CRCR CERTIFICATION EXAM ACTUAL
QUESTIONS WITH REVISED ANSWERS
(2026), (A+ GUARANTEE)
1. HFMA patient financial communications best practices call for annual training for all staff EXCEPT:
A. Patient access
B. Customer service representatives
C. Nursing
D. Staff who engage in patient financial communications discussions
Answer: C. Nursing
Rationale: HFMA guidelines focus on staff who interact directly with patients about financial
matters. Nursing staff, unless directly involved in financial communications, are typically excluded
from this annual training.
2. What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from
Medicare?
A. Medical necessity documentation
B. The CMS 1500 Part B attachment
C. Correct Part A and B procedural codes
D. Revenue codes
Answer: D. Revenue codes
Rationale: UB-04/837-I claims require accurate revenue codes to categorize services for Medicare
reimbursement, ensuring payment aligns with billed services.
3. The most common resolution methods for credit balances include all of the following EXCEPT:
A. Designate the overpayment for charity care
B. Determine the correct primary payer and notify incorrect payer of overpayment
C. Submit the corrected claim to the payer incorporating credits
D. Either send a refund or complete a takeback form as directed by the payer
Answer: A. Designate the overpayment for charity care
Rationale: Overpayments cannot simply be assigned to charity care; proper resolution requires
correction, payer notification, or refund, ensuring compliance with regulations.
4. Net Accounts Receivable is:
A. The total bad debt
B. Total debt owed by an entity
C. The amount an entity is reasonably confident of collecting from overall accounts receivable
D. The total claims amount billed to health plans
Answer: C. The amount an entity is reasonably confident of collecting from overall accounts
receivable
Rationale: Net accounts receivable reflects the realistic collectible amount after accounting for
expected write-offs, providing an accurate financial picture.
5. For routine scenarios, such as patients with insurance coverage or a known ability to pay, financial
discussions:
A. May take place between the patient and discharge planning
B. Should take place between the patient or guarantor and properly trained provider representatives
C. Are optional
D. Are focused on verifying required third-party payer information
Answer: B. Should take place between the patient or guarantor and properly trained provider
, representatives
Rationale: Properly trained staff ensure financial discussions are accurate, compliant, and sensitive,
protecting patient rights and institutional integrity.
6. Scheduled procedures routinely include:
A. Physician's office contact information
B. Physician notification that scheduling is complete
C. The scheduler's name and contact information
D. Patient preparation instructions
Answer: D. Patient preparation instructions
Rationale: Providing preparation instructions is essential for patient safety and procedure success,
reducing delays and enhancing care quality.
7. ICD-10-CM and ICD-10-PCS code sets are modifications of:
A. DRGs
B. CPT codes
C. ICD 9 codes
D. The international ICD-10 codes as developed by the WHO (World Health Organization)
Answer: D. The international ICD-10 codes as developed by the WHO (World Health Organization)
Rationale: ICD-10-CM and PCS are U.S. adaptations of WHO ICD-10, tailored for detailed clinical
documentation and billing purposes.
8. The Medicare Bundled Payments for Care Initiative (BCPI) is designed to:
A. Prevent duplicate billing
B. "Stretch" the impact of patient self-pay by squeezing costs down through a lump-sum payment to
providers
C. Align incentives between hospitals, physicians, and non-physician providers in order to better
coordinate patient care
D. Drive down physician fees by forcing physicians to share equitably in one payment
Answer: C. Align incentives between hospitals, physicians, and non-physician providers in order to
better coordinate patient care
Rationale: BCPI focuses on quality and cost-efficiency by incentivizing coordinated care among
providers rather than targeting billing or individual fee reductions.
9. Which of the following describes the purpose of a remittance advice (RA)?
A. To provide clinical documentation
B. To report patient satisfaction scores
C. To communicate payer payments and adjustments to providers
D. To schedule patient appointments
Answer: C. To communicate payer payments and adjustments to providers
Rationale: Remittance advices provide detailed information about claims paid, denied, or adjusted,
helping providers reconcile accounts accurately.
10. What is the primary function of a guarantor in patient billing?
A. Providing clinical information
B. Ensuring the payment of the patient’s medical bills
C. Diagnosing conditions
D. Authorizing medical procedures
Answer: B. Ensuring the payment of the patient’s medical bills
Rationale: The guarantor is financially responsible for a patient’s account, either the patient or a
designated party, making them central to revenue cycle management.
