CRCR Certification Exam | 2025/2026 Latest
Edition
Real Exam Questions and Verified Answers | 100% Accuracy | Certified
Revenue Cycle Representative | Graded A+
Introduction
This resource includes 150 verified multiple-choice questions and correct answers from the
most current CRCR (Certified Revenue Cycle Representative) Exam, fully aligned with the
HFMA® 2025/2026 testing standards. It covers essential areas such as Revenue Cycle
Management, Patient Access, Billing, Compliance, and Healthcare Reimbursement.
Answer Format
All correct answers are clearly marked in bold and green to enhance review efficiency and
support confident exam preparation.
CRCR Certification Exam 2025/2026
Question 1
What is the primary goal of the revenue cycle in healthcare?
A. To reduce patient wait times
B. To ensure timely and accurate payment for services
C. To improve clinical outcomes
D. To manage employee schedules
Answer: To ensure timely and accurate payment for services
Rationale: The revenue cycle manages financial processes to secure timely and
accurate payments for healthcare services. Domain: Revenue Cycle Management.
Question 2
What is the first step in verifying insurance eligibility during patient access?
A. Collect co-payment
B. Verify patient insurance coverage
C. Schedule the appointment
D. Submit a claim
Answer: Verify patient insurance coverage
Rationale: Verifying insurance ensures the patient’s plan is active and covers
services. Domain: Patient Access.
,Question 3
What does the term "clean claim" refer to in billing?
A. A claim with no errors or missing information
B. A claim that meets payer requirements for processing
C. A claim submitted without patient consent
D. A claim paid within 30 days
Answer: A claim that meets payer requirements for processing
Rationale: A clean claim is complete, accurate, and compliant with payer standards
for processing. Domain: Billing.
Question 4
Which regulation ensures patient privacy in healthcare?
A. Affordable Care Act
B. HIPAA
C. Medicare Access and CHIP Reauthorization Act
D. False Claims Act
Answer: HIPAA
Rationale: HIPAA (Health Insurance Portability and Accountability Act) protects
patient health information and ensures privacy compliance. Domain: Compliance.
Question 5
What is the purpose of a chargemaster in healthcare?
A. To schedule patient appointments
B. To maintain a list of billable services and prices
C. To track employee performance
D. To manage insurance contracts
Answer: To maintain a list of billable services and prices
Rationale: The chargemaster lists all billable services and their associated charges
for accurate billing. Domain: Billing.
Question 6
What is a key component of patient financial counseling?
A. Scheduling follow-up appointments
B. Discussing payment options and financial assistance
C. Verifying clinical diagnoses
,D. Reviewing medical records
Answer: Discussing payment options and financial assistance
Rationale: Financial counseling helps patients understand costs and explore
payment or assistance options. Domain: Patient Access.
Question 7
What does the term "denial management" involve?
A. Approving all claims
B. Resolving rejected or denied claims
C. Reducing patient co-pays
D. Scheduling patient visits
Answer: Resolving rejected or denied claims
Rationale: Denial management focuses on addressing claim rejections to secure
payment. Domain: Billing.
Question 8
Which document outlines a patient’s financial responsibility for services?
A. Medical record
B. Explanation of Benefits (EOB)
C. Insurance card
D. Appointment schedule
Answer: Explanation of Benefits (EOB)
Rationale: The EOB details the patient’s financial obligations after insurance
processing. Domain: Healthcare Reimbursement.
Question 9
What is the purpose of pre-authorization in the revenue cycle?
A. To schedule patient appointments
B. To obtain payer approval for services
C. To collect co-payments
D. To verify patient identity
Answer: To obtain payer approval for services
Rationale: Pre-authorization ensures services are covered by the payer before they
are provided. Domain: Patient Access.
, Question 10
What is a common reason for claim denials?
A. Timely payment by the payer
B. Missing or incorrect patient information
C. Accurate coding
D. Patient satisfaction
Answer: Missing or incorrect patient information
Rationale: Errors in patient data, such as demographics or insurance details, often
lead to claim rejections. Domain: Billing.
Question 11
Which coding system is used for inpatient hospital procedures?
A. CPT
B. ICD-10-PCS
C. HCPCS Level II
D. ICD-10-CM
Answer: ICD-10-PCS
Rationale: ICD-10-PCS is used for coding inpatient hospital procedures. Domain:
Billing.
Question 12
What is the purpose of a revenue cycle dashboard?
A. To schedule patient appointments
B. To monitor key performance indicators
C. To manage clinical outcomes
D. To assign staff tasks
Answer: To monitor key performance indicators
Rationale: The dashboard tracks metrics like claim denials and collection rates to
assess revenue cycle performance. Domain: Revenue Cycle Management.
Question 13
What does the term "AR days" refer to in the revenue cycle?
