Healthcare Financial Management
PERP MAXE · RCRC
HFMA
CRCR
Association
Certified Revenue Cycle Representative Program
EST. 1946
L E A D I N G H E A LT H C A R E F I N A N C E
CRCR — Certified Revenue Cycle Representative
Examination
R E V E N U E CYC L E · PAT I E N T ACC E SS · B I L L I N G · CO M P L I A N C E · M E D I C A R E · M A N AG E D
CARE
INSTITUTION Healthcare Financial Management PROGRAM Certified Revenue Cycle
Association (HFMA) Representative (CRCR)
ACADEMIC YEAR EXAM TITLE CRCR Exam Prep —
Comprehensive Review
TOTAL QUESTIONS 150 Questions COURSE TITLE Revenue Cycle Representative
Certification
FORMAT Multiple Choice — Select the HQ Westchester, Illinois
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Content covers revenue cycle, patient access, billing, compliance, Medicare regulations, managed care,
and financial management.
▸ Correct answers and detailed rationales appear below each question for CRCR certification preparation.
, SECTION I — REVENUE CYCLE FUNDAMENTALS &
Questions 1 – 40
PATIENT ACCESS
1. What are collection agency fees based on?
A. A flat monthly retainer
B. A percentage of dollars collected
C. The number of accounts assigned
D. The age of the accounts
CORRECT ANSWER B — A percentage of dollars collected
RATIONALE Collection agencies typically charge a contingency fee based on a percentage of
the amounts they successfully collect. This aligns the agency's incentive with the
provider's goal — the agency is only paid when they recover money. The
percentage varies based on account volume, age of accounts, and type of debt.
This is the industry standard for healthcare collection agency agreements.
2. Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule?
A. Age rule
B. Birthday rule
C. Employment rule
D. Enrollment date rule
CORRECT ANSWER B — Birthday rule
RATIONALE The birthday rule is a common COB (Coordination of Benefits) method: the
parent whose birthday (month and day) falls earlier in the calendar year is
primary. Self-funded plans may use either the gender rule or the birthday rule.
The birthday rule is the most commonly applied coordination method when
dependents are covered by both parents' plans.
,3. In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers?
A. Fee-for-service
B. Per diem
C. Case rates
D. Discounted charges
CORRECT ANSWER C — Case rates
RATIONALE Case rates (also called bundled payments or episode-of-care payments) involve a
single lump sum payment that covers all services related to a specific procedure
or condition across multiple providers. This contrasts with fee-for-service (A)
where each service is paid separately, per diem (B) which pays a daily rate, and
discounted charges (D) which applies a discount to billed charges.
4. What customer service improvements might improve the patient accounts department?
A. Reducing staff training to cut costs
B. Holding staff accountable for customer service during performance reviews
C. Limiting patient contact hours
D. Automating all patient interactions without human oversight
CORRECT ANSWER B — Holding staff accountable for customer service during performance
reviews
RATIONALE Integrating customer service metrics into performance evaluations creates
accountability and incentivizes staff to provide excellent patient interactions.
This is a key HFMA best practice. Reducing training (A) and limiting contact (C)
would worsen service. Complete automation without oversight (D) may miss
complex patient needs requiring human judgment.
, 5. What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
A. Guarantee Medicare payment for the service
B. Inform a Medicare beneficiary that Medicare may not pay for the order or service
C. Authorize the provider to bill the patient at a higher rate
D. Replace the need for a physician's order
CORRECT ANSWER B — Inform a Medicare beneficiary that Medicare may not pay for the order
or service
RATIONALE An ABN is a mandatory notice given to Medicare beneficiaries BEFORE receiving a
service that Medicare may not cover. It informs the patient of their potential
financial liability and gives them the choice to accept or decline the service. It
does NOT guarantee payment (A), authorize higher billing (C), or replace
physician orders (D).
6. What type of account adjustment results from the patient's unwillingness to pay for a
self-pay balance?
A. Charity adjustment
B. Bad debt adjustment
C. Contractual adjustment
D. Administrative adjustment
CORRECT ANSWER B — Bad debt adjustment
RATIONALE Bad debt results from a patient's UNWILLINGNESS (not inability) to pay. Charity
care (A) is for patients who CANNOT pay. Contractual adjustments (C) are
negotiated discounts with payers. Administrative adjustments (D) correct billing
errors. The distinction between bad debt (unwillingness) and charity care
(inability) is critical for financial reporting and IRS 990 Schedule H requirements.
