HFMA CRCR EXAM LATEST EXAM QUESTIONS AND
CORRECT ANSWERS(VERIFIED
ANSWERS)
A valid CPT or HCPCS - CORRECT codeMedicare guidelines require
that when a test is ANSWER>> ordered for a LCD or NCD exists,
the information provided on the order must include:
Access their information and perform functions on-line - CORRECT
ANSWER>>With advances in internet security and encryption, revenue-cycle
processes are expanding to allow patients to do
what? - CORRECT ANSWER>>
A percentage of dollars collectedWhat are collection
agency - CORRECT fees based on?
ANSWER>> BirthdaySelf-funded benefit plans may choose to
coordinate benefits using the gender rule or what
other rule?
Case - CORRECT ANSWER>> ratesIn what type of payment methodology is a lump
sum or bundled payment negotiated between the payer and some or all
providers?
Holding staff accountable for customer service during performance reviews CORRECT
ANSWER>>What customer service improvements might improve the patient
accounts department?
2|Page
Inform a Medicare beneficiary that Medicare may not pay for the order or service
- CORRECT ANSWER>>What is an ABN (Advance Beneficiary Notice of Non coverage) required to do?
Bad debt adjustment - CORRECT ANSWER>>What type of account adjustment results from the
patient's unwillingness to pay for a self-pay balance? Two 90-day periods and an unlimited number
of subsequent periods - CORRECT ANSWER>>What is the initial hospice benefit?
If the patient requires ambulance transportation to a skilled nursing facility
CORRECT ANSWER>>When does a hospital add ambulance charges to the
Medicare inpatient claim?
Post a late-charge adjustment to the - CORRECT accountHow should a
provider resolve a late-charge credit posted ANSWER>> after an account is
billed?
They are not being processed in a timely - CORRECT ANSWER>> manneran
increase in the dollars aged greater than 90 days from date of service in dicate
what about accounts
It reduces processing times at the time of - CORRECT
serviceWhat is an advantage of a preregistration ANSWER>>
program?
3|Page
Medically unnecessary services and custodial - CORRECT ANSWER>>
careWhat are the two statutory exclusions from hospice coverage?
Scheduling, insurance verification, discharge processing, and payment of point-of service receipts -
CORRECT ANSWER>> What core financial activities are resolved
within patient access?
The services do not involve an overnight - CORRECT ANSWER>> stayWhat
statement applies to the scheduled outpatient?
, Comparing the contract reimbursement rates with the contract
on the admittance - CORRECT
advice to identify the correct ANSWER>> amountHow is a mis-posted
contractual allowance resolved?
- CORRECT ANSWER>> ObservationWhat type of patient status is used
to evaluate the patient's need for inpatient care?
Medically necessary inpatient hospital services for at least 3 consecutive
days - CORRECT
before the skilled nursing care ANSWER>> admissionCoverage rules
for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what?
When the patient is the - CORRECT ANSWER>> insuredWhen is the word "SAME"
entered on the CMS 1500 billing form in Field 0$?
4|Page
Unscheduled - CORRECT patientsWhat are non-emergency
patients who come ANSWER>> for service without prior notification
to the provider called?
Neither enrolled not entitled to - CORRECT ANSWER>> benefitsIf the insurance
verification response reports that a subscriber has a single policy, what is the
status of the subscriber's spouse?
Disclosure rules for consumer credit sales and consumer loans - CORRECT
ANSWER>>Regulation Z of the Consumer Credit Protection Act, also known as the
Truth in Lending Act, establishes what?
Primary reason for the patient's - CORRECT ANSWER>> admissionWhat
is a principal diagnosis?
Lower accounts receivable - CORRECT levelsCollecting patient liability
dollars after service leads to ANSWER>> what?
50% of the current deductible amountWhat is the daily - CORRECT ANSWER>> out-of-
pocket amount for each lifetime reserve day used?
Inpatient - CORRECT ANSWER>> careWhat service provided to a Medicare
beneficiary in a rural health clinic (RHC) is not billable as an
RHC services? - CORRECT ANSWER>>
Patient discharge status codeWhat code indicates the disposition of the patient at the
conclusion of service?
5|Page
They result in lost reimbursement and additional cost to collect - CORRECT
ANSWER>>What are hospitals required to do for Medicare credit balance
accounts?
- CORRECT ANSWER>> PatientWhen an undue delay of payment results from a
dispute between the patient and the third party payer, who is responsible for
payment?
onset date of current - CORRECT illnessWhat date is required on all
CMS 1500 claim forms? ANSWER>>
Review appropriateness of the service - CORRECT ANSWER>> requestWhat does
scheduling allow provider staff to do
Condition - CORRECT ANSWER>> codeWhat code is used to report the
provider's most common semiprivate room rate?
