Newest CRCR Exam Prep (150 Correctly
Answered Practice Questions 2026-2027)/ CRCR
Exam (Certified Revenue Cycle Representative )
Medicare has established guidelines called Local Coverage Determinations (LCD)
and National Coverage Determinations (NCD that establish:
A. Reasonable and customary prices for services in a given area
B. Prospective Medicare patient financial responsibilities for a given diagnosis
C. Provider and physician reimbursement for specific diagnoses and tests
D. What services or healthcare items are covered under Medicare - ANSWER-D.
What services or healthcare items are covered under Medicare
Medicare Part B has an annual deductible, and the beneficiary is responsible for:
A. A co-insurance payment for all Part B covered services
B. Physician's office fees
C. Tests outside of an inpatient setting
D. Prescriptions - ANSWER-A. A co-insurance payment for all Part B covered
services
The benefit of a Medicare Advantage Plan is:
A. It is a less costly plan compared to traditional Medicare
B. Patients may retain a primary care physician and see another physician for a
second opinion at no charge
C. Patients generally have their entire Medicare-covered healthcare through the
plan and do not need to worry about "Part A" or "Part B' benefits
1
,D. Patients receive significant discounting on services contracted by the federal
government - ANSWER-C. Patients generally have their entire Medicare-covered
healthcare through the plan and do not need to worry about "Part A" or "Part B"
benefits
Medicare patients are NOT required to produce a physician's order to receive
which of the services?
A. Diagnostic mammography, flu vaccine or B-12 shots
B. Diagnostic mammography, flu vaccine or pneumonia vaccine
C. Screening mammography, flu vaccine or pneumonia vaccine
D. Screening mammography, flu vaccine or B-12 shots - ANSWER-C. Screening
mammography, flu vaccine or pneumonia vaccine
The most effective payment plan programs:
A. Screen patients to determine if they are capable of paying
B. Are rigorous in patient follow-up
C. Do not allow missed payments
D. Are turned over to a collection agency - ANSWER-A. Screen patients to
determine if they are capable of paying
Most major health insurance payers, including Medicare and Medicaid, offer:
A. Hard-copy documentation of insurance coverage
B. Insurance verification through agents who are available during normal business
hours
C. Electronic verification of insurance coverage
D. Provider "self-service" web portal accessible through the policy holder's plan ID
number - ANSWER-C. Electronic verification of insurance coverage
2
,Most major health plans including Medicare and Medicaid, offer:
A. Toll free verification hot lines, staffed around the clock
B. Electronic and/or web portal verification
C. Patient "verification of benefits" cards
D. A grace period for obtaining verification within 72 hours of treatment -
ANSWER-B. Electronic and/or web portal verification
A nightly room charge will be incorrect if the patient's:
A. Transfer from the ICU (Intensive care unit) to the Medical/Surgical floor is not
reflected in the registration system
B. Pharmacy orders have not been entered into the pharmacy system
C. Condition has not been discussed during the shift change report meeting
D. Discharge for the next day has not been charted - ANSWER-A. Transfer from
the ICU (intensive care unit) to the Medical/Surgical floor is not reflected in the
registration system
Once the EMTALA requirements are satisfied:
A. Third-party payer information should be collected from the patient and payer be
notified of the ED visit
B. An initial registration record is completed so that the proper coding can be
initiated
C. The patients then assume full liability for services unless a third-party payer is
notified or the patient applies for financial assistance within the first 48 hours
D. The remaining registration processing is initiated either at the bedside or in a
registration area - ANSWER-D. The remaining registration processing in initiated
either at the bedside or in a registration area
Once the price is estimated in the pre-service stage, a provider's financial best
practice is to:
3
, A. Allow the patient time to compare prices with other providers
B. Have another employee double check the price estimate
C. Lock-in prices
D. Explain to the patient their financial responsibility and to determine the plan for
payment - ANSWER-D. Explain to the patient their financial responsibility and to
determine the plan for payment
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons on a monthly
fee is known as a:
A. HMO
B. PPO
C. MSO
D. GPO - ANSWER-A. HMO
Any provider that has filed a timely cost report may appeal an adverse final
decision received from the Medicare Administrative Contractor (MAC). This
appeal may be filed with:
A. The Provider Reimbursement Review Board
B. The Department of Health and Human Services Provider Relations Division
C. A court appointed federal mediator
D. The Office of the Inspector General - ANSWER-A. The Provider
Reimbursement Review Board
Applying the contracted payment methodology to the total charges yields:
A. An estimated price
B. An anticipated health plan payment
C. A price justified revenue accrual
4
Answered Practice Questions 2026-2027)/ CRCR
Exam (Certified Revenue Cycle Representative )
Medicare has established guidelines called Local Coverage Determinations (LCD)
and National Coverage Determinations (NCD that establish:
