CRCR EXAM MULTIPLE CHOICE,
CRCR
Exam Prep, Certified Revenue
Cycle Representative - CRCR (2025)
questions and answers well
illustrated.
What are collection agency fees based on? CORRECT ANSWER. A percentage
of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? CORRECT ANSWER. Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? CORRECT
ANSWER. Case rates
What customer service improvements might improve the patient accounts
department?
CORRECT ANSWER. Holding staff accountable for customer service during
performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to
do? CORRECT ANSWER. Inform a Medicare beneficiary that Medicare may not
pay for the order or service
What type of account adjustment results from the patient's unwillingness
to pay for a self-pay balance? CORRECT ANSWER. Bad debt adjustment
,What is the initial hospice benefit? CORRECT ANSWER. Two 90-day
periods and an unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient
claim? CORRECT ANSWER. If the patient requires ambulance transportation
to a skilled nursing facility
How should a provider resolve a late-charge credit posted after an account
is billed? CORRECT ANSWER. Post a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts CORRECT ANSWER. They are not being
processed in a timely manner
What is an advantage of a preregistration program? CORRECT ANSWER.
It
reduces processing times at the time of service
What are the two statutory exclusions from hospice coverage? CORRECT
ANSWER. Medically unnecessary services and custodial care
What core financial activities are resolved within patient access?
CORRECT ANSWER. Scheduling, insurance verification, discharge
processing, and payment of point-of- service receipts
What statement applies to the scheduled outpatient? CORRECT ANSWER.
The
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? CORRECT ANSWER.
Comparing
the contract reimbursement rates with the contract on the admittance
advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for
inpatient care? CORRECT ANSWER. Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? CORRECT ANSWER.
Medically necessary inpatient
hospital services for at least 3 consecutive days before the skilled nursing
care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field
0$? CORRECT ANSWER. When the patient is the insured
What are non-emergency patients who come for service without prior
notification to the provider called? CORRECT ANSWER. Unscheduled
patients
,If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? CORRECT ANSWER.
Neither enrolled not
entitled to benefits
, Regulation 3Z 3of 3the 3Consumer 3Credit 3Protection 3Act, 3also 3known 3as 3the
3Truth 3in 3Lending 3Act, 3establishes 3what? 3CORRECT 3ANSWER . Disclosure
3rules 3for 3consumer 3credit 3sales 3and 3consumer 3loans
What 3is 3a 3principal 3diagnosis? 3CORRECT 3ANSWER. Primary 3reason 3for
3the 3patient's 3admission
Collecting 3patient 3liability 3dollars 3after 3service 3leads 3to 3what? 3CORRECT
3ANSWER .
Lower 3accounts 3receivable 3levels
What 3is 3the 3daily 3out-of-pocket 3amount 3for 3each 3lifetime 3reserve 3day
3used? 3CORRECT 3ANSWER . 50% 3of 3the 3current 3deductible 3amount
What 3service 3provided 3to 3a 3Medicare 3beneficiary 3in 3a 3rural 3health 3clinic
3(RHC) 3is 3not 3billable 3as 3an 3RHC 3services? 3CORRECT 3ANSWER . Inpatient
3care
What 3code 3indicates 3the 3disposition 3of 3the 3patient 3at 3the 3conclusion 3of
3service? 3CORRECT 3ANSWER . Patient 3discharge 3status 3code
What 3are 3hospitals 3required 3to 3do 3for 3Medicare 3credit 3balance
3accounts? 3CORRECT 3ANSWER . They 3result 3in 3lost 3reimbursement
3and 3additional 3cost 3to 3collect
When 3an 3undue 3delay 3of 3payment 3results 3from 3a 3dispute 3between 3the
3patient 3and 3the 3third 3party 3payer, 3who 3is 3responsible 3for 3payment?
3CORRECT 3ANSWER. Patient
Medicare 3guidelines 3require 3that 3when 3a 3test 3is 3ordered 3for 3a 3LCD 3or
3NCD 3exists, 3the 3information 3provided 3on 3the 3order 3must 3include:
3CORRECT 3ANSWER. A 3valid 3CPT 3or
3HCPCS 3code
With 3advances 3in 3internet 3security 3and 3encryption, 3revenue-cycle 3processes
3are 3expanding 3to 3allow 3patients 3to 3do 3what? 3CORRECT 3ANSWER . Access
3their 3information 3and 3perform 3functions 3on-line
What 3date 3is 3required 3on 3all 3CMS 31500 3claim 3forms? 3CORRECT 3ANSWER.
onset 3date
3of 3current 3illness
What 3does 3scheduling 3allow 3provider 3staff 3to 3do 3CORRECT
3ANSWER .
