1|Page
2025 Latest CRCR Certification Exam 400 Recent
Practice Questions and Correct Verified Answers/
Certified Revenue Cycle Representative – CRCR
Exam Prep
Through what document does a hospital establish
compliance standards? - ...ANSWER...✓✓ code of conduct
What is the purpose OIG work plant? - ...ANSWER...✓✓
Identify Acceptable compliance programs in various
provider setting
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
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
,2|Page
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
what is a recurring or series registration? -
...ANSWER...✓✓ One registration record is created for
multiple days of service
What are nonemergency patients who come for service
without prior notification to the provider called? -
...ANSWER...✓✓ Unscheduled patients
Which of the following statement apply to the observation
patient type? - ...ANSWER...✓✓ It is used to evaluate the
need for an inpatient admission
which services are hospice programs required to provide
around the clock patient - ...ANSWER...✓✓ Physician,
Nursing, Pharmacy
,3|Page
Scheduler instructions are used to prompt the scheduler
to do what? - ...ANSWER...✓✓ Complete the scheduling
process correctly based on service requeste
The Time needed to prepare the patient before service is
the difference between the patients arrival time and
which of the following? - ...ANSWER...✓✓ Procedure time
Medicare guidelines require that when a test is ordered
for a LCD or NCD exists, the information provided on the
order must include: - ...ANSWER...✓✓ Documentation of
the medical necessity for the test
What is the advantage of a pre-registration program -
...ANSWER...✓✓ It reduces processing times at the time
of service
What date are required to establish a new MPI(Master
patient Index) entry - ...ANSWER...✓✓ The responsible
party's full legal name, date of birth, and social security
number
, 4|Page
Which of the following statements is true about third-
party payments? - ...ANSWER...✓✓ The payments are
received by the provider from the payer responsible for
reimbursing the provider for the patient's covered
services.
Which provision protects the patient from medical
expenses that exceed the pre-set level - ...ANSWER...✓✓
stop loss
what documentation must a primary care physician send
to HMO patient to authorize a visit to a specialist for
additional testing or care? - ...ANSWER...✓✓ Referral
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
Which of the following is a step in the discharge process?
- ...ANSWER...✓✓ Have a case management service
complete the discharge plan
2025 Latest CRCR Certification Exam 400 Recent
Practice Questions and Correct Verified Answers/
Certified Revenue Cycle Representative – CRCR
Exam Prep
Through what document does a hospital establish
compliance standards? - ...ANSWER...✓✓ code of conduct
What is the purpose OIG work plant? - ...ANSWER...✓✓
Identify Acceptable compliance programs in various
provider setting
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
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
,2|Page
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
what is a recurring or series registration? -
...ANSWER...✓✓ One registration record is created for
multiple days of service
What are nonemergency patients who come for service
without prior notification to the provider called? -
...ANSWER...✓✓ Unscheduled patients
Which of the following statement apply to the observation
patient type? - ...ANSWER...✓✓ It is used to evaluate the
need for an inpatient admission
which services are hospice programs required to provide
around the clock patient - ...ANSWER...✓✓ Physician,
Nursing, Pharmacy
,3|Page
Scheduler instructions are used to prompt the scheduler
to do what? - ...ANSWER...✓✓ Complete the scheduling
process correctly based on service requeste
The Time needed to prepare the patient before service is
the difference between the patients arrival time and
which of the following? - ...ANSWER...✓✓ Procedure time
Medicare guidelines require that when a test is ordered
for a LCD or NCD exists, the information provided on the
order must include: - ...ANSWER...✓✓ Documentation of
the medical necessity for the test
What is the advantage of a pre-registration program -
...ANSWER...✓✓ It reduces processing times at the time
of service
What date are required to establish a new MPI(Master
patient Index) entry - ...ANSWER...✓✓ The responsible
party's full legal name, date of birth, and social security
number
, 4|Page
Which of the following statements is true about third-
party payments? - ...ANSWER...✓✓ The payments are
received by the provider from the payer responsible for
reimbursing the provider for the patient's covered
services.
Which provision protects the patient from medical
expenses that exceed the pre-set level - ...ANSWER...✓✓
stop loss
what documentation must a primary care physician send
to HMO patient to authorize a visit to a specialist for
additional testing or care? - ...ANSWER...✓✓ Referral
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
Which of the following is a step in the discharge process?
- ...ANSWER...✓✓ Have a case management service
complete the discharge plan
