PREP, CERTIFIED REVENUE CYCLE
REPRESENTATIVE - CRCR Q&A (2024-2025)
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
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,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
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,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
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, 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
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