CRCR Exam Preparation 2024/2025 QUESTIONS AND CORRECT ANSWERS
PROFESSOR VERIFIED
1. What are collection agency fees based on?: A percentage of dollars collected
2. Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule?: Birthday
3. In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all providers?: Case
rates
4. What customer service improvements might improve the patient
accounts department?: Holding staff accountable for customer service during
performance reviews
5. 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
6. What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance?: Bad debt adjustment
7. What is the initial hospice benefit?: Two 90-day periods and an unlimited
number of subsequent periods
8. When does a hospital add ambulance charges to the Medicare inpatient
claim?: If the patient requires ambulance transportation to a skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an
account is billed?: Post a late-charge adjustment to the account
10. an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts: They are not being processed in a timely manner
11. What is an advantage of a preregistration program?: It reduces processing
times at the time of service
12. What are the two statutory exclusions from hospice coverage?: Medically
unnecessary services and custodial care
, .
13. What core financial activities are resolved within patient access?:
Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
14. What statement applies to the scheduled outpatient?: The services do not
involve an overnight stay
15. 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
16. What type of patient status is used to evaluate the patient's need for
inpatient care?: Observation
17. 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
18 When is the word "SAME" entered on the CMS 1500 billing form in Field
0$?: When the patient is the insured
19. What are non-emergency patients who come for service without prior
notification to the provider called?: Unscheduled patients
20. 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
21. 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
22. What is a principal diagnosis?: Primary reason for the patient's admission
23. Collecting patient liability dollars after service leads to what?: Lower
accounts receivable levels
24. What is the daily out-of-pocket amount for each lifetime reserve day
used?-
: 50% of the current deductible amount
25. What service provided to a Medicare beneficiary in a rural health clinic
(RHC) is not billable as an RHC services?: Inpatient care
26. What code indicates the disposition of the patient at the conclusion of
service?: Patient discharge status code
27. What are hospitals required to do for Medicare credit balance accounts?:
They result in lost reimbursement and additional cost to collect
PROFESSOR VERIFIED
1. What are collection agency fees based on?: A percentage of dollars collected
2. Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule?: Birthday
3. In what type of payment methodology is a lump sum or bundled
payment negotiated between the payer and some or all providers?: Case
rates
4. What customer service improvements might improve the patient
accounts department?: Holding staff accountable for customer service during
performance reviews
5. 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
6. What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance?: Bad debt adjustment
7. What is the initial hospice benefit?: Two 90-day periods and an unlimited
number of subsequent periods
8. When does a hospital add ambulance charges to the Medicare inpatient
claim?: If the patient requires ambulance transportation to a skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an
account is billed?: Post a late-charge adjustment to the account
10. an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts: They are not being processed in a timely manner
11. What is an advantage of a preregistration program?: It reduces processing
times at the time of service
12. What are the two statutory exclusions from hospice coverage?: Medically
unnecessary services and custodial care
, .
13. What core financial activities are resolved within patient access?:
Scheduling, insurance verification, discharge processing, and payment of point-of-
service receipts
14. What statement applies to the scheduled outpatient?: The services do not
involve an overnight stay
15. 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
16. What type of patient status is used to evaluate the patient's need for
inpatient care?: Observation
17. 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
18 When is the word "SAME" entered on the CMS 1500 billing form in Field
0$?: When the patient is the insured
19. What are non-emergency patients who come for service without prior
notification to the provider called?: Unscheduled patients
20. 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
21. 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
22. What is a principal diagnosis?: Primary reason for the patient's admission
23. Collecting patient liability dollars after service leads to what?: Lower
accounts receivable levels
24. What is the daily out-of-pocket amount for each lifetime reserve day
used?-
: 50% of the current deductible amount
25. What service provided to a Medicare beneficiary in a rural health clinic
(RHC) is not billable as an RHC services?: Inpatient care
26. What code indicates the disposition of the patient at the conclusion of
service?: Patient discharge status code
27. What are hospitals required to do for Medicare credit balance accounts?:
They result in lost reimbursement and additional cost to collect
