HFMA CRCR EXAM ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS LATEST UPDATES
2025-2026 (100% CORRECT VERIFIED ANSWERS)
ALREADY GRADED A+
IF outpatient diagnostic services are provided within three days of the
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective
Payment System) hospital, what must happen to these charges -
ANSWER-They must be billed separately to the part B Carrier
what is a recurring or series registration? - ANSWER-One registration
record is created for multiple days of service
What are nonemergency patients who come for service without prior
notification to the provider called? - ANSWER-Unscheduled patients
Which of the following statement apply to the observation patient
type? - ANSWER-It is used to evaluate the need for an inpatient
admission
,which services are hospice programs required to provide around the
clock patient - ANSWER-Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what? -
ANSWER-Complete the scheduling process correctly based on service
requested
The Time needed to prepare the patient before service is the difference
between the patient’s arrival time and which of the following? -
ANSWER-Procedure time
Medicare guidelines require that when a test is ordered for a LCD or
NCD exists, the information provided on the order must include: -
ANSWER-Documentation of the medical necessity for the test
What is the advantage of a pre-registration program - ANSWER-It
reduces processing times at the time of service
What date are required to establish a new MPI (Master patient Index)
entry - ANSWER-The responsible party's full legal name, date of birth,
and social security number
Which of the following statements is true about third-party payments? -
ANSWER-The payments are received by the provider from the payer
, responsible for reimbursing the provider for the patient's covered
services.
Which provision protects the patient from medical expenses that
exceed the pre-set level - ANSWER-stop loss
what documentation must a primary care physician send to HMO
patient to authorize a visit to a specialist for additional testing or care? -
ANSWER-Referral
Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance
information if it would delay what? - ANSWER-Medical screening and
stabilizing treatment
Which of the following is a step in the discharge process? - ANSWER-
Have a case management service complete the discharge plan
The hospital has an APC based contract for the payment of outpatient
services. Total anticipated charges for the visit are $2,380. The approved
APC payment rate is $780. Where will the patients benefit package be
applied? - ANSWER-To the approved APC payment rate
CORRECT DETAILED ANSWERS LATEST UPDATES
2025-2026 (100% CORRECT VERIFIED ANSWERS)
ALREADY GRADED A+
IF outpatient diagnostic services are provided within three days of the
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective
Payment System) hospital, what must happen to these charges -
ANSWER-They must be billed separately to the part B Carrier
what is a recurring or series registration? - ANSWER-One registration
record is created for multiple days of service
What are nonemergency patients who come for service without prior
notification to the provider called? - ANSWER-Unscheduled patients
Which of the following statement apply to the observation patient
type? - ANSWER-It is used to evaluate the need for an inpatient
admission
,which services are hospice programs required to provide around the
clock patient - ANSWER-Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do what? -
ANSWER-Complete the scheduling process correctly based on service
requested
The Time needed to prepare the patient before service is the difference
between the patient’s arrival time and which of the following? -
ANSWER-Procedure time
Medicare guidelines require that when a test is ordered for a LCD or
NCD exists, the information provided on the order must include: -
ANSWER-Documentation of the medical necessity for the test
What is the advantage of a pre-registration program - ANSWER-It
reduces processing times at the time of service
What date are required to establish a new MPI (Master patient Index)
entry - ANSWER-The responsible party's full legal name, date of birth,
and social security number
Which of the following statements is true about third-party payments? -
ANSWER-The payments are received by the provider from the payer
, responsible for reimbursing the provider for the patient's covered
services.
Which provision protects the patient from medical expenses that
exceed the pre-set level - ANSWER-stop loss
what documentation must a primary care physician send to HMO
patient to authorize a visit to a specialist for additional testing or care? -
ANSWER-Referral
Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance
information if it would delay what? - ANSWER-Medical screening and
stabilizing treatment
Which of the following is a step in the discharge process? - ANSWER-
Have a case management service complete the discharge plan
The hospital has an APC based contract for the payment of outpatient
services. Total anticipated charges for the visit are $2,380. The approved
APC payment rate is $780. Where will the patients benefit package be
applied? - ANSWER-To the approved APC payment rate
