Page 1 of 185
CRCR EXAM AND PRACTICE EXAM NEWEST 2025
TEST BANK| COMPLETE 650 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ GRADED A+|
CERTIFIED REVENUE CYCLE REPRESENTATIVE
EXAM PREP 2025 (MOST RECENT!!)
Any healthcare insurance plan that provides or ensures comprehensive
health maintenance and treatment services for an enrolled group of
persons on a monthly fee is known as a:
A. HMO
B. PPO
C. MSO
D. GPO - Correct Answer -A. HMO
Applying the contracted payment methodology to the total charges
yields:
A. An estimated price
B. An anticipated health plan payment
C. A price justified revenue accrual
D. A pricing agreement - Correct Answer -A. An estimated price
The concept encompasses all activities required to send a request for
payment to a third-party health plan for payment of benefits:
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,Page 2 of 185
A. Billing
B. Account resolution
C. Claims Processing
D. Third-party invoicing - Correct Answer -C. Claims processing
Appropriate training for the patient financial counselling staff must
cover all of the following EXCEPT:
A. Patient financial communications best practices specific to staff role
B. Financial assistance policies
C. Documenting the conversation in the medical record
D. Available patient financing options - Correct Answer -C.
The legal authority to request and analyze provider claim documentation
to ensure that services provided were reasonable and necessary is given
to:
A. Recovery Audit Contractors (RAC)
B. All health plans
C. The Office of the U.S. Inspector General (OIC)
D. State Insurance Commissioners - Correct Answer -A. Recovery Audit
Contractors (RAC)
The healthcare industry is vulnerable to compliance issues, in large part
due to the complexity of the statues and regulations pertaining to:
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,Page 3 of 185
A. Patient financial obligations for the entire cost of treatment
B. Unregulated market activity for third-party payers
C. Medicare and Medicaid payments
D. Commercial third-party payers - Correct Answer -C. Medicare and
Medicaid payments
Health Information Management (HIM) is responsible for:
A. All patient medical records
B. The maintenance of all software applications
C. The maintenance of the entire technology infrastructure
D. Clean claims being filed - Correct Answer -A. All patient medical
records
A four digit number code established by the National Uniform Billing
(NUBC) that categorizes/classifies 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
HIPAA has adopted Employer Identification Numbers (EINs) to be used
in standard transactions to identify the employer of an individual
described transaction. EINs are created and assigned by:
pg. 3
, Page 4 of 185
A. The Social Security Administration
B. The United States Department of the Treasury
C. The United States Department of Labor
D. The Internal Revenue Service - Correct Answer -D. The Internal
Revenue Service
ICD-10-CM and ICD-10-PCD code sets are modifications of:
A. The international ICD-10 codes as developed by the WHO (World
Health Organization)
B. ICD 9 codes
C. CPT codes
D. DRGs - Correct Answer -B. ICD 9 codes
The impact of denials on the revenue cycle includes all of the following
EXCEPT:
A. Loss of revenue
B. Increased collection fees
C. Staff productivity
D. Quality reputation - Correct Answer -D. Quality reputation
Any provider that has filed a timely cost report may appeal an adverse
final decision received from the Medicare Administrative Contractor
(MAC). This appeal may be filed with:
pg. 4
CRCR EXAM AND PRACTICE EXAM NEWEST 2025
TEST BANK| COMPLETE 650 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ GRADED A+|
CERTIFIED REVENUE CYCLE REPRESENTATIVE
EXAM PREP 2025 (MOST RECENT!!)
Any healthcare insurance plan that provides or ensures comprehensive
health maintenance and treatment services for an enrolled group of
persons on a monthly fee is known as a:
A. HMO
B. PPO
C. MSO
D. GPO - Correct Answer -A. HMO
Applying the contracted payment methodology to the total charges
yields:
A. An estimated price
B. An anticipated health plan payment
C. A price justified revenue accrual
D. A pricing agreement - Correct Answer -A. An estimated price
The concept encompasses all activities required to send a request for
payment to a third-party health plan for payment of benefits:
pg. 1
,Page 2 of 185
A. Billing
B. Account resolution
C. Claims Processing
D. Third-party invoicing - Correct Answer -C. Claims processing
Appropriate training for the patient financial counselling staff must
cover all of the following EXCEPT:
A. Patient financial communications best practices specific to staff role
B. Financial assistance policies
C. Documenting the conversation in the medical record
D. Available patient financing options - Correct Answer -C.
The legal authority to request and analyze provider claim documentation
to ensure that services provided were reasonable and necessary is given
to:
A. Recovery Audit Contractors (RAC)
B. All health plans
C. The Office of the U.S. Inspector General (OIC)
D. State Insurance Commissioners - Correct Answer -A. Recovery Audit
Contractors (RAC)
The healthcare industry is vulnerable to compliance issues, in large part
due to the complexity of the statues and regulations pertaining to:
pg. 2
,Page 3 of 185
A. Patient financial obligations for the entire cost of treatment
B. Unregulated market activity for third-party payers
C. Medicare and Medicaid payments
D. Commercial third-party payers - Correct Answer -C. Medicare and
Medicaid payments
Health Information Management (HIM) is responsible for:
A. All patient medical records
B. The maintenance of all software applications
C. The maintenance of the entire technology infrastructure
D. Clean claims being filed - Correct Answer -A. All patient medical
records
A four digit number code established by the National Uniform Billing
(NUBC) that categorizes/classifies 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
HIPAA has adopted Employer Identification Numbers (EINs) to be used
in standard transactions to identify the employer of an individual
described transaction. EINs are created and assigned by:
pg. 3
, Page 4 of 185
A. The Social Security Administration
B. The United States Department of the Treasury
C. The United States Department of Labor
D. The Internal Revenue Service - Correct Answer -D. The Internal
Revenue Service
ICD-10-CM and ICD-10-PCD code sets are modifications of:
A. The international ICD-10 codes as developed by the WHO (World
Health Organization)
B. ICD 9 codes
C. CPT codes
D. DRGs - Correct Answer -B. ICD 9 codes
The impact of denials on the revenue cycle includes all of the following
EXCEPT:
A. Loss of revenue
B. Increased collection fees
C. Staff productivity
D. Quality reputation - Correct Answer -D. Quality reputation
Any provider that has filed a timely cost report may appeal an adverse
final decision received from the Medicare Administrative Contractor
(MAC). This appeal may be filed with:
pg. 4