A. Reasonable and customary prices for services in a given area
B. Prospective Medicare patient financial responsibilities for a given diagnosis
C. Provider and physician reimbursement for specific diagnoses and tests
D. What services or healthcare items are covered under Medicare - ANSWER-D.
What services or healthcare items are covered under Medicare
Medicare Part B has an annual deductible, and the beneficiary is responsible for:
A. A co-insurance payment for all Part B covered services
B. Physician's office fees
C. Tests outside of an inpatient setting
D. Prescriptions - ANSWER-A. A co-insurance payment for all Part B covered
services
The benefit of a Medicare Advantage Plan is:
A. It is a less costly plan compared to traditional Medicare
B. Patients may retain a primary care physician and see another physician for a
second opinion at no charge
C. Patients generally have their entire Medicare-covered healthcare through the
plan and do not need to worry about "Part A" or "Part B' benefits
1
,D. Patients receive significant discounting on services contracted by the federal
government - ANSWER-C. Patients generally have their entire Medicare-covered
healthcare through the plan and do not need to worry about "Part A" or "Part B"
benefits
Medicare patients are NOT required to produce a physician's order to receive
which of the services?
A. Diagnostic mammography, flu vaccine or B-12 shots
B. Diagnostic mammography, flu vaccine or pneumonia vaccine
C. Screening mammography, flu vaccine or pneumonia vaccine
D. Screening mammography, flu vaccine or B-12 shots - ANSWER-C. Screening
mammography, flu vaccine or pneumonia vaccine
The most effective payment plan programs:
A. Screen patients to determine if they are capable of paying
B. Are rigorous in patient follow-up
C. Do not allow missed payments
D. Are turned over to a collection agency - ANSWER-A. Screen patients to
determine if they are capable of paying
Most major health insurance payers, including Medicare and Medicaid, offer:
A. Hard-copy documentation of insurance coverage
B. Insurance verification through agents who are available during normal business
hours
C. Electronic verification of insurance coverage
D. Provider "self-service" web portal accessible through the policy holder's plan ID
number - ANSWER-C. Electronic verification of insurance coverage
2
,Most major health plans including Medicare and Medicaid, offer:
A. Toll free verification hot lines, staffed around the clock
B. Electronic and/or web portal verification
C. Patient "verification of benefits" cards
D. A grace period for obtaining verification within 72 hours of treatment -
ANSWER-B. Electronic and/or web portal verification
A nightly room charge will be incorrect if the patient's:
A. Transfer from the ICU (Intensive care unit) to the Medical/Surgical floor is not
reflected in the registration system
B. Pharmacy orders have not been entered into the pharmacy system
C. Condition has not been discussed during the shift change report meeting
D. Discharge for the next day has not been charted - ANSWER-A. Transfer from
the ICU (intensive care unit) to the Medical/Surgical floor is not reflected in the
registration system
Once the EMTALA requirements are satisfied:
A. Third-party payer information should be collected from the patient and payer be
notified of the ED visit
B. An initial registration record is completed so that the proper coding can be
initiated
C. The patients then assume full liability for services unless a third-party payer is
notified or the patient applies for financial assistance within the first 48 hours
D. The remaining registration processing is initiated either at the bedside or in a
registration area - ANSWER-D. The remaining registration processing in initiated
either at the bedside or in a registration area
Once the price is estimated in the pre-service stage, a provider's financial best
practice is to:
3
, A. Allow the patient time to compare prices with other providers
B. Have another employee double check the price estimate
C. Lock-in prices
D. Explain to the patient their financial responsibility and to determine the plan for
payment - ANSWER-D. Explain to the patient their financial responsibility and to
determine the plan for payment
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons on a monthly
fee is known as a:
A. HMO
B. PPO
C. MSO
D. GPO - ANSWER-A. HMO
Any provider that has filed a timely cost report may appeal an adverse final
decision received from the Medicare Administrative Contractor (MAC). This
appeal may be filed with:
A. The Provider Reimbursement Review Board
B. The Department of Health and Human Services Provider Relations Division
C. A court appointed federal mediator
D. The Office of the Inspector General - ANSWER-A. The Provider
Reimbursement Review Board
Applying the contracted payment methodology to the total charges yields:
A. An estimated price
B. An anticipated health plan payment
C. A price justified revenue accrual
4