11. What is the key purpose of the patient financial clearance process?
A. To schedule surgeries
QUESTIONS WITH REVISED ANSWERS
(2026), (A+ GUARANTEE)
1. HFMA patient financial communications best practices call for annual training for all staff EXCEPT:
A. Patient access
B. Customer service representatives
C. Nursing
D. Staff who engage in patient financial communications discussions
Answer: C. Nursing
Rationale: HFMA guidelines focus on staff who interact directly with patients about financial
matters. Nursing staff, unless directly involved in financial communications, are typically excluded
from this annual training.
2. What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from
Medicare?
A. Medical necessity documentation
B. The CMS 1500 Part B attachment
C. Correct Part A and B procedural codes
D. Revenue codes
Answer: D. Revenue codes
Rationale: UB-04/837-I claims require accurate revenue codes to categorize services for Medicare
reimbursement, ensuring payment aligns with billed services.
3. The most common resolution methods for credit balances include all of the following EXCEPT:
A. Designate the overpayment for charity care
B. Determine the correct primary payer and notify incorrect payer of overpayment
C. Submit the corrected claim to the payer incorporating credits
D. Either send a refund or complete a takeback form as directed by the payer
Answer: A. Designate the overpayment for charity care
Rationale: Overpayments cannot simply be assigned to charity care; proper resolution requires
correction, payer notification, or refund, ensuring compliance with regulations.
4. Net Accounts Receivable is:
A. The total bad debt
B. Total debt owed by an entity
C. The amount an entity is reasonably confident of collecting from overall accounts receivable
D. The total claims amount billed to health plans
Answer: C. The amount an entity is reasonably confident of collecting from overall accounts
receivable
Rationale: Net accounts receivable reflects the realistic collectible amount after accounting for
expected write-offs, providing an accurate financial picture.
5. For routine scenarios, such as patients with insurance coverage or a known ability to pay, financial
discussions:
A. May take place between the patient and discharge planning
B. Should take place between the patient or guarantor and properly trained provider representatives
C. Are optional
D. Are focused on verifying required third-party payer information
Answer: B. Should take place between the patient or guarantor and properly trained provider
, representatives
Rationale: Properly trained staff ensure financial discussions are accurate, compliant, and sensitive,
protecting patient rights and institutional integrity.
6. Scheduled procedures routinely include:
A. Physician's office contact information
B. Physician notification that scheduling is complete
C. The scheduler's name and contact information
D. Patient preparation instructions
Answer: D. Patient preparation instructions
Rationale: Providing preparation instructions is essential for patient safety and procedure success,
reducing delays and enhancing care quality.
7. ICD-10-CM and ICD-10-PCS code sets are modifications of:
A. DRGs
B. CPT codes
C. ICD 9 codes
D. The international ICD-10 codes as developed by the WHO (World Health Organization)
Answer: D. The international ICD-10 codes as developed by the WHO (World Health Organization)
Rationale: ICD-10-CM and PCS are U.S. adaptations of WHO ICD-10, tailored for detailed clinical
documentation and billing purposes.
8. The Medicare Bundled Payments for Care Initiative (BCPI) is designed to:
A. Prevent duplicate billing
B. "Stretch" the impact of patient self-pay by squeezing costs down through a lump-sum payment to
providers
C. Align incentives between hospitals, physicians, and non-physician providers in order to better
coordinate patient care
D. Drive down physician fees by forcing physicians to share equitably in one payment
Answer: C. Align incentives between hospitals, physicians, and non-physician providers in order to
better coordinate patient care
Rationale: BCPI focuses on quality and cost-efficiency by incentivizing coordinated care among
providers rather than targeting billing or individual fee reductions.
9. Which of the following describes the purpose of a remittance advice (RA)?
A. To provide clinical documentation
B. To report patient satisfaction scores
C. To communicate payer payments and adjustments to providers
D. To schedule patient appointments
Answer: C. To communicate payer payments and adjustments to providers
Rationale: Remittance advices provide detailed information about claims paid, denied, or adjusted,
helping providers reconcile accounts accurately.
10. What is the primary function of a guarantor in patient billing?
A. Providing clinical information
B. Ensuring the payment of the patient’s medical bills
C. Diagnosing conditions
D. Authorizing medical procedures
Answer: B. Ensuring the payment of the patient’s medical bills
Rationale: The guarantor is financially responsible for a patient’s account, either the patient or a
designated party, making them central to revenue cycle management.
11. What is the key purpose of the patient financial clearance process?
A. To schedule surgeries
