Certified Revenue Cycle Representative Exam
Questions with Correct Answers
100% Verified Graded A+
1. What are collection agency fees based on?
Answer> A percentage of dollars collected
2. Self-funded benefit plans may choose to coordinate benefits using the gender rule
or what other rule?
Answer> Birthday
3. In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers?
Answer> Case rates
4. What customer service improvements might improve the patient accounts
department?
Answer> Holding staff accountable for customer service during performance reviews
5. What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
Answer> Inform a Medicare beneficiary that Medicare may not pay for the order or
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,service
6. What type of account adjustment results from the patient's unwillingness to pay for a
self-pay balance?
Answer> Bad debt adjustment
7. What is the initial hospice benefit?
Answer> Two 90-day periods and an unlimited number of subsequent periods
8. When does a hospital add ambulance charges to the Medicare inpatient claim?
Answer> If the patient requires ambulance transportation to a skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an account is billed?
Answer> Post a late-charge adjustment to the account
10. an increase in the dollars aged greater than 90 days from date of service indicate
what about accounts
Answer> They are not being processed in a timely manner
11. What is an advantage of a preregistration program?
Answer> It reduces processing times at the time of service
12. What are the two statutory exclusions from hospice coverage?
Answer> Medically unnecessary services and custodial care
13. What core financial activities are resolved within patient access?
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, Answer> Sched- uling, insurance verification, discharge processing, and payment of point-
of-service receipts
14. What statement applies to the scheduled outpatient?
Answer> The services do not involve an overnight stay
15. How is a mis-posted contractual allowance resolved?
Answer> Comparing the con- tract reimbursement rates with the contract on the
admittance advice to identify the correct amount
16. What type of patient status is used to evaluate the patient's need for inpatient
care?
Answer> Observation
17. Coverage rules for Medicare beneficiaries receiving skilled nursing care require that
the beneficiary has received what?
Answer> Medically necessary inpatient hospital services for at least 3 consecutive days
before the skilled nursing care admission
18. When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
Answer> When the patient is the insured
19. What are non-emergency patients who come for service without prior
notification to the provider called?
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Questions with Correct Answers
100% Verified Graded A+
1. What are collection agency fees based on?
Answer> A percentage of dollars collected
2. Self-funded benefit plans may choose to coordinate benefits using the gender rule
or what other rule?
Answer> Birthday
3. In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers?
Answer> Case rates
4. What customer service improvements might improve the patient accounts
department?
Answer> Holding staff accountable for customer service during performance reviews
5. What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
Answer> Inform a Medicare beneficiary that Medicare may not pay for the order or
1/
25
,service
6. What type of account adjustment results from the patient's unwillingness to pay for a
self-pay balance?
Answer> Bad debt adjustment
7. What is the initial hospice benefit?
Answer> Two 90-day periods and an unlimited number of subsequent periods
8. When does a hospital add ambulance charges to the Medicare inpatient claim?
Answer> If the patient requires ambulance transportation to a skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an account is billed?
Answer> Post a late-charge adjustment to the account
10. an increase in the dollars aged greater than 90 days from date of service indicate
what about accounts
Answer> They are not being processed in a timely manner
11. What is an advantage of a preregistration program?
Answer> It reduces processing times at the time of service
12. What are the two statutory exclusions from hospice coverage?
Answer> Medically unnecessary services and custodial care
13. What core financial activities are resolved within patient access?
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25
, Answer> Sched- uling, insurance verification, discharge processing, and payment of point-
of-service receipts
14. What statement applies to the scheduled outpatient?
Answer> The services do not involve an overnight stay
15. How is a mis-posted contractual allowance resolved?
Answer> Comparing the con- tract reimbursement rates with the contract on the
admittance advice to identify the correct amount
16. What type of patient status is used to evaluate the patient's need for inpatient
care?
Answer> Observation
17. Coverage rules for Medicare beneficiaries receiving skilled nursing care require that
the beneficiary has received what?
Answer> Medically necessary inpatient hospital services for at least 3 consecutive days
before the skilled nursing care admission
18. When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
Answer> When the patient is the insured
19. What are non-emergency patients who come for service without prior
notification to the provider called?
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25
