HFMA CRCR FINAL EXAM AND PRACTICE EXAM
QUESTION BANK (300+ MULTIPLE CHOICE) | 2025
ACTUAL EXAM WITH QUESTIONS AND DETAILED
ANSWERS GRADED A+ | GUARANTEED
EXCELLENCE PASS
Why is it critical that a chargemaster is reviewed and updated regularly?
A. To ensure it supports and represents the services provided within the
organization.
B. To ensure the most appropriate measure of the utilization of resources.
C. So the CPT databases can have the most current and accurate information.
D. Because charge descriptions can vary greatly between providers.
A. To ensure it supports and represents the services provided within the
organization.
Which activity is not considered when initiating self-pay follow-up and account
resolution activities?
A. Poverty Guidelines
B. Financial Profile
C. Presumptive Financial Assistance Determination
D. Patient Open Balance Billing
,D. Patient Open Balance Billing
Which patients are considered scheduled?
A. Observation Patients
B. Emergency Department Patients
C. Recurring/Series Patients
D. Hospice Care
C. Recurring/Series Patients
What do business/organizational ethics represent?
A. Principles and standards by which organizations operate
B. A healthcare provider's practices and principles
C. An employee's actions influenced by experiences and value system
D. The patient privacy standard within healthcare
A. Principles and standards by which organizations operate
Which option is a federally-aided, state-operated program to provide health and
long-term care coverage?
A. Medicare
B. Medicaid
C. Self-Insured Plans
,D. Liability
B. Medicaid
Credit balances may be created by any of the following activities EXCEPT:
A. Incorrectly posting allowances or incorrect payment estimates
B. Late credits processed after a claim is billed
C. Duplicate payments
D. Credits to pharmacy charges posted before the claim final bills
D. Credits to pharmacy charges posted before the claim final bills
Which of the following statements represent common reasons for inpatient claim
denials:
A. Failure to obtain a required pre-authorizations; failure to complete a continued
stay authorization and services provided which were not medical necessary.
B. Providing an inappropriate level of care as supported by the documentation
provided with the claim
C. An omitted HCPCS code
D. The APC payment was incorrectly calculated by the provider
, A. Failure to obtain a required pre-authorizations; failure to complete a
continued stay authorization and services provided which were not medical
necessary.
A 68 year old patient, a Medicare beneficiary, was in a car accident. A medical
insurance claim was filed with the auto insurance carrier. Six months alter this
claim remains unpaid. How can the provider pursue payment from Medicare?
A. The provider cannot bill Medicare for this claim
B. The provider must first bill the auto insurer; however, after a period for 120
days, if the claim remains unpaid, the provider may cancel the liability claim and
bill Medicare
C. The provider will need to take the auto insurer to court to secure payment
D. The provider may bill Medicare and accept both the Medicare payment and the
auto insurance payment when received
B. The provider must first bill the auto insurer; however, after a period for 120
days, if the claim remains unpaid, the provider may cancel the liability claim and
bill Medicare
The difference between bad debt and financial assistance (charity) is:
QUESTION BANK (300+ MULTIPLE CHOICE) | 2025
ACTUAL EXAM WITH QUESTIONS AND DETAILED
ANSWERS GRADED A+ | GUARANTEED
EXCELLENCE PASS
Why is it critical that a chargemaster is reviewed and updated regularly?
A. To ensure it supports and represents the services provided within the
organization.
B. To ensure the most appropriate measure of the utilization of resources.
C. So the CPT databases can have the most current and accurate information.
D. Because charge descriptions can vary greatly between providers.
A. To ensure it supports and represents the services provided within the
organization.
Which activity is not considered when initiating self-pay follow-up and account
resolution activities?
A. Poverty Guidelines
B. Financial Profile
C. Presumptive Financial Assistance Determination
D. Patient Open Balance Billing
,D. Patient Open Balance Billing
Which patients are considered scheduled?
A. Observation Patients
B. Emergency Department Patients
C. Recurring/Series Patients
D. Hospice Care
C. Recurring/Series Patients
What do business/organizational ethics represent?
A. Principles and standards by which organizations operate
B. A healthcare provider's practices and principles
C. An employee's actions influenced by experiences and value system
D. The patient privacy standard within healthcare
A. Principles and standards by which organizations operate
Which option is a federally-aided, state-operated program to provide health and
long-term care coverage?
A. Medicare
B. Medicaid
C. Self-Insured Plans
,D. Liability
B. Medicaid
Credit balances may be created by any of the following activities EXCEPT:
A. Incorrectly posting allowances or incorrect payment estimates
B. Late credits processed after a claim is billed
C. Duplicate payments
D. Credits to pharmacy charges posted before the claim final bills
D. Credits to pharmacy charges posted before the claim final bills
Which of the following statements represent common reasons for inpatient claim
denials:
A. Failure to obtain a required pre-authorizations; failure to complete a continued
stay authorization and services provided which were not medical necessary.
B. Providing an inappropriate level of care as supported by the documentation
provided with the claim
C. An omitted HCPCS code
D. The APC payment was incorrectly calculated by the provider
, A. Failure to obtain a required pre-authorizations; failure to complete a
continued stay authorization and services provided which were not medical
necessary.
A 68 year old patient, a Medicare beneficiary, was in a car accident. A medical
insurance claim was filed with the auto insurance carrier. Six months alter this
claim remains unpaid. How can the provider pursue payment from Medicare?
A. The provider cannot bill Medicare for this claim
B. The provider must first bill the auto insurer; however, after a period for 120
days, if the claim remains unpaid, the provider may cancel the liability claim and
bill Medicare
C. The provider will need to take the auto insurer to court to secure payment
D. The provider may bill Medicare and accept both the Medicare payment and the
auto insurance payment when received
B. The provider must first bill the auto insurer; however, after a period for 120
days, if the claim remains unpaid, the provider may cancel the liability claim and
bill Medicare
The difference between bad debt and financial assistance (charity) is:
