CERTIFIED REVENUE CYCLE REPRESENTATIVE
EXAM 2 REVIEW AND SOLUTIONS 2026
◉ What is the intended outcome of collaborations made through an
ACO delivery system? Answer: **A. To ensure appropriateness of
care, elimination of duplicate services, and prevention of medical
errors for a population of patients.
B. To create cost-containment provisions to reform the healthcare
delivery system.
C. To reform the healthcare system into a system that rewards
greater value, improves the quality of care and increases efficiency
in the delivery of services.
D. To provide financial incentives to physicians for reporting quality
data to CMS.
◉ Which of these statements describes the new methodology for the
determination of net patient service revenue: Answer: A. Net patient
service revenue is defined as the average payment amount for the
payer but not recorded until the end of the month processing is
completed.
B. Gross patient service revenue is recorded as net patient service
revenue until such time as all payments are received.
**C. Net patient service revenue is defined as the total incurred
charges, less the explicit price concession, less any applicable
,implicit price concession(s) as applied to the specific portfolio of
accounts.
D. Net patient service revenue is gross revenue minus any
contractual adjustments applicable to the account. Any additional
adjustments are not recorded until the account reaches a zero
balance.
E. Net patient service revenue is the sum of the balances of all
charges and payments recorded in the accounting period.
◉ What are KPIs? Answer: A. Benchmarks which are used to
compare Key Performance Indicators in an organization to an agreed
upon average or expected standard within the same industry.
**B. Key performance indicators, which set standards for accounts
receivable (A/R) and provide a method of measuring the collection
and control of A/R.
C. Days in A/R is calculated based on the value of the total accounts
receivable on a specific date.
D. A component that can divide the accounts receivable into 30, 60,
90, 120 days, and over 120 days categories, based on the date of
service/discharge
◉ While the highest level of differentiation among patients is
scheduled patient vs unscheduled patient, a variety of patient types
are routinely identified in both the acute and non-acute settings.
Which patient types are typically considered acute care patient
types? Answer: Observation, newborn, Emergency (ED)
, ◉ Accurate identification of the patient is the first step in the
scheduling process. Identifiers used in various combination to
achieve accurate patient identification include? Answer: Full legal
name, date of birth, sex and social security number
◉ Pre-registration is defined as: Answer: The collection of
demographic information, insurance data, financial information,
providing reminders, prep information, and identifying the potential
need for financial assistance for scheduled patients.
◉ Medicare has unique features not found in other health plan
programs. It is government sponsored and financed through taxes
and general revenue funds. Which of the following statements
accurately describes the various Medicare benefits programs:
Answer: Medicare Part A provides benefits for inpatient hospital
services, skilled nursing care and home health care; Medicare Part B
covers outpatient and professional services, Medicare Part C or
Medicare Advantage plans are managed care plans combining Part A
and Part B Coverages; and Medicare Part D is the prescription drug
coverage benefit.
◉ Which of the following statements about Medicaid eligibility is not
true? Answer: Medicaid categories are restricted to children,
pregnant women and elderly in nursing homes.
EXAM 2 REVIEW AND SOLUTIONS 2026
◉ What is the intended outcome of collaborations made through an
ACO delivery system? Answer: **A. To ensure appropriateness of
care, elimination of duplicate services, and prevention of medical
errors for a population of patients.
B. To create cost-containment provisions to reform the healthcare
delivery system.
C. To reform the healthcare system into a system that rewards
greater value, improves the quality of care and increases efficiency
in the delivery of services.
D. To provide financial incentives to physicians for reporting quality
data to CMS.
◉ Which of these statements describes the new methodology for the
determination of net patient service revenue: Answer: A. Net patient
service revenue is defined as the average payment amount for the
payer but not recorded until the end of the month processing is
completed.
B. Gross patient service revenue is recorded as net patient service
revenue until such time as all payments are received.
**C. Net patient service revenue is defined as the total incurred
charges, less the explicit price concession, less any applicable
,implicit price concession(s) as applied to the specific portfolio of
accounts.
D. Net patient service revenue is gross revenue minus any
contractual adjustments applicable to the account. Any additional
adjustments are not recorded until the account reaches a zero
balance.
E. Net patient service revenue is the sum of the balances of all
charges and payments recorded in the accounting period.
◉ What are KPIs? Answer: A. Benchmarks which are used to
compare Key Performance Indicators in an organization to an agreed
upon average or expected standard within the same industry.
**B. Key performance indicators, which set standards for accounts
receivable (A/R) and provide a method of measuring the collection
and control of A/R.
C. Days in A/R is calculated based on the value of the total accounts
receivable on a specific date.
D. A component that can divide the accounts receivable into 30, 60,
90, 120 days, and over 120 days categories, based on the date of
service/discharge
◉ While the highest level of differentiation among patients is
scheduled patient vs unscheduled patient, a variety of patient types
are routinely identified in both the acute and non-acute settings.
Which patient types are typically considered acute care patient
types? Answer: Observation, newborn, Emergency (ED)
, ◉ Accurate identification of the patient is the first step in the
scheduling process. Identifiers used in various combination to
achieve accurate patient identification include? Answer: Full legal
name, date of birth, sex and social security number
◉ Pre-registration is defined as: Answer: The collection of
demographic information, insurance data, financial information,
providing reminders, prep information, and identifying the potential
need for financial assistance for scheduled patients.
◉ Medicare has unique features not found in other health plan
programs. It is government sponsored and financed through taxes
and general revenue funds. Which of the following statements
accurately describes the various Medicare benefits programs:
Answer: Medicare Part A provides benefits for inpatient hospital
services, skilled nursing care and home health care; Medicare Part B
covers outpatient and professional services, Medicare Part C or
Medicare Advantage plans are managed care plans combining Part A
and Part B Coverages; and Medicare Part D is the prescription drug
coverage benefit.
◉ Which of the following statements about Medicaid eligibility is not
true? Answer: Medicaid categories are restricted to children,
pregnant women and elderly in nursing homes.
