CRCR Practice Questions
A "Compliance Program" is defined as:
A. Educating staff on regulations
B. The development of operational policies that correspond to regulations
C. Systematic procedures to ensure that the provisions of regulations imposed by a
government agency are being met
D. Annual legal audit and review for adherence to regulations - ANS-C. Systematic
procedures to ensure that provisions of regulations imposed by government agency are
being met
A benefit period begins:
A. With admission as an inpatient
B. Upon the day the coverage premium is paid
C. The first day in which a patient is furnished extended care services in the period the
patient is entitled to hospital insurance
D. Immediately once authorization for treatment is provided by the health plan - ANS-C. The
first day in which a patient is furnished extended care services in the period the patient is
entitled to hospital insurance
A decision of whether a patient should be admitted as an inpatient or become an outpatient
observation patient requires medical judgments based on all of the following EXCEPT:
A. The patient's medical history
B. The safe-guarding against medical error
C. Current medical needs
D. The Medical predictability of something adverse happening - ANS-B. The safe-guarding
against medical error
A four digit number code established by the National Uniform Billing (NUBC) that
categorizes/classifies a line item in the chargemaster is known as:
A. HCPCs codes
B. ICD-10 Procedural codes
C. CPT codes
D. Revenue codes - ANS-D. Revenue codes
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 - ANS-A. Transfer from the ICU
(intensive care unit) to the Medical/Surgical floor is not reflected in the registration system
A recurring/series registration is characterized by:
A. The creation of one registration record for multiple days of service
B. The creation of multiple registrations for multiple services
C. The creation of one registration record per diagnosis per visit
D. The creation of multiple patient types for one date of service - ANS-A. The creation of one
registration record for multiple days of service
,A successful pre-registration program:
A. Helps the patient feel welcome
B. Identifies clearly what information must be gathered including demographic data,
insurance data, and financial information
C. Thoroughly discusses the patient's financial obligation
D. Collects patient deductibles and co-pays - ANS-B. Identifies clearly what information must
be gathered including demographic data, insurance data, and financial information
Across all care settings, if a patient consents to a financial discussion during a medical
encounter to expedite discharge, the HFMA best practice is to:
A. Have a patient financial responsibilities kit ready for the patient, containing all of the
required registration forms and instructions.
B. Make sure that the attending staff can answer questions and assist in obtaining required
patient financial data.
C. Support that choice, providing that the discussion does not interfere with patient care or
disrupt patient flow.
D. Decline such request as finance discussions can disrupt patient care and patient flow. -
ANS-C. Support that choice, providing that the discussion does not interfere with patient
care or disrupt patient flow
Activities completed when the scheduled, pre-registered patient arrives for service includes:
A. Verifying insurance, activating the record and directing the patient to the service area.
B. Scanning the driver's license or other phot identification and directing the patient to the
financial counselor.
C. Activating the record, obtaining signatures and finalizing financial issues.
D. Registering the patient and directing the patient to the service area. - ANS-C. Activating
the record, obtaining signatures and
All of the following are conditions that disqualify a procedure or service from being paid for
by Medicare EXCEPT:
A. Offered in an outpatient setting
B. Medically unnecessary
C. Not delivered in a Medicare licensed care setting.
D. Services and procedures that are custodial in nature - ANS-C. Not delivered in a
Medicare licensed care setting
All of the following are reference resources used to help guide in the application for business
ethics EXCEPT:
A. Consumer satisfaction reports
B. Mission & Value Statements
C. Code of Ethics / Code of Conduct
D. Compliance Office & Policies - ANS-A. Consumer satisfaction reports
All of the following are steps in safeguarding collections EXCEPT:
A. Placing collections in a lock-box for posting review the next business day.
B. Posting the payment to the patient's account
C. Completing balancing activities
D. Issuing receipts - ANS-A. Placing collections in a lock-box for posting review the next
business day
All of the following are steps in verifying insurance EXCEPT:
A. Sequencing plans involved in a coordination of benefits (COB) situation.
B. The patient signing the statement of financial responsibility.
C. Identifying and documenting the patient's health plan benefits
, D. Confirming the patient's eligibility for benefits - ANS-B. The patient signing the statement
of financial responsibility
All of the following information is used to identify a patient EXCEPT:
A. Date of Birth
B. Gender
C. Social Security Number
D. Address - ANS-D. Address
All of the following information should be reviewed as part of schedule finalization EXCEPT:
A. The estimated patient financial obligations
B. The service to be provided
C. The arrival time and procedure time
D. The patient's preparation instructions - ANS-A. The estimated patient financial obligations
Ambulance services are billed directly to the health plan for :
A. All pre-admission emergency transports
B. Transport deemed medically necessary by the attending paramedic-ambulance crew
C. Services provided before a patient is admitted and for ambulance rides arranged to pick
up the patient from the hospital after discharge to take him/her home or to another facility
D. The portion of the bill outside of the patient's self-pay - ANS-C. Services provided before
a patient is admitted and for ambulance rides arranged to pick up the patient from the
hospital after discharge to take him/her home or the another facility
An advantage of a pre-registration program is:
A. The markets value of such a program
B. The ability to eliminate no-show appointments.
C. The opportunity to reduce processing times at the time of service.
D. The opportunity to reduce corporate compliance failures within the registration process. -
ANS-C. The opportunity to reduce processing times at the time of service.
