1|Page
Certified Revenue Cycle Representative -
CRCR | Revised Questions With Correct
Answers
What do business/organizational ethics represent? - Correct-answer-**A.
Principles and standards by which organizations operate
B. A healthcare provider's practices and principles
C. An employee's actions influenced by experiences and value system
D. The patient privacy standard within healthcare
What is the intended outcome of collaborations made through an ACO delivery
system? - Correct-answer-**A. To ensure appropriateness of care, elimination of
duplicate services, and prevention of medical errors for a population of patients.
B. To create cost-containment provisions to reform the healthcare delivery
system.
C. To reform the healthcare system into a system that rewards greater value,
improves the quality of care and increases efficiency in the delivery of services.
D. To provide financial incentives to physicians for reporting quality data to CMS.
,2|Page
Which of these statements describes the new methodology for the determination
of net patient service revenue: - Correct-answer-A. Net patient service revenue is
defined as the average payment amount for the payer but not recorded until the
end of the month processing is completed.
B. Gross patient service revenue is recorded as net patient service revenue until
such time as all payments are received.
**C. Net patient service revenue is defined as the total incurred charges, less the
explicit price concession, less any applicable implicit price concession(s) as applied
to the specific portfolio of accounts.
D. Net patient service revenue is gross revenue minus any contractual
adjustments applicable to the account. Any additional adjustments are not
recorded until the account reaches a zero balance.
E. Net patient service revenue is the sum of the balances of all charges and
payments recorded in the accounting period.
What are KPIs? - Correct-answer-A. Benchmarks which are used to compare Key
Performance Indicators in an organization to an agreed upon average or expected
standard within the same industry.
**B. Key performance indicators, which set standards for accounts receivable
(A/R) and provide a method of measuring the collection and control of A/R.
C. Days in A/R is calculated based on the value of the total accounts receivable on
a specific date.
D. A component that can divide the accounts receivable into 30, 60, 90, 120 days,
and over 120 days categories, based on the date of service/discharge
,3|Page
While the highest level of differentiation among patients is scheduled patient vs
unscheduled patient, a variety of patient types are routinely identified in both the
acute and non-acute settings. Which patient types are typically considered acute
care patient types? - Correct-answer-Observation, newborn, Emergency (ED)
Accurate identification of the patient is the first step in the scheduling process.
Identifiers used in various combination to achieve accurate patient identification
include? - Correct-answer-Full legal name, date of birth, sex and social security
number
Pre-registration is defined as: - Correct-answer-The collection of demographic
information, insurance data, financial information, providing reminders, prep
information, and identifying the potential need for financial assistance for
scheduled patients.
Medicare has unique features not found in other health plan programs. It is
government sponsored and financed through taxes and general revenue funds.
Which of the following statements accurately describes the various Medicare
benefits programs: - Correct-answer-Medicare Part A provides benefits for
inpatient hospital services, skilled nursing care and home health care; Medicare
Part B covers outpatient and professional services, Medicare Part C or Medicare
, 4|Page
Advantage plans are managed care plans combining Part A and Part B Coverages;
and Medicare Part D is the prescription drug coverage benefit.
Which of the following statements about Medicaid eligibility is not true? -
Correct-answer-Medicaid categories are restricted to children, pregnant women
and elderly in nursing homes.
Examples of managed care plans include: - Correct-answer-All of the above
Patient Financial Communications best practices include all of the following
activities except: - Correct-answer-Collecting payment or initiating the process to
immediately remove the patient from the service schedule.
Which statement includes the required components of an accurate pricing
determination? - Correct-answer-Insurance coverage and benefits, service or test
involved, diagnosis and procedure codes, total estimated charges, adjudication
calculations based on the patient's benefit package.
Certified Revenue Cycle Representative -
CRCR | Revised Questions With Correct
Answers
What do business/organizational ethics represent? - Correct-answer-**A.
Principles and standards by which organizations operate
B. A healthcare provider's practices and principles
C. An employee's actions influenced by experiences and value system
D. The patient privacy standard within healthcare
What is the intended outcome of collaborations made through an ACO delivery
system? - Correct-answer-**A. To ensure appropriateness of care, elimination of
duplicate services, and prevention of medical errors for a population of patients.
B. To create cost-containment provisions to reform the healthcare delivery
system.
C. To reform the healthcare system into a system that rewards greater value,
improves the quality of care and increases efficiency in the delivery of services.
D. To provide financial incentives to physicians for reporting quality data to CMS.
,2|Page
Which of these statements describes the new methodology for the determination
of net patient service revenue: - Correct-answer-A. Net patient service revenue is
defined as the average payment amount for the payer but not recorded until the
end of the month processing is completed.
B. Gross patient service revenue is recorded as net patient service revenue until
such time as all payments are received.
**C. Net patient service revenue is defined as the total incurred charges, less the
explicit price concession, less any applicable implicit price concession(s) as applied
to the specific portfolio of accounts.
D. Net patient service revenue is gross revenue minus any contractual
adjustments applicable to the account. Any additional adjustments are not
recorded until the account reaches a zero balance.
E. Net patient service revenue is the sum of the balances of all charges and
payments recorded in the accounting period.
What are KPIs? - Correct-answer-A. Benchmarks which are used to compare Key
Performance Indicators in an organization to an agreed upon average or expected
standard within the same industry.
**B. Key performance indicators, which set standards for accounts receivable
(A/R) and provide a method of measuring the collection and control of A/R.
C. Days in A/R is calculated based on the value of the total accounts receivable on
a specific date.
D. A component that can divide the accounts receivable into 30, 60, 90, 120 days,
and over 120 days categories, based on the date of service/discharge
,3|Page
While the highest level of differentiation among patients is scheduled patient vs
unscheduled patient, a variety of patient types are routinely identified in both the
acute and non-acute settings. Which patient types are typically considered acute
care patient types? - Correct-answer-Observation, newborn, Emergency (ED)
Accurate identification of the patient is the first step in the scheduling process.
Identifiers used in various combination to achieve accurate patient identification
include? - Correct-answer-Full legal name, date of birth, sex and social security
number
Pre-registration is defined as: - Correct-answer-The collection of demographic
information, insurance data, financial information, providing reminders, prep
information, and identifying the potential need for financial assistance for
scheduled patients.
Medicare has unique features not found in other health plan programs. It is
government sponsored and financed through taxes and general revenue funds.
Which of the following statements accurately describes the various Medicare
benefits programs: - Correct-answer-Medicare Part A provides benefits for
inpatient hospital services, skilled nursing care and home health care; Medicare
Part B covers outpatient and professional services, Medicare Part C or Medicare
, 4|Page
Advantage plans are managed care plans combining Part A and Part B Coverages;
and Medicare Part D is the prescription drug coverage benefit.
Which of the following statements about Medicaid eligibility is not true? -
Correct-answer-Medicaid categories are restricted to children, pregnant women
and elderly in nursing homes.
Examples of managed care plans include: - Correct-answer-All of the above
Patient Financial Communications best practices include all of the following
activities except: - Correct-answer-Collecting payment or initiating the process to
immediately remove the patient from the service schedule.
Which statement includes the required components of an accurate pricing
determination? - Correct-answer-Insurance coverage and benefits, service or test
involved, diagnosis and procedure codes, total estimated charges, adjudication
calculations based on the patient's benefit package.