PERP MAXE · RCRC
HFMA
CRCR
Association
Certified Revenue Cycle Representative Program
EST. 1946
L E A D I N G H E A LT H C A R E F I N A N C E
CRCR — Certified Revenue Cycle Representative
Examination
R E V E N U E CYC L E · PAT I E N T ACC E SS · B I L L I N G · CO M P L I A N C E · M E D I C A R E · M A N AG E D
CARE
INSTITUTION Healthcare Financial Management PROGRAM Certified Revenue Cycle
Association (HFMA) Representative (CRCR)
ACADEMIC YEAR EXAM TITLE CRCR Exam Prep —
Comprehensive Review
TOTAL QUESTIONS 150 Questions COURSE TITLE Revenue Cycle Representative
Certification
FORMAT Multiple Choice — Select the HQ Westchester, Illinois
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Content covers revenue cycle, patient access, billing, compliance, Medicare regulations, managed care,
and financial management.
▸ Correct answers and detailed rationales appear below each question for CRCR certification preparation.
, SECTION I — REVENUE CYCLE FUNDAMENTALS &
Questions 1 – 40
PATIENT ACCESS
1. What are collection agency fees based on?
A. A flat monthly retainer
B. A percentage of dollars collected
C. The number of accounts assigned
D. The age of the accounts
CORRECT ANSWER B — A percentage of dollars collected
RATIONALE Collection agencies typically charge a contingency fee based on a percentage of
the amounts they successfully collect. This aligns the agency's incentive with the
provider's goal — the agency is only paid when they recover money. The
percentage varies based on account volume, age of accounts, and type of debt.
This is the industry standard for healthcare collection agency agreements.
2. Self-funded benefit plans may choose to coordinate benefits using the gender rule or
what other rule?
A. Age rule
B. Birthday rule
C. Employment rule
D. Enrollment date rule
CORRECT ANSWER B — Birthday rule
RATIONALE The birthday rule is a common COB (Coordination of Benefits) method: the
parent whose birthday (month and day) falls earlier in the calendar year is
primary. Self-funded plans may use either the gender rule or the birthday rule.
The birthday rule is the most commonly applied coordination method when
dependents are covered by both parents' plans.
,3. In what type of payment methodology is a lump sum or bundled payment negotiated
between the payer and some or all providers?
A. Fee-for-service
B. Per diem
C. Case rates
D. Discounted charges
CORRECT ANSWER C — Case rates
RATIONALE Case rates (also called bundled payments or episode-of-care payments) involve a
single lump sum payment that covers all services related to a specific procedure
or condition across multiple providers. This contrasts with fee-for-service (A)
where each service is paid separately, per diem (B) which pays a daily rate, and
discounted charges (D) which applies a discount to billed charges.
4. What customer service improvements might improve the patient accounts department?
A. Reducing staff training to cut costs
B. Holding staff accountable for customer service during performance reviews
C. Limiting patient contact hours
D. Automating all patient interactions without human oversight
CORRECT ANSWER B — Holding staff accountable for customer service during performance
reviews
RATIONALE Integrating customer service metrics into performance evaluations creates
accountability and incentivizes staff to provide excellent patient interactions.
This is a key HFMA best practice. Reducing training (A) and limiting contact (C)
would worsen service. Complete automation without oversight (D) may miss
complex patient needs requiring human judgment.
, 5. What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
A. Guarantee Medicare payment for the service
B. Inform a Medicare beneficiary that Medicare may not pay for the order or service
C. Authorize the provider to bill the patient at a higher rate
D. Replace the need for a physician's order
CORRECT ANSWER B — Inform a Medicare beneficiary that Medicare may not pay for the order
or service
RATIONALE An ABN is a mandatory notice given to Medicare beneficiaries BEFORE receiving a
service that Medicare may not cover. It informs the patient of their potential
financial liability and gives them the choice to accept or decline the service. It
does NOT guarantee payment (A), authorize higher billing (C), or replace
physician orders (D).
6. What type of account adjustment results from the patient's unwillingness to pay for a
self-pay balance?
A. Charity adjustment
B. Bad debt adjustment
C. Contractual adjustment
D. Administrative adjustment
CORRECT ANSWER B — Bad debt adjustment
RATIONALE Bad debt results from a patient's UNWILLINGNESS (not inability) to pay. Charity
care (A) is for patients who CANNOT pay. Contractual adjustments (C) are
negotiated discounts with payers. Administrative adjustments (D) correct billing
errors. The distinction between bad debt (unwillingness) and charity care
(inability) is critical for financial reporting and IRS 990 Schedule H requirements.
