CRCR Certification questions and answers
2025\2026 A+ Grade
Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by
- correct answer The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid
- correct answer Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost
- correct answer Respect the patients privacy
A nightly room charge will be incorrect if the patient's
- correct answer Transfer from ICU (intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals
and small businesses can
- correct answer Purchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes:
- correct answer Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare?
- correct answer Revenue codes
This directive was developed to promote and ensure healthcare quality and value and also to protect
consumers and workers in the healthcare system. This directive is called
- correct answer Patient bill of rights
,The activity which results in the accurate recording of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time basis is known as
- correct answer Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation?
- correct answer Registration staff may routinely contact managed are plans for prior authorizations
before the patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to
identify the employer of an individual described in a transaction EIN's are
assigned by
- correct answer The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all examples of
- correct answer Control points for cash posting
What are some core elements if a board-approved financial assistance policy?
- correct answer Eligibility, application process, and nonpayment collection activities
A recurring/series registration is characterized by
- correct answer The creation of one registration record for multiple days of service
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of
Medicaid in some states, it is more important than ever for hospitals to
- correct answer Assist patients in understanding their insurance coverage and their financial obligation
The purpose of a financial report is to:
- correct answer Present financial information to decision makers
Patient financial communications best practices produce communications that are
- correct answer Consistent, clear and transparent
, Medicare has established guidelines called the Local Coverage Determinations (LCD) and National
Coverage Determinations (NCD) that establish
- correct answer What services or healthcare items are covered under Medicare
Any provider that has filed a timely cost report may appeal an adverse final decision received from the
Medicare Administrative Contractor (MAC). This appeal may be filed with
- correct answer The Provider Reimbursement Review Board
Concurrent review and discharge planning
- correct answer Occurs during service
Duplicate payments occur:
- correct answer When providers re-bill claims based on nonpayment from the initial bill submission
An individual enrolled in Medicare who is dissatisfied with the government's claim determination is
entitled to reconsideration of the decision. This type of appeal is known as
- correct answer A beneficiary appeal
Insurance verification results in which of the following
- correct answer The accurate identification of the patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the
following levels EXCEPT:
- correct answer Judicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask
about a patient's insurance information if it would delay what?
- correct answer Medical screening and stabilizing treatment
Ambulance services are billed directly to the health plan for
- correct answer Services provided before a patient is admitted and for ambulance rides arranged to pick
up the patient from the hospital after discharge to take him/her home or to another facility
2025\2026 A+ Grade
Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by
- correct answer The Medicare Administrative Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid
- correct answer Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first and foremost
- correct answer Respect the patients privacy
A nightly room charge will be incorrect if the patient's
- correct answer Transfer from ICU (intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals
and small businesses can
- correct answer Purchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing includes:
- correct answer Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare?
- correct answer Revenue codes
This directive was developed to promote and ensure healthcare quality and value and also to protect
consumers and workers in the healthcare system. This directive is called
- correct answer Patient bill of rights
,The activity which results in the accurate recording of patient bed and level of care assessment, patient
transfer and patient discharge status on a real-time basis is known as
- correct answer Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation?
- correct answer Registration staff may routinely contact managed are plans for prior authorizations
before the patient is seen by the on-duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to
identify the employer of an individual described in a transaction EIN's are
assigned by
- correct answer The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all examples of
- correct answer Control points for cash posting
What are some core elements if a board-approved financial assistance policy?
- correct answer Eligibility, application process, and nonpayment collection activities
A recurring/series registration is characterized by
- correct answer The creation of one registration record for multiple days of service
With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of
Medicaid in some states, it is more important than ever for hospitals to
- correct answer Assist patients in understanding their insurance coverage and their financial obligation
The purpose of a financial report is to:
- correct answer Present financial information to decision makers
Patient financial communications best practices produce communications that are
- correct answer Consistent, clear and transparent
, Medicare has established guidelines called the Local Coverage Determinations (LCD) and National
Coverage Determinations (NCD) that establish
- correct answer What services or healthcare items are covered under Medicare
Any provider that has filed a timely cost report may appeal an adverse final decision received from the
Medicare Administrative Contractor (MAC). This appeal may be filed with
- correct answer The Provider Reimbursement Review Board
Concurrent review and discharge planning
- correct answer Occurs during service
Duplicate payments occur:
- correct answer When providers re-bill claims based on nonpayment from the initial bill submission
An individual enrolled in Medicare who is dissatisfied with the government's claim determination is
entitled to reconsideration of the decision. This type of appeal is known as
- correct answer A beneficiary appeal
Insurance verification results in which of the following
- correct answer The accurate identification of the patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the
following levels EXCEPT:
- correct answer Judicial review by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask
about a patient's insurance information if it would delay what?
- correct answer Medical screening and stabilizing treatment
Ambulance services are billed directly to the health plan for
- correct answer Services provided before a patient is admitted and for ambulance rides arranged to pick
up the patient from the hospital after discharge to take him/her home or to another facility