Review 3appropriateness 3of 3the 3service 3request
What 3code 3is 3used 3to 3report 3the 3provider's 3most 3common 3semiprivate
CRCR
Exam Prep, Certified Revenue
Cycle Representative - CRCR (2025)
questions and answers well
illustrated.
What are collection agency fees based on? CORRECT ANSWER. A percentage
of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? CORRECT ANSWER. Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? CORRECT
ANSWER. Case rates
What customer service improvements might improve the patient accounts
department?
CORRECT ANSWER. Holding staff accountable for customer service during
performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to
do? CORRECT ANSWER. Inform a Medicare beneficiary that Medicare may not
pay for the order or service
What type of account adjustment results from the patient's unwillingness
to pay for a self-pay balance? CORRECT ANSWER. Bad debt adjustment
,What is the initial hospice benefit? CORRECT ANSWER. Two 90-day
periods and an unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient
claim? CORRECT ANSWER. If the patient requires ambulance transportation
to a skilled nursing facility
How should a provider resolve a late-charge credit posted after an account
is billed? CORRECT ANSWER. Post a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts CORRECT ANSWER. They are not being
processed in a timely manner
What is an advantage of a preregistration program? CORRECT ANSWER.
It
reduces processing times at the time of service
What are the two statutory exclusions from hospice coverage? CORRECT
ANSWER. Medically unnecessary services and custodial care
What core financial activities are resolved within patient access?
CORRECT ANSWER. Scheduling, insurance verification, discharge
processing, and payment of point-of- service receipts
What statement applies to the scheduled outpatient? CORRECT ANSWER.
The
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? CORRECT ANSWER.
Comparing
the contract reimbursement rates with the contract on the admittance
advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for
inpatient care? CORRECT ANSWER. Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? CORRECT ANSWER.
Medically necessary inpatient
hospital services for at least 3 consecutive days before the skilled nursing
care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field
0$? CORRECT ANSWER. When the patient is the insured
What are non-emergency patients who come for service without prior
notification to the provider called? CORRECT ANSWER. Unscheduled
patients
,If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? CORRECT ANSWER.
Neither enrolled not
entitled to benefits
, Regulation 3Z 3of 3the 3Consumer 3Credit 3Protection 3Act, 3also 3known 3as 3the
3Truth 3in 3Lending 3Act, 3establishes 3what? 3CORRECT 3ANSWER . Disclosure
3rules 3for 3consumer 3credit 3sales 3and 3consumer 3loans
What 3is 3a 3principal 3diagnosis? 3CORRECT 3ANSWER. Primary 3reason 3for
3the 3patient's 3admission
Collecting 3patient 3liability 3dollars 3after 3service 3leads 3to 3what? 3CORRECT
3ANSWER .
Lower 3accounts 3receivable 3levels
What 3is 3the 3daily 3out-of-pocket 3amount 3for 3each 3lifetime 3reserve 3day
3used? 3CORRECT 3ANSWER . 50% 3of 3the 3current 3deductible 3amount
What 3service 3provided 3to 3a 3Medicare 3beneficiary 3in 3a 3rural 3health 3clinic
3(RHC) 3is 3not 3billable 3as 3an 3RHC 3services? 3CORRECT 3ANSWER . Inpatient
3care
What 3code 3indicates 3the 3disposition 3of 3the 3patient 3at 3the 3conclusion 3of
3service? 3CORRECT 3ANSWER . Patient 3discharge 3status 3code
What 3are 3hospitals 3required 3to 3do 3for 3Medicare 3credit 3balance
3accounts? 3CORRECT 3ANSWER . They 3result 3in 3lost 3reimbursement
3and 3additional 3cost 3to 3collect
When 3an 3undue 3delay 3of 3payment 3results 3from 3a 3dispute 3between 3the
3patient 3and 3the 3third 3party 3payer, 3who 3is 3responsible 3for 3payment?
3CORRECT 3ANSWER. Patient
Medicare 3guidelines 3require 3that 3when 3a 3test 3is 3ordered 3for 3a 3LCD 3or
3NCD 3exists, 3the 3information 3provided 3on 3the 3order 3must 3include:
3CORRECT 3ANSWER. A 3valid 3CPT 3or
3HCPCS 3code
With 3advances 3in 3internet 3security 3and 3encryption, 3revenue-cycle 3processes
3are 3expanding 3to 3allow 3patients 3to 3do 3what? 3CORRECT 3ANSWER . Access
3their 3information 3and 3perform 3functions 3on-line
What 3date 3is 3required 3on 3all 3CMS 31500 3claim 3forms? 3CORRECT 3ANSWER.
onset 3date
3of 3current 3illness
What 3does 3scheduling 3allow 3provider 3staff 3to 3do 3CORRECT
3ANSWER .
Review 3appropriateness 3of 3the 3service 3request
What 3code 3is 3used 3to 3report 3the 3provider's 3most 3common 3semiprivate
