HFMA CRCR EXAM 2025| ACTUAL EXAM QUESTIONS
AND ACCURATE ANSWERS|LATEST UPDATE|EXPERT
VERIFIED FOR GUARANTEED PASS
1. What are collection agency fees based on?
A. The number of accounts assigned
B. A percentage of dollars collected
C. A flat monthly rate regardless of collections
D. Fixed fees per account worked
Correct Answer: B. A percentage of dollars collected
Rationale: Most collection agencies charge a contingency fee, meaning they earn a
percentage of what they recover.
2. Self-funded benefit plans may choose to coordinate benefits using the gender rule
or which other rule?
A. Age rule
B. Birthday rule
C. Numeric rule
D. Dependent rule
Correct Answer: B. Birthday rule
Rationale: Self-funded plans often use the birthday rule (the plan of the parent whose
birthday falls first in a calendar year is considered primary).
3. In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers?
A. Capitation
B. Fee-for-service
C. Case rates
D. Per diem
Correct Answer: C. Case rates
Rationale: Case rates involve a single, negotiated payment for an entire episode of care.
4. Which customer service improvement might benefit the patient accounts
department?
A. Using only automated reminders instead of live representatives
B. Hiring only external call centers
,C. Holding staff accountable for customer service during performance reviews
D. Eliminating staff feedback on performance
Correct Answer: C. Holding staff accountable for customer service
Rationale: Tying performance reviews to customer service metrics helps build a culture
of patient-centered care.
5. What is an Advance Beneficiary Notice of Non-coverage (ABN) required to do?
A. Confirm that Medicare will pay in full
B. Inform a Medicare beneficiary that Medicare may not pay for the order or
service
C. Guarantee that the patient’s secondary insurance will pay
D. Waive any future co-insurance
Correct Answer: B. Inform a Medicare beneficiary that Medicare may not pay
Rationale: ABNs notify patients in advance that Medicare may not cover certain
services, allowing the patient to accept financial responsibility if they proceed.
6. What type of account adjustment results from the patient’s unwillingness to pay a
self-pay balance?
A. Charity adjustment
B. Bad debt adjustment
C. Contractual allowance
D. Administrative write-off
Correct Answer: B. Bad debt adjustment
Rationale: Bad debt arises when a patient chooses not to pay or cannot pay despite
having the means (i.e., unwillingness or refusal).
7. What is the initial hospice benefit for a Medicare beneficiary?
A. One 90-day period
B. Two 90-day periods and an unlimited number of subsequent periods
C. Three 30-day periods
D. Unlimited 60-day periods
Correct Answer: B. Two 90-day periods and unlimited subsequent periods
Rationale: Medicare’s hospice benefit initially covers two 90-day periods, followed by
unlimited 60-day periods (renewals) as long as the patient remains eligible.
, 8. When does a hospital add ambulance charges to a Medicare inpatient claim?
A. Whenever the patient arrives by ambulance
B. If the patient requires ambulance transportation to a skilled nursing facility
C. Only if the distance is over 35 miles
D. Only when the patient has no other insurance
Correct Answer: B. If the patient requires ambulance transport to an SNF
Rationale: Ambulance charges to an SNF may be bundled into the inpatient claim if it
meets Medicare’s billing requirements.
9. How should a provider resolve a late-charge credit posted after an account is
billed?
A. Send a corrected statement to the payer
B. Reduce future charges
C. Post a late-charge adjustment to the account
D. Cancel the account and re-bill
Correct Answer: C. Post a late-charge adjustment
Rationale: Late charges (or credits) after billing typically require an appropriate late-
charge adjustment procedure.
10. An increase in the dollars aged greater than 90 days from the date of service
indicates what about the accounts?
A. They have all been denied
B. They were billed correctly
C. They are not being processed in a timely manner
D. They have automatically gone to collections
Correct Answer: C. They are not processed timely
Rationale: A high volume of accounts >90 days usually signals processing or follow-up
delays.
