2026/2027
HFMA CRER Certification Exam
2026/2027 Comprehensive Study
Guide, Practice Questions, Test Bank
Review, and Exam Preparation
Manual
Question 1:
What are collection agency fees typically based on in healthcare revenue cycle
management?
A. The patient's annual income
B. A percentage of dollars collected
C. The number of collection calls completed
D. A flat monthly administrative fee
Correct Answer: B. A percentage of dollars collected
Rationale: Collection agencies are commonly paid on a contingency basis, meaning
they earn a percentage of the amount successfully recovered. This aligns their
incentive with performance. The other options are not standard payment structures in
healthcare collections.
Question 2:
Self-funded benefit plans may coordinate benefits using the gender rule or which
other rule?
A. Employer rule
B. Birthday rule
C. Seniority rule
D. Geographic rule
Correct Answer: B. Birthday rule
Rationale: The birthday rule is widely used in coordination of benefits and determines
primary coverage based on the parent whose birthday falls earlier in the year. Other
options are not standard COB rules.
,2026/2027
Question 3:
In what payment methodology is a lump sum or bundled payment negotiated for
services?
A. Fee-for-service
B. Capitation
C. Case rates
D. Retrospective payment
Correct Answer: C. Case rates
Rationale: Case rates provide a fixed payment for a defined episode of care,
encouraging cost efficiency. Fee-for-service pays per service, while capitation pays
per member per month.
Question 4:
What customer service improvement helps patient accounts departments?
A. Reducing supervision
B. Eliminating reviews
C. Holding staff accountable during performance reviews
D. Ignoring complaints
Correct Answer: C. Holding staff accountable during performance reviews
Rationale: Performance accountability improves service quality, patient satisfaction,
and financial outcomes. Lack of accountability reduces performance standards.
Question 5:
What is the purpose of an ABN (Advance Beneficiary Notice)?
A. Approve surgery
B. Report fraud
C. Inform Medicare may not pay
D. Guarantee insurance payment
Correct Answer: C. Inform Medicare may not pay
Rationale: ABNs notify Medicare patients that a service may not be covered, allowing
them to decide whether to proceed and accept financial responsibility.
Question 6:
,2026/2027
What type of adjustment results from a patient's refusal to pay self-pay balances?
A. Contractual adjustment
B. Charity adjustment
C. Bad debt adjustment
D. Credit adjustment
Correct Answer: C. Bad debt adjustment
Rationale: Bad debt occurs when a patient refuses or fails to pay after collection
efforts. Charity care is pre-approved financial assistance.
Question 7:
What is the initial hospice benefit period under Medicare?
A. One 30-day period
B. Two 90-day periods plus unlimited 60-day periods
C. Three 60-day periods only
D. One lifetime period
Correct Answer: B. Two 90-day periods plus unlimited 60-day periods
Rationale: Medicare hospice begins with two 90-day periods followed by unlimited
60-day recertifications if eligibility continues.
Question 8:
When are ambulance charges added to a Medicare inpatient claim?
A. Routine transport
B. Transport to physician office
C. Transport to skilled nursing facility when medically necessary
D. Patient convenience transport
Correct Answer: C. Transport to skilled nursing facility when medically
necessary
Rationale: Medicare covers medically necessary ambulance transport to SNFs when
criteria are met.
Question 9:
How should late charge credits be handled after billing?
, 2026/2027
A. Ignore
B. Void claim
C. Post late-charge adjustment
D. Send new claim
Correct Answer: C. Post late-charge adjustment
Rationale: Adjustments ensure accurate financial records without rebilling entire
claims.
Question 10:
What does an increase in accounts over 90 days indicate?
A. Efficient billing
B. Timely processing
C. Delayed revenue cycle processing
D. Increased profit
Correct Answer: C. Delayed revenue cycle processing
Rationale: Aging accounts indicate inefficiency in billing, follow-up, or collections.
Question 11:
Advantage of preregistration?
A. Increases wait time
B. Reduces processing time at service
C. Eliminates insurance
D. Removes billing
Correct Answer: B. Reduces processing time at service
Rationale: Preregistration improves workflow and reduces delays during patient
arrival.
