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HFMA CRCR 2025/2026 EXAM LATEST EXAM 540 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS GRADED A+)
Ambulance services are billed directly to the health plan for a) All pre-admission
emergency transports b) Transport deemed medically necessary by the attending
paramedic-ambulance crew c) Services provided before a patient is admitted and for
ambulance rides arranged to pick up the patient from the hospital after discharge to take
him/her home or to another facility d) The portion of the bill outside of the patient's self-pay
- ......ANSWER........C
An advantage of a pre-registration program is
a) The opportunity to reduce processing times at the time-of-service b) The ability to
eliminate no-show appointments c) The opportunity to reduce the corporate compliance
failures within the registration process d) The marketing value of such a program
- ......ANSWER........C
An increase in the dollars aged greater than 90 days from date of service indicate what
about accounts - ......ANSWER........They are not being processed in a timely manner
An increase in the dollars aged greater than 90 days from date of service indicate what
about accounts - ......ANSWER........They are not being processed in a timely manner
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is known as
a) A beneficiary appeal b) A Medicare supplemental review c) A payment review d) A
Medicare determination appeal - ......ANSWER........A
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is known as
a) A Medicare determination appeal b) A payment review c) A Medicare supplemental
review d) A beneficiary appeal - ......ANSWER........D
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An originating site is a) The location where the pts bill is generated b) The location of the pt
at the time the service is provided c) The site that generates reimbursement of a claim d)
The location of the medical treatment provider - ......ANSWER........B
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons based on; a monthly
fee is known as a a) HMO b) PPO c) MSO d) GPO - ......ANSWER........A
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and 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 - ......ANSWER........B
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
a) A court appointed federal mediator b) The Department of Health and Human Services
Provider Relations Division c) The Office of the Inspector General d) The Provider
Reimbursement Review Board - ......ANSWER........D
Appropriate training for patient financial counseling staff must cover all the following
EXCEPT: a) Patient financial communications best practices specific to staff role b)
Financial assistance policies c) Documenting the conversation in the medical records d)
Available patient financing options - ......ANSWER........C
At the end of each shift, what must happen to cash, checks, and credit card transaction
documents? - ......ANSWER........They must be balanced
At the end of each shift, what must happen to cash, checks, and credit card transaction
documents? - ......ANSWER........They must be balanced
Because 501(r) regulations focus on identifying potential eligible financial assistants
patients hospitals must: a) Capture their experience with such patients to properly budget
b) Hold financial conversations with patients as soon as possible c) Build the necessary
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processes to handle the potentially lengthy payment schedule d) Expedite payment
processing of normal accounts receivable to protect cash flow - ......ANSWER........B
Before classifying and subsequently writing off an account to financial assistance or bad
debt, the hospital must establish policy, define appropriate criteria, implement
procedures for identifying and processing accounts: a) Monitor compliance b) Have the
account triaged for any partial payment possibilities c) Assist in arranging for a commercial
bank loan d) Obtain the patients income tax statements from the prior 2 years
- ......ANSWER........A
Business ethics, or organizational ethics represent:
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 - ......ANSWER........A
Care purchaser - ......ANSWER........Individual or entity that contributes to the purchase of
healthcare services
Care purchaser - ......ANSWER........Individual or entity that contributes to the purchase of
healthcare services
Case management - ......ANSWER........The process whereby all health-related
components of a case are managed by a designated health professional. Intended to
ensure continuity of healthcare accessibility and services
Case management - ......ANSWER........The process whereby all health-related
components of a case are managed by a designated health professional. Intended to
ensure continuity of healthcare accessibility and services
Case management and discharge planning services are a post-service activty
- ......ANSWER........True **False
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Case Management requires that a case manager be assigned
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
- ......ANSWER........B
Case managers are involved from admission with the discharge planning process. The
purpose of discharge planning is: - ......ANSWER........To estimate how long the patient will
be in the hospital, identify the expected outcome of the hospitalization and initiate any
special requirements for services at or after the time of discharge.