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is known as:
A. A Medicare determination appeal
B. A payment review
C. A Medicare supplemental review
D. A beneficiary appeal - ANS-D. A beneficiary appeal
An originating site is:
A. The location where the patient's bill is generated
B. The location of the patient at the time the service is provided
C. The site that generates reimbursement of a claim
D. The location of the medical treatment provider - ANS-B. The location of the patient at the
time the service is provided
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 - ANS-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
A "Compliance Program" is defined as:
A. Educating staff on regulations
B. The development of operational policies that correspond to regulations
C. Systematic procedures to ensure that the provisions of regulations imposed by a
government agency are being met
D. Annual legal audit and review for adherence to regulations - ANS-C. Systematic
procedures to ensure that provisions of regulations imposed by government agency are
being met
A benefit period begins:
A. With admission as an inpatient
B. Upon the day the coverage premium is paid
C. The first day in which a patient is furnished extended care services in the period the
patient is entitled to hospital insurance
D. Immediately once authorization for treatment is provided by the health plan - ANS-C. The
first day in which a patient is furnished extended care services in the period the patient is
entitled to hospital insurance
A decision of whether a patient should be admitted as an inpatient or become an outpatient
observation patient requires medical judgments based on all of the following EXCEPT:
A. The patient's medical history
B. The safe-guarding against medical error
C. Current medical needs
D. The Medical predictability of something adverse happening - ANS-B. The safe-guarding
against medical error
A four digit number code established by the National Uniform Billing (NUBC) that
categorizes/classifies a line item in the chargemaster is known as:
A. HCPCs codes
B. ICD-10 Procedural codes
C. CPT codes
D. Revenue codes - ANS-D. Revenue codes
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 - ANS-A. Transfer from the ICU
(intensive care unit) to the Medical/Surgical floor is not reflected in the registration system
A recurring/series registration is characterized by:
A. The creation of one registration record for multiple days of service
B. The creation of multiple registrations for multiple services
C. The creation of one registration record per diagnosis per visit
D. The creation of multiple patient types for one date of service - ANS-A. The creation of one
registration record for multiple days of service
,A successful pre-registration program:
A. Helps the patient feel welcome
B. Identifies clearly what information must be gathered including demographic data,
insurance data, and financial information
C. Thoroughly discusses the patient's financial obligation
D. Collects patient deductibles and co-pays - ANS-B. Identifies clearly what information must
be gathered including demographic data, insurance data, and financial information
Across all care settings, if a patient consents to a financial discussion during a medical
encounter to expedite discharge, the HFMA best practice is to:
A. Have a patient financial responsibilities kit ready for the patient, containing all of the
required registration forms and instructions.
B. Make sure that the attending staff can answer questions and assist in obtaining required
patient financial data.
C. Support that choice, providing that the discussion does not interfere with patient care or
disrupt patient flow.
D. Decline such request as finance discussions can disrupt patient care and patient flow. -
ANS-C. Support that choice, providing that the discussion does not interfere with patient
care or disrupt patient flow
Activities completed when the scheduled, pre-registered patient arrives for service includes:
A. Verifying insurance, activating the record and directing the patient to the service area.
B. Scanning the driver's license or other phot identification and directing the patient to the
financial counselor.
C. Activating the record, obtaining signatures and finalizing financial issues.
D. Registering the patient and directing the patient to the service area. - ANS-C. Activating
the record, obtaining signatures and
All of the following are conditions that disqualify a procedure or service from being paid for
by Medicare EXCEPT:
A. Offered in an outpatient setting
B. Medically unnecessary
C. Not delivered in a Medicare licensed care setting.
D. Services and procedures that are custodial in nature - ANS-C. Not delivered in a
Medicare licensed care setting
All of the following are reference resources used to help guide in the application for business
ethics EXCEPT:
A. Consumer satisfaction reports
B. Mission & Value Statements
C. Code of Ethics / Code of Conduct
D. Compliance Office & Policies - ANS-A. Consumer satisfaction reports
All of the following are steps in safeguarding collections EXCEPT:
A. Placing collections in a lock-box for posting review the next business day.
B. Posting the payment to the patient's account
C. Completing balancing activities
D. Issuing receipts - ANS-A. Placing collections in a lock-box for posting review the next
business day
All of the following are steps in verifying insurance EXCEPT:
A. Sequencing plans involved in a coordination of benefits (COB) situation.
B. The patient signing the statement of financial responsibility.
C. Identifying and documenting the patient's health plan benefits
, D. Confirming the patient's eligibility for benefits - ANS-B. The patient signing the statement
of financial responsibility
All of the following information is used to identify a patient EXCEPT:
A. Date of Birth
B. Gender
C. Social Security Number
D. Address - ANS-D. Address
All of the following information should be reviewed as part of schedule finalization EXCEPT:
A. The estimated patient financial obligations
B. The service to be provided
C. The arrival time and procedure time
D. The patient's preparation instructions - ANS-A. The estimated patient financial obligations
Ambulance services are billed directly to the health plan for :
A. All pre-admission emergency transports
B. Transport deemed medically necessary by the attending paramedic-ambulance crew
C. Services provided before a patient is admitted and for ambulance rides arranged to pick
up the patient from the hospital after discharge to take him/her home or to another facility
D. The portion of the bill outside of the patient's self-pay - ANS-C. Services provided before
a patient is admitted and for ambulance rides arranged to pick up the patient from the
hospital after discharge to take him/her home or the another facility
An advantage of a pre-registration program is:
A. The markets value of such a program
B. The ability to eliminate no-show appointments.
C. The opportunity to reduce processing times at the time of service.
D. The opportunity to reduce corporate compliance failures within the registration process. -
ANS-C. The opportunity to reduce processing times at the time of service.
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is known as:
A. A Medicare determination appeal
B. A payment review
C. A Medicare supplemental review
D. A beneficiary appeal - ANS-D. A beneficiary appeal
An originating site is:
A. The location where the patient's bill is generated
B. The location of the patient at the time the service is provided
C. The site that generates reimbursement of a claim
D. The location of the medical treatment provider - ANS-B. The location of the patient at the
time the service is provided
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 - ANS-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
