CRCR Certification
PERP · RCRC
★ $ ★
CRCR Certified Revenue Cycle Representative
EST. 2005
EXCELLENCE IN REVENUE CYCLE MANAGEMENT
CRCR Exam Prep — Comprehensive Review
R E V E N U E CYC L E M A N AG E M E N T
INSTITUTION CRCR Certification COURSE CODE CRCR Prep
PROGRAM Revenue Cycle Certification ACADEMIC YEAR
EXAM TITLE Exam Preparation TOTAL QUESTIONS 110 Questions
COURSE TITLE Revenue Cycle Management FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover revenue cycle management principles and regulations.
▸ Topics include Medicare, Medicaid, HIPAA, and financial management.
▸ Correct answers and detailed rationales appear below each question.
▸ All content reflects current HFMA and healthcare finance standards.
, SECTION I — REVENUE CYCLE MANAGEMENT Questions 1 – 110
1. What are collection agency fees based on?
A. A percentage of dollars collected
B. A flat fee per account
C. Hourly rates
D. Monthly retainer fees
CORRECT ANSWER A — A percentage of dollars collected
RATIONALE Collection agency fees are typically based on a percentage of the dollars
collected. The percentage varies based on the age of the account and the agency's
fee structure.
2. Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule?
A. Birthday
B. Age
C. Employment status
D. Social Security number
CORRECT ANSWER A — Birthday
RATIONALE Self-funded benefit plans may use the birthday rule to coordinate benefits. Under
this rule, the plan of the person whose birthday occurs first in the calendar year is
primary.
,3. In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers?
A. Case rates
B. Per diem rates
C. Capitation
D. Fee-for-service
CORRECT ANSWER A — Case rates
RATIONALE Case rates involve a lump sum or bundled payment negotiated between the payer
and providers for a specific episode of care or procedure.
4. What customer service improvements might improve the patient accounts department?
A. Holding staff accountable for customer service during performance reviews
B. Reducing staff training
C. Eliminating customer service metrics
D. Automating all patient interactions
CORRECT ANSWER A — Holding staff accountable for customer service during performance
reviews
RATIONALE Holding staff accountable for customer service during performance reviews
improves patient accounts department performance. It reinforces the importance
of patient satisfaction.
, 5. What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
A. Inform a Medicare beneficiary that Medicare may not pay for the order or service
B. Guarantee Medicare payment
C. Waive patient financial responsibility
D. Notify the provider of coverage changes
CORRECT ANSWER A — Inform a Medicare beneficiary that Medicare may not pay for the order
or service
RATIONALE An Advance Beneficiary Notice (ABN) informs Medicare beneficiaries that
Medicare may not pay for the ordered service. It allows the beneficiary to decide
whether to proceed and accept financial responsibility.
6. What type of account adjustment results from the patient's unwillingness to pay for a self-
pay balance?
A. Bad debt adjustment
B. Financial assistance adjustment
C. Contractual adjustment
D. Administrative adjustment
CORRECT ANSWER A — Bad debt adjustment
RATIONALE Bad debt adjustment results from a patient's unwillingness to pay a self-pay
balance after reasonable collection efforts have been made.
PERP · RCRC
★ $ ★
CRCR Certified Revenue Cycle Representative
EST. 2005
EXCELLENCE IN REVENUE CYCLE MANAGEMENT
CRCR Exam Prep — Comprehensive Review
R E V E N U E CYC L E M A N AG E M E N T
INSTITUTION CRCR Certification COURSE CODE CRCR Prep
PROGRAM Revenue Cycle Certification ACADEMIC YEAR
EXAM TITLE Exam Preparation TOTAL QUESTIONS 110 Questions
COURSE TITLE Revenue Cycle Management FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover revenue cycle management principles and regulations.
▸ Topics include Medicare, Medicaid, HIPAA, and financial management.
▸ Correct answers and detailed rationales appear below each question.
▸ All content reflects current HFMA and healthcare finance standards.
, SECTION I — REVENUE CYCLE MANAGEMENT Questions 1 – 110
1. What are collection agency fees based on?
A. A percentage of dollars collected
B. A flat fee per account
C. Hourly rates
D. Monthly retainer fees
CORRECT ANSWER A — A percentage of dollars collected
RATIONALE Collection agency fees are typically based on a percentage of the dollars
collected. The percentage varies based on the age of the account and the agency's
fee structure.
2. Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule?
A. Birthday
B. Age
C. Employment status
D. Social Security number
CORRECT ANSWER A — Birthday
RATIONALE Self-funded benefit plans may use the birthday rule to coordinate benefits. Under
this rule, the plan of the person whose birthday occurs first in the calendar year is
primary.
,3. In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers?
A. Case rates
B. Per diem rates
C. Capitation
D. Fee-for-service
CORRECT ANSWER A — Case rates
RATIONALE Case rates involve a lump sum or bundled payment negotiated between the payer
and providers for a specific episode of care or procedure.
4. What customer service improvements might improve the patient accounts department?
A. Holding staff accountable for customer service during performance reviews
B. Reducing staff training
C. Eliminating customer service metrics
D. Automating all patient interactions
CORRECT ANSWER A — Holding staff accountable for customer service during performance
reviews
RATIONALE Holding staff accountable for customer service during performance reviews
improves patient accounts department performance. It reinforces the importance
of patient satisfaction.
, 5. What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
A. Inform a Medicare beneficiary that Medicare may not pay for the order or service
B. Guarantee Medicare payment
C. Waive patient financial responsibility
D. Notify the provider of coverage changes
CORRECT ANSWER A — Inform a Medicare beneficiary that Medicare may not pay for the order
or service
RATIONALE An Advance Beneficiary Notice (ABN) informs Medicare beneficiaries that
Medicare may not pay for the ordered service. It allows the beneficiary to decide
whether to proceed and accept financial responsibility.
6. What type of account adjustment results from the patient's unwillingness to pay for a self-
pay balance?
A. Bad debt adjustment
B. Financial assistance adjustment
C. Contractual adjustment
D. Administrative adjustment
CORRECT ANSWER A — Bad debt adjustment
RATIONALE Bad debt adjustment results from a patient's unwillingness to pay a self-pay
balance after reasonable collection efforts have been made.
