CRCR CERTIFICATION EXAM PREP STUDY
GUIDE 2026 ALL QUESTIONS WITH ANSWERS
GUARANTEED PASS
◉ ABC Hospital has experienced a 16% increase in new patients over
the past 6 months. The hospital is understaffed in its insurance claim and
payment processing department and cannot handle this increase in work
load. It is considering hiring an outsourcing vendor to assist. What are
the steps that the hospital needs to take to establish and ensure a
successful vendor relationship? Answer: The hospital should distribute a
RFP to solicit vendor capabilities, evaluate vendor's expertise to provide
outsourcing services, visit vendor locations, perform vendor reference
checks, talk with vendor clients, and interview vendor employees to
assess experience level. This sets up an evaluation process, the same as
any other purchased service would be evaluated.
◉ True or False - Patient service costs are calculated in the pre-service
process for scheduled patients. Answer: True
◉ What is the intended outcome of collaborations made through an
ACO delivery system? Answer: By meeting established benchmarks for
quality and efficiency, participating organizations may receive a share of
the savings generated by reducing duplicative services, improving
productivity, minimizing paperwork, and other cost efficiencies.
,◉ Which option is NOT a department that supports and collaborates
with the revenue cycle? Answer: Assisted Living Services
◉ Annually, the OIG publishes a work plan of compliance issues and
objectives that will be focused on throughout the following year. Identify
which option is NOT a work plan task mentioned in this course. Answer:
Standard Unique Employer Identifier
◉ What is the purpose of insurance verification? Answer: To ensure
accuracy of he health plan information.
◉ What are the required components of financial assistance policy
(FAP)? Answer: Eligibility criteria, application process, application
assistance, list of all providers - regardless of network status
◉ Federally-aided, state-operated program to provide health and long-
term care coverage. Answer: Medicaid
Medicaid is for low-income individuals or families. Eligibility for
Medicaid benefits expanded effective January 1, 2014 through a
provision of the Patient Protection and Affordable Care Act (PPACA), as
states were provided additional funding if benefits were extended to
individuals under 65 years of age with incomes up to 133% of the
federal poverty level.
,◉ What are claim edits? Answer: Rules developed to verify the accuracy
and completeness of claims based on each health plan's policies.
Data sources for these claim edits (rules) are Medicare and Medicaid
bulletins and manuals, individual health plan manuals and contracts, and
other documents routinely provided by health plans. The claim editing
process lets providers identify and resolve claim issues to ensure clean
claim submission to the health plan.
◉ What are the various lien types? Answer: By Agreement (consensus),
By Judicial Process, By Statute
◉ Explain the By Agreement (Consensus) lien type. Answer: A creditor
can protect his/her security interest (which lasts until the full balance is
paid) by filing a financing statement under the Uniform Commercial
Code (UCC), usually at the Secretary of State's Office.
The financing statement generally includes the following information:
- Names and addresses of the agreeing parties
- A description of the collateral (the property to which the lien attaches)
Signatures of all agreeing parties
When personal property is used as collateral, the agreement is called a
security interest.
, When the secured property is real estate, the agreement is called a
mortgage.
◉ Explain the By Judicial Process lien type. Answer: A judicial lien
results from a creditor's efforts to collect the debt. When a creditor is
unable to collect a debt using reasonable "pressuring" techniques (which
are regulated by the Fair Debt Collection Practices Act), the creditor
must resort to legally prescribed collection procedures.
◉ Explain the By Statute lien type. Answer: Statutory liens are defined
in specific laws which allow a creditor to secure a specified asset owned
by the debtor. The specified asset may be converted into cash by the
creditor to resolve the outstanding debt.
Four common statutory liens:
- The employee's lien is placed on the employer's personal property to
secure payment of back wages.
- The landlord's lien is placed on the tenant's property to secure payment
of back rent.
- The materialman's and mechanic's liens are placed to secure
compensation of contractors, suppliers, or repair workers.