A. Appointment reminder days
B. Accounts receivable days outstanding
C. Authorization request days
Edition
Real Exam Questions and Verified Answers | 100% Accuracy | Certified
Revenue Cycle Representative | Graded A+
Introduction
This resource includes 150 verified multiple-choice questions and correct answers from the
most current CRCR (Certified Revenue Cycle Representative) Exam, fully aligned with the
HFMA® 2025/2026 testing standards. It covers essential areas such as Revenue Cycle
Management, Patient Access, Billing, Compliance, and Healthcare Reimbursement.
Answer Format
All correct answers are clearly marked in bold and green to enhance review efficiency and
support confident exam preparation.
CRCR Certification Exam 2025/2026
Question 1
What is the primary goal of the revenue cycle in healthcare?
A. To reduce patient wait times
B. To ensure timely and accurate payment for services
C. To improve clinical outcomes
D. To manage employee schedules
Answer: To ensure timely and accurate payment for services
Rationale: The revenue cycle manages financial processes to secure timely and
accurate payments for healthcare services. Domain: Revenue Cycle Management.
Question 2
What is the first step in verifying insurance eligibility during patient access?
A. Collect co-payment
B. Verify patient insurance coverage
C. Schedule the appointment
D. Submit a claim
Answer: Verify patient insurance coverage
Rationale: Verifying insurance ensures the patient’s plan is active and covers
services. Domain: Patient Access.
,Question 3
What does the term "clean claim" refer to in billing?
A. A claim with no errors or missing information
B. A claim that meets payer requirements for processing
C. A claim submitted without patient consent
D. A claim paid within 30 days
Answer: A claim that meets payer requirements for processing
Rationale: A clean claim is complete, accurate, and compliant with payer standards
for processing. Domain: Billing.
Question 4
Which regulation ensures patient privacy in healthcare?
A. Affordable Care Act
B. HIPAA
C. Medicare Access and CHIP Reauthorization Act
D. False Claims Act
Answer: HIPAA
Rationale: HIPAA (Health Insurance Portability and Accountability Act) protects
patient health information and ensures privacy compliance. Domain: Compliance.
Question 5
What is the purpose of a chargemaster in healthcare?
A. To schedule patient appointments
B. To maintain a list of billable services and prices
C. To track employee performance
D. To manage insurance contracts
Answer: To maintain a list of billable services and prices
Rationale: The chargemaster lists all billable services and their associated charges
for accurate billing. Domain: Billing.
Question 6
What is a key component of patient financial counseling?
A. Scheduling follow-up appointments
B. Discussing payment options and financial assistance
C. Verifying clinical diagnoses
,D. Reviewing medical records
Answer: Discussing payment options and financial assistance
Rationale: Financial counseling helps patients understand costs and explore
payment or assistance options. Domain: Patient Access.
Question 7
What does the term "denial management" involve?
A. Approving all claims
B. Resolving rejected or denied claims
C. Reducing patient co-pays
D. Scheduling patient visits
Answer: Resolving rejected or denied claims
Rationale: Denial management focuses on addressing claim rejections to secure
payment. Domain: Billing.
Question 8
Which document outlines a patient’s financial responsibility for services?
A. Medical record
B. Explanation of Benefits (EOB)
C. Insurance card
D. Appointment schedule
Answer: Explanation of Benefits (EOB)
Rationale: The EOB details the patient’s financial obligations after insurance
processing. Domain: Healthcare Reimbursement.
Question 9
What is the purpose of pre-authorization in the revenue cycle?
A. To schedule patient appointments
B. To obtain payer approval for services
C. To collect co-payments
D. To verify patient identity
Answer: To obtain payer approval for services
Rationale: Pre-authorization ensures services are covered by the payer before they
are provided. Domain: Patient Access.
, Question 10
What is a common reason for claim denials?
A. Timely payment by the payer
B. Missing or incorrect patient information
C. Accurate coding
D. Patient satisfaction
Answer: Missing or incorrect patient information
Rationale: Errors in patient data, such as demographics or insurance details, often
lead to claim rejections. Domain: Billing.
Question 11
Which coding system is used for inpatient hospital procedures?
A. CPT
B. ICD-10-PCS
C. HCPCS Level II
D. ICD-10-CM
Answer: ICD-10-PCS
Rationale: ICD-10-PCS is used for coding inpatient hospital procedures. Domain:
Billing.
Question 12
What is the purpose of a revenue cycle dashboard?
A. To schedule patient appointments
B. To monitor key performance indicators
C. To manage clinical outcomes
D. To assign staff tasks
Answer: To monitor key performance indicators
Rationale: The dashboard tracks metrics like claim denials and collection rates to
assess revenue cycle performance. Domain: Revenue Cycle Management.
Question 13
What does the term "AR days" refer to in the revenue cycle?
A. Appointment reminder days
B. Accounts receivable days outstanding
C. Authorization request days
