@PROFDOCDIGITALLIBRARIES
1
CRCR EXAM MULTIPLE CHOICE, CRCR
Exam Prep, Certified Revenue Cycle
Representative - CRCR (2024/2025)
What are collection agency fees based on? ✔✔A percentage of dollars collected
PR
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule? ✔✔Birthday
O
In what type of payment methodology is a lump sum or bundled payment negotiated between the
FD
payer and some or all providers? ✔✔Case rates
O
What customer service improvements might improve the patient accounts department?
C
✔✔Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? ✔✔Inform a
Medicare beneficiary that Medicare may not pay for the order or service
What type of account adjustment results from the patient's unwillingness to pay for a self-pay
balance? ✔✔Bad debt adjustment
,@PROFDOCDIGITALLIBRARIES
2
What is the initial hospice benefit? ✔✔Two 90-day periods and an unlimited number of
subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? ✔✔If the patient
PR
requires ambulance transportation to a skilled nursing facility
How should a provider resolve a late-charge credit posted after an account is billed? ✔✔Post a
O
late-charge adjustment to the account
FD
an increase in the dollars aged greater than 90 days from date of service indicate what about
O
accounts ✔✔They are not being processed in a timely manner
C
What is an advantage of a preregistration program? ✔✔It reduces processing times at the time of
service
What are the two statutory exclusions from hospice coverage? ✔✔Medically unnecessary
services and custodial care
,@PROFDOCDIGITALLIBRARIES
3
What core financial activities are resolved within patient access? ✔✔Scheduling, insurance
verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? ✔✔The services do not involve an overnight
stay
PR
How is a mis-posted contractual allowance resolved? ✔✔Comparing the contract reimbursement
rates with the contract on the admittance advice to identify the correct amount
O
FD
What type of patient status is used to evaluate the patient's need for inpatient care?
✔✔Observation
O
C
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what? ✔✔Medically necessary inpatient hospital services for at least 3
consecutive days before the skilled nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? ✔✔When the
patient is the insured
, @PROFDOCDIGITALLIBRARIES
4
What are non-emergency patients who come for service without prior notification to the provider
called? ✔✔Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the
status of the subscriber's spouse? ✔✔Neither enrolled not entitled to benefits
PR
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act,
establishes what? ✔✔Disclosure rules for consumer credit sales and consumer loans
O
FD
What is a principal diagnosis? ✔✔Primary reason for the patient's admission
O
Collecting patient liability dollars after service leads to what? ✔✔Lower accounts receivable
C
levels
What is the daily out-of-pocket amount for each lifetime reserve day used? ✔✔50% of the
current deductible amount
What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not billable as
an RHC services? ✔✔Inpatient care
1
CRCR EXAM MULTIPLE CHOICE, CRCR
Exam Prep, Certified Revenue Cycle
Representative - CRCR (2024/2025)
What are collection agency fees based on? ✔✔A percentage of dollars collected
PR
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule? ✔✔Birthday
O
In what type of payment methodology is a lump sum or bundled payment negotiated between the
FD
payer and some or all providers? ✔✔Case rates
O
What customer service improvements might improve the patient accounts department?
C
✔✔Holding staff accountable for customer service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? ✔✔Inform a
Medicare beneficiary that Medicare may not pay for the order or service
What type of account adjustment results from the patient's unwillingness to pay for a self-pay
balance? ✔✔Bad debt adjustment
,@PROFDOCDIGITALLIBRARIES
2
What is the initial hospice benefit? ✔✔Two 90-day periods and an unlimited number of
subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient claim? ✔✔If the patient
PR
requires ambulance transportation to a skilled nursing facility
How should a provider resolve a late-charge credit posted after an account is billed? ✔✔Post a
O
late-charge adjustment to the account
FD
an increase in the dollars aged greater than 90 days from date of service indicate what about
O
accounts ✔✔They are not being processed in a timely manner
C
What is an advantage of a preregistration program? ✔✔It reduces processing times at the time of
service
What are the two statutory exclusions from hospice coverage? ✔✔Medically unnecessary
services and custodial care
,@PROFDOCDIGITALLIBRARIES
3
What core financial activities are resolved within patient access? ✔✔Scheduling, insurance
verification, discharge processing, and payment of point-of-service receipts
What statement applies to the scheduled outpatient? ✔✔The services do not involve an overnight
stay
PR
How is a mis-posted contractual allowance resolved? ✔✔Comparing the contract reimbursement
rates with the contract on the admittance advice to identify the correct amount
O
FD
What type of patient status is used to evaluate the patient's need for inpatient care?
✔✔Observation
O
C
Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the
beneficiary has received what? ✔✔Medically necessary inpatient hospital services for at least 3
consecutive days before the skilled nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? ✔✔When the
patient is the insured
, @PROFDOCDIGITALLIBRARIES
4
What are non-emergency patients who come for service without prior notification to the provider
called? ✔✔Unscheduled patients
If the insurance verification response reports that a subscriber has a single policy, what is the
status of the subscriber's spouse? ✔✔Neither enrolled not entitled to benefits
PR
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act,
establishes what? ✔✔Disclosure rules for consumer credit sales and consumer loans
O
FD
What is a principal diagnosis? ✔✔Primary reason for the patient's admission
O
Collecting patient liability dollars after service leads to what? ✔✔Lower accounts receivable
C
levels
What is the daily out-of-pocket amount for each lifetime reserve day used? ✔✔50% of the
current deductible amount
What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not billable as
an RHC services? ✔✔Inpatient care
