Certified Revenue Cycle Representative (CRCR) Certification:Questions and Verified
Answers
"Hard-coded" is the term used to refer to - ansCodes for services, procedures, and drugs automatically assigned
by the charge master
A balance sheet is - ansA statement of assets, liabilities, and capital for an organization at a specified point in
time
A claim for reimbursement submitted to a third-party payer that has all the information and documentation
required for the payer to make a decision on it is known as - ansA clean claim
A claim is denied for the following reasons, EXCEPT: - ansThe submitted claim does not have the physicians
signature
A comprehensive "Compliance Program" is defined as - ansSystematic procedures to ensure that the provisions
of regulations imposed by a government agency are being met
A decision on whether a patient should be admitted as an inpatient or become about patient observation
patient requires medical judgments based on all of the following EXCEPT - ansThe patient's home care coverage
A four digit number code established by the National Uniform Billing Committee (NUBC)that
categorizes/classifies a line item in the charge master is known as - ansRevenue codes
A large number of credit balances are not the result of overpayments but of - ansPosting errors in the patient
accounting system
A Medicare Part A benefit period begins: - ansWith admission as an inpatient
A nightly room charge will be incorrect if the patient's - ansTransfer from ICU (intensive care unit) to the
,Medical/Surgical
floor is not reflected in the registration system
A portion of the accounts receivable inventory which has NOT qualified for billing includes - ansCharitable
pledges
A portion of the accounts receivable inventory which has NOT qualified for billing includes: - ansCharitable
pledges
A recurring/series registration is characterized by - ansThe creation of one registration record for multiple days
of service
A scheduled inpatient represents an opportunity for the provider to do which of the following? - ansComplete
registration and insurance approval before service
A typical routine patient financial discussion would include - ansExplaining the benefits identified through
verifying the patients insurance
Account Receivable (A/R) Aging reports - ansDivide accounts receivable into 30, 60, 90 ,120 days past due
categories
Across all care settings, if a patient consents to a financial discussion during a medical encounter - ansSupport
that choice, providing that the discussion does not interfere with patient care or disrupt patient flow
Across all care settings, if a patient consents to a financial discussion during a medical encounter to expedite
discharge, the HFMA best practice is to: - ansSupport that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow
All Hospitals are required to establish a written financial assistance policy that applies to - ansAll emergency
and medically necessary care
,All of the following are conditions that disqualify a procedure or service from being paid for by Medicare
EXCEPT - ansServices and procedures that are custodial in nature
All of the following are forms of hospital payment contracting EXCEPT - ansContracted Rebating
All of the following are minimum requirements for new patients with no MPI number EXCEPT - ansAddress
All of the following are potential causes of credit balances EXCEPT - ansA patient's choice to build up a credit
against future medical bills
All of the following are reference resources used to help guide in the application of business ethics EXCEPT -
ansConsumer satisfaction reports
All of the following are steps in safeguarding collections EXCEPT - ansIssuing receipts
All of the following are steps in verifying insurance EXCEPT - ansThe patient signing the statement of financial
responsibility
All of the following information should be reviewed as part of schedule finalization EXCEPT: - ansThe results of
any and all test
Ambulance services are billed directly to the health plan for - ansServices provided before a patient is admitted
and for ambulance rides arranged to pick up the patient from the hospital after discharge to take him/her
home or to another facility
Ambulance services are billed directly to the health plan for - ansThe portion of the bill outside of the patient's
self-pay
An advantage of a pre-registration program is - ansThe opportunity to reduce the corporate compliance
failures within the registration process
, An individual enrolled in Medicare who is dissatisfied with the government's claim determination is entitled to
reconsideration of the decision. This type of appeal is known as - ansA beneficiary appeal
An originating site is - ansThe location of the patient at the time the service is provided
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and treatment
services for an enrolled group of persons based on a monthly fee is known as a - ansHMO
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and treatment
services for an enrolled group of persons based on; a monthly fee is known as a - ansHMO
Any provider that has filed a timely cost report may appeal an adverse final decision received from the
Medicare Administrative Contractor (MAC). This appeal may be filed with - ansThe Provider Reimbursement
Review Board
Applying the contracted payment amount to the amount of total charges yields - ansA pricing agreement
Appropriate training for patient financial counseling staff must cover all of the following EXCEPT: -
ansDocumenting the conversation in the medical records
Because 501(r) regulations focus on identifying potential eligible financial assistants patients hospitals must: -
ansHold financial conversations with patients as soon as possible
Because case managers document the clinical reasons for treatment, they are - ansA good resource when
developing written appeals of denials
Before classifying and subsequently writing off an account to financial assistance or bad debt, the hospital must
