HFMA CRCR EXAM LATEST EXAM 170+ QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS)

HFMA CRCR EXAM LATEST 2024-
2026 EXAM 170+ QUESTIONS AND
CORRECT ANSWERS(VERIFIED
ANSWERS)

What2are2collection2agency2fees2based2on?2-2Ans--
A2percentage2of2dollars2collected

Self-
funded2benefit2plans2may2choose2to2coordinate2benefits2using2the2gend
er2rule2or2what2other2rule?2-2Ans--Birthday

In2what2type2of2payment2methodology2is2a2lump2sum2or2bundled2payme
nt2negotiated2between2the2payer2and2some2or2all2providers?2-2Ans--
Case2rates

What2customer2service2improvements2might2improve2the2patient2accou
nts2department?2-2Ans--
Holding2staff2accountable2for2customer2service2during2performance2rev
iews

What2is2an2ABN2(Advance2Beneficiary2Notice2of2Non-
coverage)2required2to2do?2-2Ans--
Inform2a2Medicare2beneficiary2that2Medicare2may2not2pay2for2the2order2
or2service

What2type2of2account2adjustment2results2from2the2patient's2unwillingne
ss2to2pay2for2a2self-pay2balance?2-2Ans--Bad2debt2adjustment

What2is2the2initial2hospice2benefit?2-2Ans--Two290-
day2periods2and2an2unlimited2number2of2subsequent2periods

,When2does2a2hospital2add2ambulance2charges2to2the2Medicare2inpatie
nt2claim?2-2Ans--
If2the2patient2requires2ambulance2transportation2to2a2skilled2nursing2faci
lity

How2should2a2provider2resolve2a2late-
charge2credit2posted2after2an2account2is2billed?2-2Ans--Post2a2late-
charge2adjustment2to2the2account

an2increase2in2the2dollars2aged2greater2than2902days2from2date2of2servi
ce2indicate2what2about2accounts2-2Ans--
They2are2not2being2processed2in2a2timely2manner

What2is2an2advantage2of2a2preregistration2program?2-2Ans--
It2reduces2processing2times2at2the2time2of2service

What2are2the2two2statutory2exclusions2from2hospice2coverage?2-2Ans--
Medically2unnecessary2services2and2custodial2care

What2core2financial2activities2are2resolved2within2patient2access?2-
2Ans--

Scheduling,2insurance2verification,2discharge2processing,2and2payment
2of2point-of-service 2receipts



What2statement2applies2to2the2scheduled2outpatient?2-2Ans--
The2services2do2not2involve2an2overnight2stay

How2is2a2mis-posted2contractual2allowance2resolved?2-2Ans--
Comparing2the2contract2reimbursement2rates2with2the2contract2on2the2a
dmittance2advice2to2identify2the2correct2amount

What2type2of2patient2status2is2used2to2evaluate2the2patient's2need2for2in
patient2care?2-2Ans--Observation

Coverage2rules2for2Medicare2beneficiaries2receiving2skilled2nursing2car
e2require2that2the2beneficiary2has2received2what?2-2Ans--

,Medically2necessary2inpatient2hospital2services2for2at2least232consecuti
ve2days2before2the2skilled2nursing2care2admission

When2is2the2word2"SAME"2entered2on2the2CMS215002billing2form2in2Fiel
d20$?2-2Ans--When2the2patient2is2the2insured

What2are2non-
emergency2patients2who2come2for2service2without2prior2notification2to2t
he2provider2called?2-2Ans--Unscheduled2patients

If2the2insurance2verification2response2reports2that2a2subscriber2has2a2si
ngle2policy,2what2is2the2status2of2the2subscriber's2spouse?2-2Ans--
Neither2enrolled2not2entitled2to2benefits

Regulation2Z2of2the2Consumer2Credit2Protection2Act,2also2known2as2the
2Truth2in2Lending2Act,2establishes2what?2-2Ans--

Disclosure2rules2for2consumer2credit2sales2and2consumer2loans

What2is2a2principal2diagnosis?2-2Ans--
Primary2reason2for2the2patient's2admission

Collecting2patient2liability2dollars2after2service2leads2to2what?2-2Ans--
Lower2accounts2receivable2levels

What2is2the2daily2out-of-
pocket2amount2for2each2lifetime2reserve2day2used?2-2Ans--
50%2of2the2current2deductible2amount

What2service2provided2to2a2Medicare2beneficiary2in2a2rural2health2clinic2
(RHC)2is2not2billable2as2an2RHC2services?2-2Ans--Inpatient2care

What2code2indicates2the2disposition2of2the2patient2at2the2conclusion2of2s
ervice?2-2Ans--Patient2discharge2status2code

What2are2hospitals2required2to2do2for2Medicare2credit2balance2accounts
?2-2Ans--
They2result2in2lost2reimbursement2and2additional2cost2to2collect

, When2an2undue2delay2of2payment2results2from2a2dispute2between2the2p
atient2and2the2third2party2payer,2who2is2responsible2for2payment?2-
2Ans--Patient



Medicare2guidelines2require2that2when2a2test2is2ordered2for2a2LCD2or2N
CD2exists,2the2information2provided2on2the2order2must2include:2-2Ans--
A2valid2CPT2or2HCPCS2code

With2advances2in2internet2security2and2encryption,2revenue-
cycle2processes2are2expanding2to2allow2patients2to2do2what?2-2Ans--
Access2their2information2and2perform2functions2on-line

What2date2is2required2on2all2CMS215002claim2forms?2-2Ans--
onset2date2of2current2illness

What2does2scheduling2allow2provider2staff2to2do2-2Ans--
Review2appropriateness2of2the2service2request

What2code2is2used2to2report2the2provider's2most2common2semiprivate2r
oom2rate?2-2Ans--Condition2code

Regulations2and2requirements2for2coding2accountable2care2organizatio
ns,2which2allows2providers2to2begin2creating2these2organizations,2were2
finalized2in:2-2Ans--2012

What2is2a2primary2responsibility2of2the2Recover2Audit2Contractor?2-
2Ans--

To2correctly2identify2proper2payments2for2Medicare2Part2A2&2B2claims

How2must2providers2handle2credit2balances?2-2Ans--
Comply2with2state2statutes2concerning2reporting2credit2balance

Insurance2verification2results2in2what?2-2Ans--
The2accurate2identification2of2the2patient's2eligibility2and2benefits