11. What is an advantage of a preregistration program?
A. The patient must wait longer at check-in
B. It reduces processing time at the time of service
C. It causes more denials
D. It is a redundant step
AND ACCURATE ANSWERS|LATEST UPDATE|EXPERT
VERIFIED FOR GUARANTEED PASS
1. What are collection agency fees based on?
A. The number of accounts assigned
B. A percentage of dollars collected
C. A flat monthly rate regardless of collections
D. Fixed fees per account worked
Correct Answer: B. A percentage of dollars collected
Rationale: Most collection agencies charge a contingency fee, meaning they earn a
percentage of what they recover.
2. Self-funded benefit plans may choose to coordinate benefits using the gender rule
or which other rule?
A. Age rule
B. Birthday rule
C. Numeric rule
D. Dependent rule
Correct Answer: B. Birthday rule
Rationale: Self-funded plans often use the birthday rule (the plan of the parent whose
birthday falls first in a calendar year is considered primary).
3. In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers?
A. Capitation
B. Fee-for-service
C. Case rates
D. Per diem
Correct Answer: C. Case rates
Rationale: Case rates involve a single, negotiated payment for an entire episode of care.
4. Which customer service improvement might benefit the patient accounts
department?
A. Using only automated reminders instead of live representatives
B. Hiring only external call centers
,C. Holding staff accountable for customer service during performance reviews
D. Eliminating staff feedback on performance
Correct Answer: C. Holding staff accountable for customer service
Rationale: Tying performance reviews to customer service metrics helps build a culture
of patient-centered care.
5. What is an Advance Beneficiary Notice of Non-coverage (ABN) required to do?
A. Confirm that Medicare will pay in full
B. Inform a Medicare beneficiary that Medicare may not pay for the order or
service
C. Guarantee that the patient’s secondary insurance will pay
D. Waive any future co-insurance
Correct Answer: B. Inform a Medicare beneficiary that Medicare may not pay
Rationale: ABNs notify patients in advance that Medicare may not cover certain
services, allowing the patient to accept financial responsibility if they proceed.
6. What type of account adjustment results from the patient’s unwillingness to pay a
self-pay balance?
A. Charity adjustment
B. Bad debt adjustment
C. Contractual allowance
D. Administrative write-off
Correct Answer: B. Bad debt adjustment
Rationale: Bad debt arises when a patient chooses not to pay or cannot pay despite
having the means (i.e., unwillingness or refusal).
7. What is the initial hospice benefit for a Medicare beneficiary?
A. One 90-day period
B. Two 90-day periods and an unlimited number of subsequent periods
C. Three 30-day periods
D. Unlimited 60-day periods
Correct Answer: B. Two 90-day periods and unlimited subsequent periods
Rationale: Medicare’s hospice benefit initially covers two 90-day periods, followed by
unlimited 60-day periods (renewals) as long as the patient remains eligible.
, 8. When does a hospital add ambulance charges to a Medicare inpatient claim?
A. Whenever the patient arrives by ambulance
B. If the patient requires ambulance transportation to a skilled nursing facility
C. Only if the distance is over 35 miles
D. Only when the patient has no other insurance
Correct Answer: B. If the patient requires ambulance transport to an SNF
Rationale: Ambulance charges to an SNF may be bundled into the inpatient claim if it
meets Medicare’s billing requirements.
9. How should a provider resolve a late-charge credit posted after an account is
billed?
A. Send a corrected statement to the payer
B. Reduce future charges
C. Post a late-charge adjustment to the account
D. Cancel the account and re-bill
Correct Answer: C. Post a late-charge adjustment
Rationale: Late charges (or credits) after billing typically require an appropriate late-
charge adjustment procedure.
10. An increase in the dollars aged greater than 90 days from the date of service
indicates what about the accounts?
A. They have all been denied
B. They were billed correctly
C. They are not being processed in a timely manner
D. They have automatically gone to collections
Correct Answer: C. They are not processed timely
Rationale: A high volume of accounts >90 days usually signals processing or follow-up
delays.
11. What is an advantage of a preregistration program?
A. The patient must wait longer at check-in
B. It reduces processing time at the time of service
C. It causes more denials
D. It is a redundant step
