CRCR Certification Study Guide Exam
Prep Practice TEST BANK Questions
Comprehensive Answers and Expert
Rationale 2026/ 2027
, 1. When does a hospital add ambulance charges to the
Medicare inpatient claim?
Correct Answer: If the patient requires ambulance transportation
to a skilled nursing facility.
Expert Rationale: Ambulance transportation may be separately
reportable when Medicare coverage requirements are met,
including medically necessary transportation to an appropriate
post-acute facility such as an SNF.
2. How should a provider resolve a late-charge credit posted
after an account is billed?
Correct Answer: Post a late-charge adjustment to the account.
Expert Rationale: A credit identified after billing should be
properly adjusted on the patient account so the account balance and
financial records accurately reflect the correction.
3. An increase in the dollars aged greater than 90 days from
date of service indicates what about accounts?
Correct Answer: They are not being processed in a timely
manner.
Expert Rationale: An increasing percentage of aged accounts
generally indicates delays in billing, claim processing, payment,
follow-up, or resolution of account issues.
4. What is an advantage of a preregistration program?
Correct Answer: It reduces processing times at the time of
service.
, Expert Rationale: Preregistration allows demographic,
insurance, authorization, and other information to be collected
before the patient's appointment, reducing registration delays.
5. What are the two statutory exclusions from hospice
coverage?
Correct Answer: Medically unnecessary services and custodial
care.
Expert Rationale: Hospice benefits focus on medically
necessary hospice services related to terminal illness and do not
cover services that are medically unnecessary or custodial services
outside the covered hospice benefit.
6. What core financial activities are resolved within patient
access?
Correct Answer: Scheduling, insurance verification, discharge
processing, and payment of point-of-service receipts.
Expert Rationale: Patient access is responsible for front-end
processes that establish accurate patient information, eligibility,
scheduling, registration, and collection of applicable patient
responsibility.
7. What statement applies to the scheduled outpatient?
Correct Answer: The services do not involve an overnight stay.
Expert Rationale: Scheduled outpatient services are generally
planned services provided without an inpatient admission or
expected overnight hospital stay.
, 8. How is a mis-posted contractual allowance resolved?
Correct Answer: Compare the contract reimbursement rates with
the contract on the remittance advice to identify the correct
amount.
Expert Rationale: Contractual adjustments must be based on the
payer's contractual reimbursement terms and the payment
information reported on the remittance advice.
9. What type of patient status is used to evaluate the
patient's need for inpatient care?
Correct Answer: Observation.
Expert Rationale: Observation status is used when additional
assessment and monitoring are needed to determine whether a
patient requires inpatient admission.
10. Coverage rules for Medicare beneficiaries receiving
skilled nursing care require that the beneficiary has
received what?
Correct Answer: Medically necessary inpatient hospital services
for at least 3 consecutive days before the skilled nursing care
admission.
Expert Rationale: Under the traditional Medicare SNF benefit
requirements, a qualifying inpatient hospital stay of at least three
consecutive days is required before covered SNF care, subject to
applicable Medicare rules and exceptions.
Prep Practice TEST BANK Questions
Comprehensive Answers and Expert
Rationale 2026/ 2027
, 1. When does a hospital add ambulance charges to the
Medicare inpatient claim?
Correct Answer: If the patient requires ambulance transportation
to a skilled nursing facility.
Expert Rationale: Ambulance transportation may be separately
reportable when Medicare coverage requirements are met,
including medically necessary transportation to an appropriate
post-acute facility such as an SNF.
2. How should a provider resolve a late-charge credit posted
after an account is billed?
Correct Answer: Post a late-charge adjustment to the account.
Expert Rationale: A credit identified after billing should be
properly adjusted on the patient account so the account balance and
financial records accurately reflect the correction.
3. An increase in the dollars aged greater than 90 days from
date of service indicates what about accounts?
Correct Answer: They are not being processed in a timely
manner.
Expert Rationale: An increasing percentage of aged accounts
generally indicates delays in billing, claim processing, payment,
follow-up, or resolution of account issues.
4. What is an advantage of a preregistration program?
Correct Answer: It reduces processing times at the time of
service.
, Expert Rationale: Preregistration allows demographic,
insurance, authorization, and other information to be collected
before the patient's appointment, reducing registration delays.
5. What are the two statutory exclusions from hospice
coverage?
Correct Answer: Medically unnecessary services and custodial
care.
Expert Rationale: Hospice benefits focus on medically
necessary hospice services related to terminal illness and do not
cover services that are medically unnecessary or custodial services
outside the covered hospice benefit.
6. What core financial activities are resolved within patient
access?
Correct Answer: Scheduling, insurance verification, discharge
processing, and payment of point-of-service receipts.
Expert Rationale: Patient access is responsible for front-end
processes that establish accurate patient information, eligibility,
scheduling, registration, and collection of applicable patient
responsibility.
7. What statement applies to the scheduled outpatient?
Correct Answer: The services do not involve an overnight stay.
Expert Rationale: Scheduled outpatient services are generally
planned services provided without an inpatient admission or
expected overnight hospital stay.
, 8. How is a mis-posted contractual allowance resolved?
Correct Answer: Compare the contract reimbursement rates with
the contract on the remittance advice to identify the correct
amount.
Expert Rationale: Contractual adjustments must be based on the
payer's contractual reimbursement terms and the payment
information reported on the remittance advice.
9. What type of patient status is used to evaluate the
patient's need for inpatient care?
Correct Answer: Observation.
Expert Rationale: Observation status is used when additional
assessment and monitoring are needed to determine whether a
patient requires inpatient admission.
10. Coverage rules for Medicare beneficiaries receiving
skilled nursing care require that the beneficiary has
received what?
Correct Answer: Medically necessary inpatient hospital services
for at least 3 consecutive days before the skilled nursing care
admission.
Expert Rationale: Under the traditional Medicare SNF benefit
requirements, a qualifying inpatient hospital stay of at least three
consecutive days is required before covered SNF care, subject to
applicable Medicare rules and exceptions.
