CRCR Certification Exam Questions and Answers 2025 (Verified Answers)
Patient financial communications best practices produce communications that are
- Precise Answer ✔✔Consistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations
(LCD) and National Coverage Determinations (NCD) that establish - Precise
Answer ✔✔What services or healthcare items are covered under Medicare
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 - Precise Answer ✔✔The Provider Reimbursement Review
Board
Concurrent review and discharge planning - Precise Answer ✔✔Occurs during
service
Duplicate payments occur: - Precise Answer ✔✔When providers re-bill claims
based on nonpayment from the initial bill submission
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 - Precise Answer ✔✔A beneficiary appeal
,Insurance verification results in which of the following - Precise Answer ✔✔The
accurate identification of the patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers
includes all of the following levels EXCEPT: - Precise Answer ✔✔Judicial review
by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the
providermay not ask about a patient's insurance information if it would delay
what? - Precise Answer ✔✔Medical screening and stabilizing treatment
Overall aggregate payments made to a hospice are subject to a computed "cap
amount" calculated by - Precise Answer ✔✔The Medicare Administrative
Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid - Precise Answer
✔✔Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first
and foremost - Precise Answer ✔✔Respect the patients privacy
,A nightly room charge will be incorrect if the patient's - Precise Answer
✔✔Transfer from ICU (intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance
Exchanges, where individuals and small businesses can - Precise Answer
✔✔Purchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing
includes: - Precise Answer ✔✔Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate
payment from Medicare? - Precise Answer ✔✔Revenue codes
This directive was developed to promote and ensure healthcare quality and value
and also to protect consumers and workers in the healthcare system. This
directive is called - Precise Answer ✔✔Patient bill of rights
, The activity which results in the accurate recording of patient bed and level of
care assessment, patient transfer and patient discharge status on a real-time
basis is known as - Precise Answer ✔✔Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor
Act) violation? - Precise Answer ✔✔Registration staff may routinely contact
managed are plans for prior authorizations before the patient is seen by the on-
duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard
transactions to identify the employer of an individual described in a transaction
EIN's are
assigned by - Precise Answer ✔✔The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all
examples of - Precise Answer ✔✔Control points for cash posting
What are some core elements if a board-approved financial assistance policy? -
Precise Answer ✔✔Eligibility, application process, and nonpayment collection
activities
A recurring/series registration is characterized by - Precise Answer ✔✔The
creation of one registration record for multiple days of service
Patient financial communications best practices produce communications that are
- Precise Answer ✔✔Consistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations
(LCD) and National Coverage Determinations (NCD) that establish - Precise
Answer ✔✔What services or healthcare items are covered under Medicare
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 - Precise Answer ✔✔The Provider Reimbursement Review
Board
Concurrent review and discharge planning - Precise Answer ✔✔Occurs during
service
Duplicate payments occur: - Precise Answer ✔✔When providers re-bill claims
based on nonpayment from the initial bill submission
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 - Precise Answer ✔✔A beneficiary appeal
,Insurance verification results in which of the following - Precise Answer ✔✔The
accurate identification of the patient's eligibility and benefits
The Medicare fee-for service appeal process for both beneficiaries and providers
includes all of the following levels EXCEPT: - Precise Answer ✔✔Judicial review
by a federal district court
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the
providermay not ask about a patient's insurance information if it would delay
what? - Precise Answer ✔✔Medical screening and stabilizing treatment
Overall aggregate payments made to a hospice are subject to a computed "cap
amount" calculated by - Precise Answer ✔✔The Medicare Administrative
Contractor (MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid - Precise Answer
✔✔Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first
and foremost - Precise Answer ✔✔Respect the patients privacy
,A nightly room charge will be incorrect if the patient's - Precise Answer
✔✔Transfer from ICU (intensive care unit) to the Medical/Surgical
floor is not reflected in the registration system
The Affordable Care Act legislated the development of Health Insurance
Exchanges, where individuals and small businesses can - Precise Answer
✔✔Purchase qualified health benefit plans regardless of insured's
health status
A portion of the accounts receivable inventory which has NOT qualified for billing
includes: - Precise Answer ✔✔Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate
payment from Medicare? - Precise Answer ✔✔Revenue codes
This directive was developed to promote and ensure healthcare quality and value
and also to protect consumers and workers in the healthcare system. This
directive is called - Precise Answer ✔✔Patient bill of rights
, The activity which results in the accurate recording of patient bed and level of
care assessment, patient transfer and patient discharge status on a real-time
basis is known as - Precise Answer ✔✔Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor
Act) violation? - Precise Answer ✔✔Registration staff may routinely contact
managed are plans for prior authorizations before the patient is seen by the on-
duty physician
HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard
transactions to identify the employer of an individual described in a transaction
EIN's are
assigned by - Precise Answer ✔✔The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all
examples of - Precise Answer ✔✔Control points for cash posting
What are some core elements if a board-approved financial assistance policy? -
Precise Answer ✔✔Eligibility, application process, and nonpayment collection
activities
A recurring/series registration is characterized by - Precise Answer ✔✔The
creation of one registration record for multiple days of service