establish policy, define appropriate criteria, implement - ansMonitor compliance
Answers
"Hard-coded" is the term used to refer to - ansCodes for services, procedures, and drugs automatically assigned
by the charge master
A balance sheet is - ansA statement of assets, liabilities, and capital for an organization at a specified point in
time
A claim for reimbursement submitted to a third-party payer that has all the information and documentation
required for the payer to make a decision on it is known as - ansA clean claim
A claim is denied for the following reasons, EXCEPT: - ansThe submitted claim does not have the physicians
signature
A comprehensive "Compliance Program" is defined as - ansSystematic procedures to ensure that the provisions
of regulations imposed by a government agency are being met
A decision on whether a patient should be admitted as an inpatient or become about patient observation
patient requires medical judgments based on all of the following EXCEPT - ansThe patient's home care coverage
A four digit number code established by the National Uniform Billing Committee (NUBC)that
categorizes/classifies a line item in the charge master is known as - ansRevenue codes
A large number of credit balances are not the result of overpayments but of - ansPosting errors in the patient
accounting system
A Medicare Part A benefit period begins: - ansWith admission as an inpatient
A nightly room charge will be incorrect if the patient's - ansTransfer from ICU (intensive care unit) to the
,Medical/Surgical
floor is not reflected in the registration system
A portion of the accounts receivable inventory which has NOT qualified for billing includes - ansCharitable
pledges
A portion of the accounts receivable inventory which has NOT qualified for billing includes: - ansCharitable
pledges
A recurring/series registration is characterized by - ansThe creation of one registration record for multiple days
of service
A scheduled inpatient represents an opportunity for the provider to do which of the following? - ansComplete
registration and insurance approval before service
A typical routine patient financial discussion would include - ansExplaining the benefits identified through
verifying the patients insurance
Account Receivable (A/R) Aging reports - ansDivide accounts receivable into 30, 60, 90 ,120 days past due
categories
Across all care settings, if a patient consents to a financial discussion during a medical encounter - ansSupport
that choice, providing that the discussion does not interfere with patient care or disrupt patient flow
Across all care settings, if a patient consents to a financial discussion during a medical encounter to expedite
discharge, the HFMA best practice is to: - ansSupport that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow
All Hospitals are required to establish a written financial assistance policy that applies to - ansAll emergency
and medically necessary care
,All of the following are conditions that disqualify a procedure or service from being paid for by Medicare
EXCEPT - ansServices and procedures that are custodial in nature
All of the following are forms of hospital payment contracting EXCEPT - ansContracted Rebating
All of the following are minimum requirements for new patients with no MPI number EXCEPT - ansAddress
All of the following are potential causes of credit balances EXCEPT - ansA patient's choice to build up a credit
against future medical bills
All of the following are reference resources used to help guide in the application of business ethics EXCEPT -
ansConsumer satisfaction reports
All of the following are steps in safeguarding collections EXCEPT - ansIssuing receipts
All of the following are steps in verifying insurance EXCEPT - ansThe patient signing the statement of financial
responsibility
All of the following information should be reviewed as part of schedule finalization EXCEPT: - ansThe results of
any and all test
Ambulance services are billed directly to the health plan for - ansServices provided before a patient is admitted
and for ambulance rides arranged to pick up the patient from the hospital after discharge to take him/her
home or to another facility
Ambulance services are billed directly to the health plan for - ansThe portion of the bill outside of the patient's
self-pay
An advantage of a pre-registration program is - ansThe opportunity to reduce the corporate compliance
failures within the registration process
, An individual enrolled in Medicare who is dissatisfied with the government's claim determination is entitled to
reconsideration of the decision. This type of appeal is known as - ansA beneficiary appeal
An originating site is - ansThe location of the patient at the time the service is provided
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and treatment
services for an enrolled group of persons based on a monthly fee is known as a - ansHMO
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and treatment
services for an enrolled group of persons based on; a monthly fee is known as a - ansHMO
Any provider that has filed a timely cost report may appeal an adverse final decision received from the
Medicare Administrative Contractor (MAC). This appeal may be filed with - ansThe Provider Reimbursement
Review Board
Applying the contracted payment amount to the amount of total charges yields - ansA pricing agreement
Appropriate training for patient financial counseling staff must cover all of the following EXCEPT: -
ansDocumenting the conversation in the medical records
Because 501(r) regulations focus on identifying potential eligible financial assistants patients hospitals must: -
ansHold financial conversations with patients as soon as possible
Because case managers document the clinical reasons for treatment, they are - ansA good resource when
developing written appeals of denials
Before classifying and subsequently writing off an account to financial assistance or bad debt, the hospital must
establish policy, define appropriate criteria, implement - ansMonitor compliance