- A tax lien is a statutory lien, existing in favor of the state or
municipality, upon the lands of a person charged with taxes, binding the
same either for the taxes assessed upon the specific tract of land or (in
some jurisdictions) for all the taxes due from the individual, and which
GUIDE 2026 ALL QUESTIONS WITH ANSWERS
GUARANTEED PASS
◉ ABC Hospital has experienced a 16% increase in new patients over
the past 6 months. The hospital is understaffed in its insurance claim and
payment processing department and cannot handle this increase in work
load. It is considering hiring an outsourcing vendor to assist. What are
the steps that the hospital needs to take to establish and ensure a
successful vendor relationship? Answer: The hospital should distribute a
RFP to solicit vendor capabilities, evaluate vendor's expertise to provide
outsourcing services, visit vendor locations, perform vendor reference
checks, talk with vendor clients, and interview vendor employees to
assess experience level. This sets up an evaluation process, the same as
any other purchased service would be evaluated.
◉ True or False - Patient service costs are calculated in the pre-service
process for scheduled patients. Answer: True
◉ What is the intended outcome of collaborations made through an
ACO delivery system? Answer: By meeting established benchmarks for
quality and efficiency, participating organizations may receive a share of
the savings generated by reducing duplicative services, improving
productivity, minimizing paperwork, and other cost efficiencies.
,◉ Which option is NOT a department that supports and collaborates
with the revenue cycle? Answer: Assisted Living Services
◉ Annually, the OIG publishes a work plan of compliance issues and
objectives that will be focused on throughout the following year. Identify
which option is NOT a work plan task mentioned in this course. Answer:
Standard Unique Employer Identifier
◉ What is the purpose of insurance verification? Answer: To ensure
accuracy of he health plan information.
◉ What are the required components of financial assistance policy
(FAP)? Answer: Eligibility criteria, application process, application
assistance, list of all providers - regardless of network status
◉ Federally-aided, state-operated program to provide health and long-
term care coverage. Answer: Medicaid
Medicaid is for low-income individuals or families. Eligibility for
Medicaid benefits expanded effective January 1, 2014 through a
provision of the Patient Protection and Affordable Care Act (PPACA), as
states were provided additional funding if benefits were extended to
individuals under 65 years of age with incomes up to 133% of the
federal poverty level.
,◉ What are claim edits? Answer: Rules developed to verify the accuracy
and completeness of claims based on each health plan's policies.
Data sources for these claim edits (rules) are Medicare and Medicaid
bulletins and manuals, individual health plan manuals and contracts, and
other documents routinely provided by health plans. The claim editing
process lets providers identify and resolve claim issues to ensure clean
claim submission to the health plan.
◉ What are the various lien types? Answer: By Agreement (consensus),
By Judicial Process, By Statute
◉ Explain the By Agreement (Consensus) lien type. Answer: A creditor
can protect his/her security interest (which lasts until the full balance is
paid) by filing a financing statement under the Uniform Commercial
Code (UCC), usually at the Secretary of State's Office.
The financing statement generally includes the following information:
- Names and addresses of the agreeing parties
- A description of the collateral (the property to which the lien attaches)
Signatures of all agreeing parties
When personal property is used as collateral, the agreement is called a
security interest.
, When the secured property is real estate, the agreement is called a
mortgage.
◉ Explain the By Judicial Process lien type. Answer: A judicial lien
results from a creditor's efforts to collect the debt. When a creditor is
unable to collect a debt using reasonable "pressuring" techniques (which
are regulated by the Fair Debt Collection Practices Act), the creditor
must resort to legally prescribed collection procedures.
◉ Explain the By Statute lien type. Answer: Statutory liens are defined
in specific laws which allow a creditor to secure a specified asset owned
by the debtor. The specified asset may be converted into cash by the
creditor to resolve the outstanding debt.
Four common statutory liens:
- The employee's lien is placed on the employer's personal property to
secure payment of back wages.
- The landlord's lien is placed on the tenant's property to secure payment
of back rent.
- The materialman's and mechanic's liens are placed to secure
compensation of contractors, suppliers, or repair workers.
- A tax lien is a statutory lien, existing in favor of the state or
municipality, upon the lands of a person charged with taxes, binding the
same either for the taxes assessed upon the specific tract of land or (in
some jurisdictions) for all the taxes due from the individual, and which
