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CRCR Exam Review 2025/26 – Complete HFMA Certification Q&A Guide with Correct Answers and Graded Solutions

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This document provides the fully updated and graded A+ question-and-answer review for the 2025/2026 Certified Revenue Cycle Representative (CRCR) exam. It comprehensively covers all key areas of the revenue cycle, including patient access, insurance verification, billing requirements, Medicare/Medicaid regulations, charge master accuracy, pricing transparency, claims processing, compliance, and ethical standards. The guide also reflects HFMA best practices and includes real-world scenarios to strengthen exam readiness for healthcare finance professionals.

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Institution
Nursing Education
Course
Nursing education










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Institution
Nursing education
Course
Nursing education

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Uploaded on
July 8, 2025
Number of pages
27
Written in
2024/2025
Type
Exam (elaborations)
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Questions & answers

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Page 1 of 27




CRCR EXAM REVIEW UPDATE
2025/26 COMPLETE VERSION OF
QUESTIONS AND CORRECT
ANSWERS ALREADY GRADED A+
Which option is NOT a main HFMA Healthcare Dollars and Sense revenue cycle
initiative?
A) Patient Financial Communications
B) Medical Account Resolution
C) Price Transparency
D) Process Compliance

- ANSWER: D) Process Compliance


Approximately what ______% of billing information is obtained during the
registration process (Patient Access).

- ANSWER: 40%


What is the objective of the HCAHPS initiative?
A) To conduct evaluations concerning patients' perspective on hospital care.
B) To provide a standardization method for evaluating patients' perspective on
hospital care.
C) To provide clear communication and good customer service, which will give
the provider a competitive edge.

,Page 2 of 27




D) To make certain that during registration key information is verified by means of
a picture ID and insurance card.

- ANSWER: B) To provide a standardization method for evaluating patients'
perspective on hospital care.


Which option is NOT a department that supports and collaborates with the revenue
cycle? A) Finance

B) Clinical Services
C) Information Technology
D) Assisted Living Services

- ANSWER: D) Assisted Living Services


What must a SNF have to participate in the Medicare Program?

- ANSWER: A written transfer agreement with one of more participating hospitals
providing for the transfer of patients between the hospital and SNF.


In order to qualify for Medicare Coverage of Home Health Service a patient must
meet 2 conditions.

- ANSWER: 1) An MD must certify that a patient is confined to his/her residence
(Not necessarily bedridden). Leaving the home would be a considerable effort
2) Hospitals and SNFs may not be considered a place of residence for purposes of
home health coverage.


Which options is NOT a continuum of care provider?
A) Physician
B) Skilled Nursing Facility (SNF)

, Page 3 of 27




C) Health Plan Contracting
D) Hospice
- ANSWER: C) Health Plan Contracting


Which of the following are essential elements of an effective compliance program?
A) Oversight of personnel by high-level personnel.
B) Established compliance standards and procedures.
C) Designation of a compliance offices employees within the Billing department.
D) Reasonable methods to achieve compliance with standards, including
monitoring systems and hotlines.
E) Automatic dismissal of any employee excluded from participating in a federal
healthcare program.
- ANSWER: A, B, and D
A) Oversight of personnel by high-level personnel.
B) Established compliance standards and procedures.
D) Reasonable methods to achieve compliance with standards, including
monitoring systems and hotlines.


What is the OIG?
- ANSWER: The Office of the Inspector General


Annually, the OIG publishes a work plan of compliance issues and objectives that
will be focused on throughout the following year. Identify which option is NOT a
work plan task mentioned in this course.
A) Standard Unique Employer Identifier
B) Provider-based status
C) Medical devices
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