1|P age
HFMA CRCR PRACTICE EXAM 1 WITH QUESTIONS
AND DETAILED ANSWERS THE LATEST UPDATED
EXAM BANK INCLUDING EXPERT VERIFIED
SOLUTIONS FOR A SURE PASS
1. If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? - ANSWER:Neither enrolled
not entitled to benefits
2. Regulation Z of the consumer Credit Protection Act, also known as the Truth
in lending Act establishes what? - ANSWER:
-Disclosure rules for consumer credit sales and consumer loans
3. What is a principle diagnosis? - ANSWER:Primary reason for the patients
admission
4. Collecting patient liability dollars after service leads to what? -
ANSWER:Lower accounts receivable levels
5. What is the daily out-of-pocket amount for each lifetime reserve day used? -
ANSWER:50% of the current deductible amount
6. What service provided to a Medicare beneficiary in a rural health
clinic(RHC) is not billable as an RHC service? - ANSWER:Inpatient care
,2|P age
7. What code indicates the disposition of the patient at the conclusion of
service? - ANSWER:Patient discharge status code
8. What are hospitals required to do for Medicare credit balance accounts? -
ANSWER:They result in lost reimbursement and additional cost to collect.
9. When an undue delay of payment results from a dispute between the patient
and the third party payer, who is responsible for payment? - ANSWER:Patient
10. With advances in internet security and encryption, revenue- cycle processes
are expanding to allow patients to do what? - ANSWER:Access their information
and perform functions on-line
11. What date is required on all CMS 1500 claim forms? - ANSWER:onset date
of current illness
12. What code is used to report the provider's most common semiprivate room
rate? - ANSWER:Condition code
,3|P age
13. Regulations and requirements for coding accountable care organizations
which allows providers to begin creating these organizations were finalized in -
ANSWER:2012
14. What is a primary responsibility of the recover audit contractor? -
ANSWER:To correctly identify proper payments for Medicare part A and B
claims
15. How must providers handle credit balances? - ANSWER:Comply with state
statutes concerning reporting credit balance
16. What activities are completed when a scheduled pre- registered patient
arrives for service? - ANSWER: Registering the patient and directing the patient
to the service area
17. In addition to being supported by information found in the patients chart, a
CMS 1500 claim must be coded using what? - ANSWER:HCPCS
18. What results from a denied claim? - ANSWER:The provider incurs rework
and appeal costs
19. Through what document does a hospital establish compliance standards? -
ANSWER:code of conduct
, 4|P age
20. What is the purpose OIG work plant? - ANSWER: Identify Acceptable
compliance programs in various provider setting
21. If a Medicare patient is admitted on Friday, what services fall within the
three-day DRG window rule? - ANSWER:Non- diagnostic service provided on
Tuesday through Friday
22. What does a modifier allow a provider to do? - ANSWER:Report a specific
circumstance that affected a procedure or service without changing the code or its
definition
23. IF outpatient diagnostic services are provided within three days of the
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment
System) hospital, what must happen to these charges - ANSWER:They must be
billed separately to the part B Carrier
24. what is a recurring or series registration? - ANSWER: One registration
record is created for multiple days of service
25. What are nonemergency patients who come for service without prior
notification to the provider called? - ANSWER:Unscheduled patients
HFMA CRCR PRACTICE EXAM 1 WITH QUESTIONS
AND DETAILED ANSWERS THE LATEST UPDATED
EXAM BANK INCLUDING EXPERT VERIFIED
SOLUTIONS FOR A SURE PASS
1. If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? - ANSWER:Neither enrolled
not entitled to benefits
2. Regulation Z of the consumer Credit Protection Act, also known as the Truth
in lending Act establishes what? - ANSWER:
-Disclosure rules for consumer credit sales and consumer loans
3. What is a principle diagnosis? - ANSWER:Primary reason for the patients
admission
4. Collecting patient liability dollars after service leads to what? -
ANSWER:Lower accounts receivable levels
5. What is the daily out-of-pocket amount for each lifetime reserve day used? -
ANSWER:50% of the current deductible amount
6. What service provided to a Medicare beneficiary in a rural health
clinic(RHC) is not billable as an RHC service? - ANSWER:Inpatient care
,2|P age
7. What code indicates the disposition of the patient at the conclusion of
service? - ANSWER:Patient discharge status code
8. What are hospitals required to do for Medicare credit balance accounts? -
ANSWER:They result in lost reimbursement and additional cost to collect.
9. When an undue delay of payment results from a dispute between the patient
and the third party payer, who is responsible for payment? - ANSWER:Patient
10. With advances in internet security and encryption, revenue- cycle processes
are expanding to allow patients to do what? - ANSWER:Access their information
and perform functions on-line
11. What date is required on all CMS 1500 claim forms? - ANSWER:onset date
of current illness
12. What code is used to report the provider's most common semiprivate room
rate? - ANSWER:Condition code
,3|P age
13. Regulations and requirements for coding accountable care organizations
which allows providers to begin creating these organizations were finalized in -
ANSWER:2012
14. What is a primary responsibility of the recover audit contractor? -
ANSWER:To correctly identify proper payments for Medicare part A and B
claims
15. How must providers handle credit balances? - ANSWER:Comply with state
statutes concerning reporting credit balance
16. What activities are completed when a scheduled pre- registered patient
arrives for service? - ANSWER: Registering the patient and directing the patient
to the service area
17. In addition to being supported by information found in the patients chart, a
CMS 1500 claim must be coded using what? - ANSWER:HCPCS
18. What results from a denied claim? - ANSWER:The provider incurs rework
and appeal costs
19. Through what document does a hospital establish compliance standards? -
ANSWER:code of conduct
, 4|P age
20. What is the purpose OIG work plant? - ANSWER: Identify Acceptable
compliance programs in various provider setting
21. If a Medicare patient is admitted on Friday, what services fall within the
three-day DRG window rule? - ANSWER:Non- diagnostic service provided on
Tuesday through Friday
22. What does a modifier allow a provider to do? - ANSWER:Report a specific
circumstance that affected a procedure or service without changing the code or its
definition
23. IF outpatient diagnostic services are provided within three days of the
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment
System) hospital, what must happen to these charges - ANSWER:They must be
billed separately to the part B Carrier
24. what is a recurring or series registration? - ANSWER: One registration
record is created for multiple days of service
25. What are nonemergency patients who come for service without prior
notification to the provider called? - ANSWER:Unscheduled patients
