied by Medicare
Collec�ng pa�ent liability dollars a�er service leads to what? - ansLower accounts receivable levels
Concurrent review and discharge planning - ansOccurs during service
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has
received what? - ansMedically necessary inpa�ent hospital services for at least 3 consecu�ve days before
the skilled nursing care admission.
Days in A/R calculated based on the value of: - ansThe total account receivable on a specific date
Departments that need to be included in Charge master maintenance include all EXCEPT - ansQuality
Assurance
LATEST VERSION VERIFIED RATIONALE GRADED
A+
A claim is denied for the following reasons EXCEPT: - ansThe submited claim does not have the physician
signature
A common billing issue with hospital-based physician's is - ansThey are not contracted with the pa�ent's
health plan to provide services
A decision on whether a pa�ent should be admited as an inpa�ent or become an outpa�ent
observa�on pa�ent requires medical judgement based on all of the following EXCEPT: - ansThe pa�ent's
home care coverage
A four-digit number code established by the Na�onal Uniform Billing Commitee (NUBC) that
categorizes/classifies a line in the charge master is known as: - ansRevenue codes
A pa�ent has met the $200 individual deduc�ble and $900 of the $1000 co-insurance responsibility. The
co-insurance rate is 20%. The es�mated insurance plan responsibility is $1975.00. What amount of
coinsurance is due from the pa�ent? - ans$100.00
A por�on of the accounts receivable inventory which has NOT qualified for billing includes: - ansAccounts
created during pre-registra�on but not ac�vated
A scheduled inpa�ent represents an opportunity for the provider to do which of the following? -
ansComplete registra�on and insurance approval before service
Account Receivable (A/R) aging reports - ansIden�fy past due accounts likely to become bad debit
Across all care se�ngs, if a pa�ent consents to a financial discussion during a medical encounter to
expedite discharge, the HFMA best prac�ce is to: - ansSupport that choice, providing that the discussion
does not interfere with pa�ent care or disrupt pa�ent flow.
All Hospitals are required to establish a writen financial assistance policy that applies to: - ansAll
emergency and medically necessary care
,HFMA CRCR PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
All of following are steps in safeguarding collec�ons EXCEPT: - ansPlacing collec�ons in a lock-box for
pos�ng review the next business day
All of the following are poten�al causes of credit balances EXCEPT: - ansA pa�ent's choice to build up a
credit against future medical bills
Ambulance services are billed directly to the health plan for: - ansServices provided before a pa�ent is
admited and for ambulance rides arranged to pick up the pa�ent from the hospital a�er discharge to
take him/her home or to another facility.
An advantage of a pre-registra�on program in - ansThe opportunity to reduce processing �mes at the
�me of service
an increase in the dollars aged greater than 90 days from date of service indicate what about accounts -
ansThey are not being processed in a �mely manner
Any healthcare insurance plan that providers or insures comprehensive health maintenance and services
for an enrolled group of persons based on a monthly fee is known as a - ansHMO
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and
treatment services for an enrolled group of persons on a monthly fee is known as: - ansHMO
Any provider that has filed a �mely cost report may appeal in an adverse final decision received from the
Medicare Administra�ve Contractor (MAC), the appeal may be filed with: - ansThe Provider
Reimbursement Review Board.
Applying the contracted payment amount to the amount of total charges yields: - ansAn es�mated price
for the pa�ent's responsibility
, HFMA CRCR PREP QUESTION AND ANSWERS
LATEST VERSION VERIFIED RATIONALE GRADED
A+
Applying the contracted payment methodology to the total charges yields: - ansAn es�mate price
Appropriate training for pa�ent financial counseling staff must cover all of the following EXCEPT: -
ansDocumen�ng the conversa�on in the medical records
Before classifying and subsequently wri�ng off an account to financial assistance or bad debit, the
hospital must establish policy define appropriate criteria, implement procedures for iden�fying accounts
and: - ansMonitor compliance
Chapter 11 Bankruptcy permits a debtor to: - ansWork out a court-supervised plan with creditors
Charges, as the most appropriate measurement of u�liza�on, enables: - ansGenera�on of �mely and
accurate billing
Claims with the dates of service received later than one calendar year beyond the date of service will be:
- ansDenied by Medicare
Collec�ng pa�ent liability dollars a�er service leads to what? - ansLower accounts receivable levels
Concurrent review and discharge planning - ansOccurs during service
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has
received what? - ansMedically necessary inpa�ent hospital services for at least 3 consecu�ve days before
the skilled nursing care admission.
Days in A/R calculated based on the value of: - ansThe total account receivable on a specific date
Departments that need to be included in Charge master maintenance include all EXCEPT - ansQuality
Assurance
