1
CRCR Certification Exam
2025/2026: 60 Questions with
Verified Answers
Section 1: Patient Access (Questions 1–15)
Question 1
What is the first step in patient financial counseling during registration?
A. Verify insurance eligibility and benefits.
B. Collect copayment or deductible.
C. Discuss payment plan options.
D. Submit a claim to the insurance provider.
Correct Answer: A. Verify insurance eligibility and benefits.
Rationale: Verifying insurance eligibility and benefits ensures accurate financial responsibility
determination, preventing claim denials, per 2025 HFMA patient access guidelines.
Question 2
A patient presents without an insurance card. What should the revenue cycle representative do?
A. Deny service until the card is provided.
B. Verify insurance using the patient’s demographic information.
C. Bill the patient as self-pay immediately.
D. Contact the provider for approval.
Correct Answer: B. Verify insurance using the patient’s demographic information.
Rationale: Using demographic data to verify insurance maintains access to care and ensures
accurate billing, per HFMA patient access standards.
Question 3
, 2
Which action ensures positive patient identification during registration?
A. Confirm identity using two identifiers (e.g., name and date of birth).
B. Ask for a driver’s license only.
C. Rely on the patient’s verbal confirmation.
D. Use the medical record number alone.
Correct Answer: A. Confirm identity using two identifiers (e.g., name and date of birth).
Rationale: Two identifiers ensure accurate patient identification, reducing errors in billing and
care, per 2025 HFMA guidelines.
Question 4
A patient receives an Advance Beneficiary Notice (ABN). How should they interpret this?
A. The procedure is guaranteed to be covered by Medicare.
B. The procedure may not be covered, and they may be responsible for costs.
C. They must pay the full amount upfront.
D. No further action is needed.
Correct Answer: B. The procedure may not be covered, and they may be responsible for
costs.
Rationale: An ABN informs patients of potential non-coverage and financial responsibility,
allowing informed decisions, per HFMA compliance standards.
Question 5
What is a key component of patient access during pre-registration?
A. Collecting payment for prior balances.
B. Obtaining accurate demographic and insurance information.
C. Scheduling follow-up appointments.
D. Reviewing medical history.
Correct Answer: B. Obtaining accurate demographic and insurance information.
Rationale: Accurate demographic and insurance data prevent claim denials and ensure proper
billing, per HFMA patient access protocols.
Section 2: Billing and Claims Processing (Questions 6–20)
Question 6
, 3
A four-digit code that categorizes a line item in the chargemaster is known as:
A. HCPCS codes
B. ICD-10 procedural codes
C. CPT codes
D. Revenue codes
Correct Answer: D. Revenue codes
Rationale: Revenue codes classify services in the chargemaster for billing purposes, ensuring
accurate claims submission, per 2025 HFMA billing standards.
Question 7
What is the best practice for managing claim denials?
A. Resubmit claims without review.
B. Analyze denial types and sources to implement process improvements.
C. Centralize billing to focus on compliance.
D. Double-check all claims before submission.
Correct Answer: B. Analyze denial types and sources to implement process improvements.
Rationale: Analyzing denials identifies root causes, reducing future errors and improving
revenue recovery, per HFMA guidelines.
Question 8
Claims with dates of service received after one year are typically:
A. Fully paid with interest.
B. Denied by Medicare.
C. The patient’s full responsibility.
D. Deemed charity care.
Correct Answer: B. Denied by Medicare.
Rationale: Medicare denies claims submitted after one year, emphasizing timely filing, per 2025
CMS regulations.
Question 9
What is the formula for calculating the Accounts Receivable (A/R) collections period?
A. Accounts Receivable Turnover multiplied by Number of Days
B. Number of Days divided by Accounts Receivable Turnover
CRCR Certification Exam
2025/2026: 60 Questions with
Verified Answers
Section 1: Patient Access (Questions 1–15)
Question 1
What is the first step in patient financial counseling during registration?
A. Verify insurance eligibility and benefits.
B. Collect copayment or deductible.
C. Discuss payment plan options.
D. Submit a claim to the insurance provider.
Correct Answer: A. Verify insurance eligibility and benefits.
Rationale: Verifying insurance eligibility and benefits ensures accurate financial responsibility
determination, preventing claim denials, per 2025 HFMA patient access guidelines.
Question 2
A patient presents without an insurance card. What should the revenue cycle representative do?
A. Deny service until the card is provided.
B. Verify insurance using the patient’s demographic information.
C. Bill the patient as self-pay immediately.
D. Contact the provider for approval.
Correct Answer: B. Verify insurance using the patient’s demographic information.
Rationale: Using demographic data to verify insurance maintains access to care and ensures
accurate billing, per HFMA patient access standards.
Question 3
, 2
Which action ensures positive patient identification during registration?
A. Confirm identity using two identifiers (e.g., name and date of birth).
B. Ask for a driver’s license only.
C. Rely on the patient’s verbal confirmation.
D. Use the medical record number alone.
Correct Answer: A. Confirm identity using two identifiers (e.g., name and date of birth).
Rationale: Two identifiers ensure accurate patient identification, reducing errors in billing and
care, per 2025 HFMA guidelines.
Question 4
A patient receives an Advance Beneficiary Notice (ABN). How should they interpret this?
A. The procedure is guaranteed to be covered by Medicare.
B. The procedure may not be covered, and they may be responsible for costs.
C. They must pay the full amount upfront.
D. No further action is needed.
Correct Answer: B. The procedure may not be covered, and they may be responsible for
costs.
Rationale: An ABN informs patients of potential non-coverage and financial responsibility,
allowing informed decisions, per HFMA compliance standards.
Question 5
What is a key component of patient access during pre-registration?
A. Collecting payment for prior balances.
B. Obtaining accurate demographic and insurance information.
C. Scheduling follow-up appointments.
D. Reviewing medical history.
Correct Answer: B. Obtaining accurate demographic and insurance information.
Rationale: Accurate demographic and insurance data prevent claim denials and ensure proper
billing, per HFMA patient access protocols.
Section 2: Billing and Claims Processing (Questions 6–20)
Question 6
, 3
A four-digit code that categorizes a line item in the chargemaster is known as:
A. HCPCS codes
B. ICD-10 procedural codes
C. CPT codes
D. Revenue codes
Correct Answer: D. Revenue codes
Rationale: Revenue codes classify services in the chargemaster for billing purposes, ensuring
accurate claims submission, per 2025 HFMA billing standards.
Question 7
What is the best practice for managing claim denials?
A. Resubmit claims without review.
B. Analyze denial types and sources to implement process improvements.
C. Centralize billing to focus on compliance.
D. Double-check all claims before submission.
Correct Answer: B. Analyze denial types and sources to implement process improvements.
Rationale: Analyzing denials identifies root causes, reducing future errors and improving
revenue recovery, per HFMA guidelines.
Question 8
Claims with dates of service received after one year are typically:
A. Fully paid with interest.
B. Denied by Medicare.
C. The patient’s full responsibility.
D. Deemed charity care.
Correct Answer: B. Denied by Medicare.
Rationale: Medicare denies claims submitted after one year, emphasizing timely filing, per 2025
CMS regulations.
Question 9
What is the formula for calculating the Accounts Receivable (A/R) collections period?
A. Accounts Receivable Turnover multiplied by Number of Days
B. Number of Days divided by Accounts Receivable Turnover
