CERTIFIED REVENUE CYCLE REPRESENTATIVE PREMIUM EXAM PAPER TESTED QUESTIONS CORRECT ANSWERS

CERTIFIED REVENUE CYCLE REPRESENTATIVE PREMIUM EXAM PAPER TESTED
QUESTIONS CORRECT ANSWERS
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Questions and Answers Verified Solutions Latest
Update 2026/2027

Question:
What data are required to establish a new MPI entry?

Answer:
The patient's full legal name, date of birth, and sex



Question:
What should the provider do if both of the patient's insurance plans pay as primary?

Answer:
Determine the correct payer and notify the incorrect payer of the processing error



Question:
What do EMTALA regulations require on-call physicians to do?

Answer:
Personally appear in the emergency department and attend to the patient within a reasonable time



Question:
At the end of each shift, what must happen to cash, checks, and credit card transaction documents?

Answer:
They must be balanced



Question:
What will cause a CMS 1500 claim to be rejected?

,Answer:
The provider is billing with a future date of service



Question:
Under Medicare regulations, which of the following is not included on a valid physician's order for
services?

Answer:
The cost of the test



Question:
how are HCPCS codes and the appropriate modifiers used?

Answer:
To report the level 1, 2, or 3 code that correctly describes the service provided



Question:
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window
rule?

Answer:
Diagnostic and clinically-related non-diagnostic charges provided on the Tuesday, Wednesday,
Thursday, and Friday before admission



Question:
What is a benefit of pre-registering patient's for service?

Answer:
Patient arrival processing is expedited, reducing wait times and delays



Question:

,What is a characteristic of a managed contracting methodology?

Answer:
Prospectively set rates for inpatient and outpatient services



Question:
What do the MSP disability rules require?

Answer:
That the patient's spouse's employer must have less than 20 employees in the group health plan



Question:
what organization originated the concept of insuring prepaid health care services?

Answer:
Blue Cross and blue Shield



Question:
What is true about screening a beneficiary for possible MSP situations?

Answer:
It is acceptable to complete the screening form after the patient has completed the registration
process and been sent to the service department



Question:
If the patient cannot agree to payment arrangements, what is the next option?

Answer:
Warn the patient that unpaid accounts are placed with collection agencies for further processing



Question:

, In services lines such as cardiology or orthopedics, what does the case-rate payment methodology
allow providers to do?

Answer:
Receive a fixed for specific procedures



Question:
What will comprehensive patient access processing accomplish?

Answer:
Minimize the need for follow-up on insurance accounts



Question:
Through what document does a hospital establish compliance standards?

Answer:
Code of conduct



Question:
How does utilization review staff use correct insurance information?

Answer:
To obtain approval for inpatient days and coordinate services



Question:
When is it not appropriate to use observation status?

Answer:
As a substitute for an inpatient admission



Question:
What is a serious consequence of misidentifying a patient in the MPI?