CRCR CERTIFICATION
370+ (2025-2026 Updated) Solved Exams + 100% Verified Solutions | Complete
Q&A
Question 1 pts
The disadvantages of outsourcing include all of the following EXCEPT:
Correct!
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff
d) Reduced internal staffing costs and a reliance on outsourced staff
Question 2 pts
The Medicare fee-for service appeal process for both beneficiaries and providers
Correct!
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for Medicare
d) Review by the Medicare Appeals Council (Appeals Council)
b) Judicial review by a federal district court
Question 3 pts
Business ethics, or organizational ethics represent:
Correct!
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct
a) The principles and standards by which organizations operate
, Question 4 pts
A portion of the accounts receivable inventory which has NOT qualified for billing
Correct!
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency
a) Charitable pledges
Question 5 pts
Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) are
Correct!
Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred to Medicaid
c) Which diagnoses, signs, or symptoms are reimbursable
Question 6 pts
Days in A/R is calculated based on the value of:
Correct!
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date
c) The time it takes to collect anticipated revenue
, Question 7 pts
Patients are contacting hospitals to proactively inquire about costs and fees prior to
Correct!
agreeing to service. The problem for hospitals in providing such information is:
a) That hospitals don't want to establish a price without knowing if
the patient has insurance and how much reimbursement can be
expected
b) The fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information
b) The fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
Question 8 pts
Across all care settings, if a patient consents to a financial discussion during a medical
Correct!
encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer questions and
assist in obtaining required patient financial data
b) Have a patient responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt patient care and patient flow
c) Support that choice, providing that the discussion does not interfere with patient care or disrupt
patient flow
Question 9 pts
A comprehensive "Compliance Program" is defined as
Correct!
a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of regulations imposed by a government
agency are being met
d) The development of operational policies that correspond to regulations
c) Systematic procedures to ensure that the provisions of regulations imposed by a government
, Question 10 pts
Case Management requires that a case manager be assigned
Correct!
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual agreement
b) To a select patient group
Question 11 pts
Pricing transparency is defined as readily available information on the price of healthcare
Correct!
services, that together with other information, help define the value of those services and
enable consumers to
a) Identify, compare, and choose providers that offer the desired level of value
b) Customize health care with a personally chosen mix of providers
c) Negotiate the cost of health plan premiums
d) Verify the cost of individual clinicians
a) Identify, compare, and choose providers that offer the desired level of value
Question 12 pts
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and
Correct!
treatment services for an enrolled group of persons based on a monthly fee is known as a
a) MSO
b) HMO
c) PPO
d) GPO
b) HMO
370+ (2025-2026 Updated) Solved Exams + 100% Verified Solutions | Complete
Q&A
Question 1 pts
The disadvantages of outsourcing include all of the following EXCEPT:
Correct!
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff
d) Reduced internal staffing costs and a reliance on outsourced staff
Question 2 pts
The Medicare fee-for service appeal process for both beneficiaries and providers
Correct!
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for Medicare
d) Review by the Medicare Appeals Council (Appeals Council)
b) Judicial review by a federal district court
Question 3 pts
Business ethics, or organizational ethics represent:
Correct!
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct
a) The principles and standards by which organizations operate
, Question 4 pts
A portion of the accounts receivable inventory which has NOT qualified for billing
Correct!
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency
a) Charitable pledges
Question 5 pts
Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) are
Correct!
Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred to Medicaid
c) Which diagnoses, signs, or symptoms are reimbursable
Question 6 pts
Days in A/R is calculated based on the value of:
Correct!
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date
c) The time it takes to collect anticipated revenue
, Question 7 pts
Patients are contacting hospitals to proactively inquire about costs and fees prior to
Correct!
agreeing to service. The problem for hospitals in providing such information is:
a) That hospitals don't want to establish a price without knowing if
the patient has insurance and how much reimbursement can be
expected
b) The fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information
b) The fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
Question 8 pts
Across all care settings, if a patient consents to a financial discussion during a medical
Correct!
encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer questions and
assist in obtaining required patient financial data
b) Have a patient responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt patient care and patient flow
c) Support that choice, providing that the discussion does not interfere with patient care or disrupt
patient flow
Question 9 pts
A comprehensive "Compliance Program" is defined as
Correct!
a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of regulations imposed by a government
agency are being met
d) The development of operational policies that correspond to regulations
c) Systematic procedures to ensure that the provisions of regulations imposed by a government
, Question 10 pts
Case Management requires that a case manager be assigned
Correct!
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual agreement
b) To a select patient group
Question 11 pts
Pricing transparency is defined as readily available information on the price of healthcare
Correct!
services, that together with other information, help define the value of those services and
enable consumers to
a) Identify, compare, and choose providers that offer the desired level of value
b) Customize health care with a personally chosen mix of providers
c) Negotiate the cost of health plan premiums
d) Verify the cost of individual clinicians
a) Identify, compare, and choose providers that offer the desired level of value
Question 12 pts
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and
Correct!
treatment services for an enrolled group of persons based on a monthly fee is known as a
a) MSO
b) HMO
c) PPO
d) GPO
b) HMO