Chapter 13 Bankruptcy, debtor rehabilitation is a court proceeding a) That reorganizes a
debtor's holdings and instructs creditors to look to the debtors' future earnings for
payment b) That establishes a payment priority order to creditors' c) That creates a clear
court-supervised payment accountability plan going forward d) That classifies the debtor
as eligible for government financial assistance for housing medical treatment and food as
debts are paid - ......ANSWER........A
Chapter 13 Bankruptcy, debtor rehabilitation, is a court proceeding a) That establishes a
payment priority order to creditors' claims b) That classifies the debtor as eligible for
government financial assistance for housing, medical treatment and food as debts are
paid c) That creates a clear court-supervised payment accountability plan going forward d)
That reorganizes a debtor's holdings and instructs creditors to look to the debtor's future
earnings for payment - ......ANSWER........D
Charge - ......ANSWER........The dollar amount a provider sets for services rendered before
negotiating any discounts. The charge can be different from the amount paid
Charge - ......ANSWER........The dollar amount a provider sets for services rendered before
negotiating any discounts. The charge can be different from the amount paid
HFMA CRCR 2025/2026 EXAM LATEST EXAM 540 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS GRADED A+)
Ambulance services are billed directly to the health plan for a) All pre-admission
emergency transports b) Transport deemed medically necessary by the attending
paramedic-ambulance crew c) Services provided before a patient is admitted and for
ambulance rides arranged to pick up the patient from the hospital after discharge to take
him/her home or to another facility d) The portion of the bill outside of the patient's self-pay
- ......ANSWER........C
An advantage of a pre-registration program is
a) The opportunity to reduce processing times at the time-of-service b) The ability to
eliminate no-show appointments c) The opportunity to reduce the corporate compliance
failures within the registration process d) The marketing value of such a program
- ......ANSWER........C
An increase in the dollars aged greater than 90 days from date of service indicate what
about accounts - ......ANSWER........They are not being processed in a timely manner
An increase in the dollars aged greater than 90 days from date of service indicate what
about accounts - ......ANSWER........They are not being processed in a timely manner
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is known as
a) A beneficiary appeal b) A Medicare supplemental review c) A payment review d) A
Medicare determination appeal - ......ANSWER........A
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is known as
a) A Medicare determination appeal b) A payment review c) A Medicare supplemental
review d) A beneficiary appeal - ......ANSWER........D
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An originating site is a) The location where the pts bill is generated b) The location of the pt
at the time the service is provided c) The site that generates reimbursement of a claim d)
The location of the medical treatment provider - ......ANSWER........B
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons based on; a monthly
fee is known as a a) HMO b) PPO c) MSO d) GPO - ......ANSWER........A
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and 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 - ......ANSWER........B
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
a) A court appointed federal mediator b) The Department of Health and Human Services
Provider Relations Division c) The Office of the Inspector General d) The Provider
Reimbursement Review Board - ......ANSWER........D
Appropriate training for patient financial counseling staff must cover all the following
EXCEPT: a) Patient financial communications best practices specific to staff role b)
Financial assistance policies c) Documenting the conversation in the medical records d)
Available patient financing options - ......ANSWER........C
At the end of each shift, what must happen to cash, checks, and credit card transaction
documents? - ......ANSWER........They must be balanced
At the end of each shift, what must happen to cash, checks, and credit card transaction
documents? - ......ANSWER........They must be balanced
Because 501(r) regulations focus on identifying potential eligible financial assistants
patients hospitals must: a) Capture their experience with such patients to properly budget
b) Hold financial conversations with patients as soon as possible c) Build the necessary
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processes to handle the potentially lengthy payment schedule d) Expedite payment
processing of normal accounts receivable to protect cash flow - ......ANSWER........B
Before classifying and subsequently writing off an account to financial assistance or bad
debt, the hospital must establish policy, define appropriate criteria, implement
procedures for identifying and processing accounts: a) Monitor compliance b) Have the
account triaged for any partial payment possibilities c) Assist in arranging for a commercial
bank loan d) Obtain the patients income tax statements from the prior 2 years
- ......ANSWER........A
Business ethics, or organizational ethics represent:
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 - ......ANSWER........A
Care purchaser - ......ANSWER........Individual or entity that contributes to the purchase of
healthcare services
Care purchaser - ......ANSWER........Individual or entity that contributes to the purchase of
healthcare services
Case management - ......ANSWER........The process whereby all health-related
components of a case are managed by a designated health professional. Intended to
ensure continuity of healthcare accessibility and services
Case management - ......ANSWER........The process whereby all health-related
components of a case are managed by a designated health professional. Intended to
ensure continuity of healthcare accessibility and services
Case management and discharge planning services are a post-service activty
- ......ANSWER........True **False
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Case Management requires that a case manager be assigned
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
- ......ANSWER........B
Case managers are involved from admission with the discharge planning process. The
purpose of discharge planning is: - ......ANSWER........To estimate how long the patient will
be in the hospital, identify the expected outcome of the hospitalization and initiate any
special requirements for services at or after the time of discharge.
Chapter 13 Bankruptcy, debtor rehabilitation is a court proceeding a) That reorganizes a
debtor's holdings and instructs creditors to look to the debtors' future earnings for
payment b) That establishes a payment priority order to creditors' c) That creates a clear
court-supervised payment accountability plan going forward d) That classifies the debtor
as eligible for government financial assistance for housing medical treatment and food as
debts are paid - ......ANSWER........A
Chapter 13 Bankruptcy, debtor rehabilitation, is a court proceeding a) That establishes a
payment priority order to creditors' claims b) That classifies the debtor as eligible for
government financial assistance for housing, medical treatment and food as debts are
paid c) That creates a clear court-supervised payment accountability plan going forward d)
That reorganizes a debtor's holdings and instructs creditors to look to the debtor's future
earnings for payment - ......ANSWER........D
Charge - ......ANSWER........The dollar amount a provider sets for services rendered before
negotiating any discounts. The charge can be different from the amount paid
Charge - ......ANSWER........The dollar amount a provider sets for services rendered before
negotiating any discounts. The charge can be different from the amount paid