Question 12:
Hospice statutory exclusions include:
A. Emergency care
B. Preventive care
C. Medically unnecessary services and custodial care
D. Dental care
HFMA CRER Certification Exam
2026/2027 Comprehensive Study
Guide, Practice Questions, Test Bank
Review, and Exam Preparation
Manual
Question 1:
What are collection agency fees typically based on in healthcare revenue cycle
management?
A. The patient's annual income
B. A percentage of dollars collected
C. The number of collection calls completed
D. A flat monthly administrative fee
Correct Answer: B. A percentage of dollars collected
Rationale: Collection agencies are commonly paid on a contingency basis, meaning
they earn a percentage of the amount successfully recovered. This aligns their
incentive with performance. The other options are not standard payment structures in
healthcare collections.
Question 2:
Self-funded benefit plans may coordinate benefits using the gender rule or which
other rule?
A. Employer rule
B. Birthday rule
C. Seniority rule
D. Geographic rule
Correct Answer: B. Birthday rule
Rationale: The birthday rule is widely used in coordination of benefits and determines
primary coverage based on the parent whose birthday falls earlier in the year. Other
options are not standard COB rules.
,2026/2027
Question 3:
In what payment methodology is a lump sum or bundled payment negotiated for
services?
A. Fee-for-service
B. Capitation
C. Case rates
D. Retrospective payment
Correct Answer: C. Case rates
Rationale: Case rates provide a fixed payment for a defined episode of care,
encouraging cost efficiency. Fee-for-service pays per service, while capitation pays
per member per month.
Question 4:
What customer service improvement helps patient accounts departments?
A. Reducing supervision
B. Eliminating reviews
C. Holding staff accountable during performance reviews
D. Ignoring complaints
Correct Answer: C. Holding staff accountable during performance reviews
Rationale: Performance accountability improves service quality, patient satisfaction,
and financial outcomes. Lack of accountability reduces performance standards.
Question 5:
What is the purpose of an ABN (Advance Beneficiary Notice)?
A. Approve surgery
B. Report fraud
C. Inform Medicare may not pay
D. Guarantee insurance payment
Correct Answer: C. Inform Medicare may not pay
Rationale: ABNs notify Medicare patients that a service may not be covered, allowing
them to decide whether to proceed and accept financial responsibility.
Question 6:
,2026/2027
What type of adjustment results from a patient's refusal to pay self-pay balances?
A. Contractual adjustment
B. Charity adjustment
C. Bad debt adjustment
D. Credit adjustment
Correct Answer: C. Bad debt adjustment
Rationale: Bad debt occurs when a patient refuses or fails to pay after collection
efforts. Charity care is pre-approved financial assistance.
Question 7:
What is the initial hospice benefit period under Medicare?
A. One 30-day period
B. Two 90-day periods plus unlimited 60-day periods
C. Three 60-day periods only
D. One lifetime period
Correct Answer: B. Two 90-day periods plus unlimited 60-day periods
Rationale: Medicare hospice begins with two 90-day periods followed by unlimited
60-day recertifications if eligibility continues.
Question 8:
When are ambulance charges added to a Medicare inpatient claim?
A. Routine transport
B. Transport to physician office
C. Transport to skilled nursing facility when medically necessary
D. Patient convenience transport
Correct Answer: C. Transport to skilled nursing facility when medically
necessary
Rationale: Medicare covers medically necessary ambulance transport to SNFs when
criteria are met.
Question 9:
How should late charge credits be handled after billing?
, 2026/2027
A. Ignore
B. Void claim
C. Post late-charge adjustment
D. Send new claim
Correct Answer: C. Post late-charge adjustment
Rationale: Adjustments ensure accurate financial records without rebilling entire
claims.
Question 10:
What does an increase in accounts over 90 days indicate?
A. Efficient billing
B. Timely processing
C. Delayed revenue cycle processing
D. Increased profit
Correct Answer: C. Delayed revenue cycle processing
Rationale: Aging accounts indicate inefficiency in billing, follow-up, or collections.
Question 11:
Advantage of preregistration?
A. Increases wait time
B. Reduces processing time at service
C. Eliminates insurance
D. Removes billing
Correct Answer: B. Reduces processing time at service
Rationale: Preregistration improves workflow and reduces delays during patient
arrival.
Question 12:
Hospice statutory exclusions include:
A. Emergency care
B. Preventive care
C. Medically unnecessary services and custodial care
D. Dental care