- CORRECT 2012Regulations and requirements for coding accountable
care ANSWER>> organizations, which allows providers to begin creating
these organizations, were finalized in:
CORRECT ANSWERS(VERIFIED
ANSWERS)
A valid CPT or HCPCS - CORRECT codeMedicare guidelines require
that when a test is ANSWER>> ordered for a LCD or NCD exists,
the information provided on the order must include:
Access their information and perform functions on-line - CORRECT
ANSWER>>With advances in internet security and encryption, revenue-cycle
processes are expanding to allow patients to do
what? - CORRECT ANSWER>>
A percentage of dollars collectedWhat are collection
agency - CORRECT fees based on?
ANSWER>> BirthdaySelf-funded benefit plans may choose to
coordinate benefits using the gender rule or what
other rule?
Case - CORRECT ANSWER>> ratesIn what type of payment methodology is a lump
sum or bundled payment negotiated between the payer and some or all
providers?
Holding staff accountable for customer service during performance reviews CORRECT
ANSWER>>What customer service improvements might improve the patient
accounts department?
2|Page
Inform a Medicare beneficiary that Medicare may not pay for the order or service
- CORRECT ANSWER>>What is an ABN (Advance Beneficiary Notice of Non coverage) required to do?
Bad debt adjustment - CORRECT ANSWER>>What type of account adjustment results from the
patient's unwillingness to pay for a self-pay balance? Two 90-day periods and an unlimited number
of subsequent periods - CORRECT ANSWER>>What is the initial hospice benefit?
If the patient requires ambulance transportation to a skilled nursing facility
CORRECT ANSWER>>When does a hospital add ambulance charges to the
Medicare inpatient claim?
Post a late-charge adjustment to the - CORRECT accountHow should a
provider resolve a late-charge credit posted ANSWER>> after an account is
billed?
They are not being processed in a timely - CORRECT ANSWER>> manneran
increase in the dollars aged greater than 90 days from date of service in dicate
what about accounts
It reduces processing times at the time of - CORRECT
serviceWhat is an advantage of a preregistration ANSWER>>
program?
3|Page
Medically unnecessary services and custodial - CORRECT ANSWER>>
careWhat are the two statutory exclusions from hospice coverage?
Scheduling, insurance verification, discharge processing, and payment of point-of service receipts -
CORRECT ANSWER>> What core financial activities are resolved
within patient access?
The services do not involve an overnight - CORRECT ANSWER>> stayWhat
statement applies to the scheduled outpatient?
, Comparing the contract reimbursement rates with the contract
on the admittance - CORRECT
advice to identify the correct ANSWER>> amountHow is a mis-posted
contractual allowance resolved?
- CORRECT ANSWER>> ObservationWhat type of patient status is used
to evaluate the patient's need for inpatient care?
Medically necessary inpatient hospital services for at least 3 consecutive
days - CORRECT
before the skilled nursing care ANSWER>> admissionCoverage rules
for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what?
When the patient is the - CORRECT ANSWER>> insuredWhen is the word "SAME"
entered on the CMS 1500 billing form in Field 0$?
4|Page
Unscheduled - CORRECT patientsWhat are non-emergency
patients who come ANSWER>> for service without prior notification
to the provider called?
Neither enrolled not entitled to - CORRECT ANSWER>> benefitsIf the insurance
verification response reports that a subscriber has a single policy, what is the
status of the subscriber's spouse?
Disclosure rules for consumer credit sales and consumer loans - CORRECT
ANSWER>>Regulation Z of the Consumer Credit Protection Act, also known as the
Truth in Lending Act, establishes what?
Primary reason for the patient's - CORRECT ANSWER>> admissionWhat
is a principal diagnosis?
Lower accounts receivable - CORRECT levelsCollecting patient liability
dollars after service leads to ANSWER>> what?
50% of the current deductible amountWhat is the daily - CORRECT ANSWER>> out-of-
pocket amount for each lifetime reserve day used?
Inpatient - CORRECT ANSWER>> careWhat service provided to a Medicare
beneficiary in a rural health clinic (RHC) is not billable as an
RHC services? - CORRECT ANSWER>>
Patient discharge status codeWhat code indicates the disposition of the patient at the
conclusion of service?
5|Page
They result in lost reimbursement and additional cost to collect - CORRECT
ANSWER>>What are hospitals required to do for Medicare credit balance
accounts?
- CORRECT ANSWER>> PatientWhen an undue delay of payment results from a
dispute between the patient and the third party payer, who is responsible for
payment?
onset date of current - CORRECT illnessWhat date is required on all
CMS 1500 claim forms? ANSWER>>
Review appropriateness of the service - CORRECT ANSWER>> requestWhat does
scheduling allow provider staff to do
Condition - CORRECT ANSWER>> codeWhat code is used to report the
provider's most common semiprivate room rate?
- CORRECT 2012Regulations and requirements for coding accountable
care ANSWER>> organizations, which allows providers to begin creating
these organizations, were finalized in:
