HFMA CRCR CERTIFICATION 2025 EXAM version
B,
PRACTICE EXAM AND A STUDY GUIDE LATEST
ACTUAL EXAM 600 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
The pt discharge process begins when
a) The physician writes the discharge orders
b) Clinical services are completed and pt accounts have all the info
necessary to bill
c) The physician writes the discharge orders and the third-party payer
sign-off on the
necessity of the services provided
d) Clinical services are completed, pt accounts can generated and
accurate bill and there
is agreement o the handling of pt financial responsibilities -
....ANSWER...A
It is important to have high registration quality standards because a)
Inaccurate or incomplete pt data will delay payment or cause
denials
b) Incomplete registrations will trigger exclusion from
Medicareparticipation
c) Inaccurate registration may cause discharge before full
treatment is obtained
d) Incomplete registrations will raise satisfaction scores for the
hospital - ....ANSWER...A
,When recovery audit contractors (RAC) identify improper payments
as over payments the claims processing contractor must
a) Assume legal responsibility for repaying the overage amount
b) Make recovery of the overpayment the top processing priority
c) Send a demand letter to the provider to recover the over payment
amount
d) Conduct an audit of all the effected providers claims within the
past 12 months - ....ANSWER...C
Internal controls addressing coding and reimbursement changes are
put I place to guard against
a) Underpayments
b) Denials
c) Compliance fraud by upcoding
d) Charge master error - ....ANSWER...C
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) Pt "verification of benefits" cards
d) A grace period for obtaining verification within 72 hours of
treatment - ....ANSWER...B
The physician who wrote the order for an inpatient service and is in
charge of the pts treatment during admission is a) The pts personal
physician
b) The primary care physician
c) The attending physician
d) The physician pt care director - ....ANSWER...C
An originating site is
a) The location where the pts bill is generated
b) The location of the pt at the time the service is provided
c) The site that generates reimbursement of a claim
,d) The location of the medical treatment provider - ....ANSWER...B
HFMA best practices stipulate that a reasonable attempt should be
made to have the
financial
responsibilities discussion
a) As early as possible, before a financial obligation is incurred
b) During the registration process
c) Before scheduling of services
d) No later than the evening of the day of admission -
....ANSWER...A
HFMA's pt financial communications best practices specify that pts
should be told about
the
types of services provided and
a) An explanation of why a specific service is not provided
b) The service providers that typically participate in the service,
e.g.radiologists, pathologists,
etc.
c) A satisfaction survey regarding clinical service providers
d) The price of service to their covering health plan - ....ANSWER...B
Telemed seeks to improve a pt's health by
a) Permitting 2-way real time interactive communication between the
pt
and the clinical professional
b) Using high-compression fiber optics to transmit medical data
c) Providing relevant, on-demand consumer medical education
d) Providing physician access to the most current medical research -
....ANSWER...A
A large number of credit balances are not the result of overpayments
but of
a) Posting errors in the pt accounting system
, b) Incorrect claim submissions
c) Inadequate staff training
d) Banking transaction errors - ....ANSWER...A
Across all care settings, if a pt consents to a financial discussion
during a medical
encounter
to expedite discharge, the HFMA best practice is to
a) Have a pt financial responsibilities kit ready for the pt
containing all of the required
registration forms and instructions
b) Make sure that the attending staff can answer questions and
assist in obtaining required pt financial data
c) Support that choice, providing that the discussion does not
interfere with pt care or disrupt pt flow
d) Decline such request as finance discussions can disrupt pt care
and pt flow - ....ANSWER...C
The office of inspector general (OIG) publishes a compliance work
plan
a) Monthly
b) Quarterly
c) Semi-annually
d) Annually - ....ANSWER...D
What are collection agency fees based on? - ....ANSWER...A
percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? - ....ANSWER...Birthday
In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all providers? -
....ANSWER...Case rates
B,
PRACTICE EXAM AND A STUDY GUIDE LATEST
ACTUAL EXAM 600 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
The pt discharge process begins when
a) The physician writes the discharge orders
b) Clinical services are completed and pt accounts have all the info
necessary to bill
c) The physician writes the discharge orders and the third-party payer
sign-off on the
necessity of the services provided
d) Clinical services are completed, pt accounts can generated and
accurate bill and there
is agreement o the handling of pt financial responsibilities -
....ANSWER...A
It is important to have high registration quality standards because a)
Inaccurate or incomplete pt data will delay payment or cause
denials
b) Incomplete registrations will trigger exclusion from
Medicareparticipation
c) Inaccurate registration may cause discharge before full
treatment is obtained
d) Incomplete registrations will raise satisfaction scores for the
hospital - ....ANSWER...A
,When recovery audit contractors (RAC) identify improper payments
as over payments the claims processing contractor must
a) Assume legal responsibility for repaying the overage amount
b) Make recovery of the overpayment the top processing priority
c) Send a demand letter to the provider to recover the over payment
amount
d) Conduct an audit of all the effected providers claims within the
past 12 months - ....ANSWER...C
Internal controls addressing coding and reimbursement changes are
put I place to guard against
a) Underpayments
b) Denials
c) Compliance fraud by upcoding
d) Charge master error - ....ANSWER...C
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) Pt "verification of benefits" cards
d) A grace period for obtaining verification within 72 hours of
treatment - ....ANSWER...B
The physician who wrote the order for an inpatient service and is in
charge of the pts treatment during admission is a) The pts personal
physician
b) The primary care physician
c) The attending physician
d) The physician pt care director - ....ANSWER...C
An originating site is
a) The location where the pts bill is generated
b) The location of the pt at the time the service is provided
c) The site that generates reimbursement of a claim
,d) The location of the medical treatment provider - ....ANSWER...B
HFMA best practices stipulate that a reasonable attempt should be
made to have the
financial
responsibilities discussion
a) As early as possible, before a financial obligation is incurred
b) During the registration process
c) Before scheduling of services
d) No later than the evening of the day of admission -
....ANSWER...A
HFMA's pt financial communications best practices specify that pts
should be told about
the
types of services provided and
a) An explanation of why a specific service is not provided
b) The service providers that typically participate in the service,
e.g.radiologists, pathologists,
etc.
c) A satisfaction survey regarding clinical service providers
d) The price of service to their covering health plan - ....ANSWER...B
Telemed seeks to improve a pt's health by
a) Permitting 2-way real time interactive communication between the
pt
and the clinical professional
b) Using high-compression fiber optics to transmit medical data
c) Providing relevant, on-demand consumer medical education
d) Providing physician access to the most current medical research -
....ANSWER...A
A large number of credit balances are not the result of overpayments
but of
a) Posting errors in the pt accounting system
, b) Incorrect claim submissions
c) Inadequate staff training
d) Banking transaction errors - ....ANSWER...A
Across all care settings, if a pt consents to a financial discussion
during a medical
encounter
to expedite discharge, the HFMA best practice is to
a) Have a pt financial responsibilities kit ready for the pt
containing all of the required
registration forms and instructions
b) Make sure that the attending staff can answer questions and
assist in obtaining required pt financial data
c) Support that choice, providing that the discussion does not
interfere with pt care or disrupt pt flow
d) Decline such request as finance discussions can disrupt pt care
and pt flow - ....ANSWER...C
The office of inspector general (OIG) publishes a compliance work
plan
a) Monthly
b) Quarterly
c) Semi-annually
d) Annually - ....ANSWER...D
What are collection agency fees based on? - ....ANSWER...A
percentage of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? - ....ANSWER...Birthday
In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all providers? -
....ANSWER...Case rates
