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Exam (elaborations)

HFMA CRCR EXAM WITH CORRECT ANSWERS 2025

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HFMA CRCR EXAM WITH CORRECT ANSWERS 2025

Institution
HFMA CRCR 2025
Course
HFMA CRCR 2025

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HFMA CRCR EXAM WITH
CORRECT ANSWERS
2025



Whatvarevcollectionvagencyvfeesvbasedvon?v-vvcorrectvanswersvAvpercentagevofvdollarsvcollected



Self-
fundedvbenefitvplansvmayvchoosevtovcoordinatevbenefitsvusingvthevgendervrulevorvwhatvothervrule
?v-vvcorrectvanswersvBirthday



Invwhatvtypevofvpaymentvmethodologyvisvavlumpvsumvorvbundledvpaymentvnegotiatedvbetweenvth
evpayervandvsomevorvallvproviders?v-vvcorrectvanswersvCasevrates



Whatvcustomervservicevimprovementsvmightvimprovevthevpatientvaccountsvdepartment?v-
vvcorrectvanswersvHoldingvstaffvaccountablevforvcustomervservicevduringvperformancevreviews

,WhatvisvanvABNv(AdvancevBeneficiaryvNoticevofvNon-coverage)vrequiredvtovdo?v-
vvcorrectvanswersvInformvavMedicarevbeneficiaryvthatvMedicarevmayvnotvpayvforvthevordervorvservic


e



Whatvtypevofvaccountvadjustmentvresultsvfromvthevpatient'svunwillingnessvtovpayvforvavself-
payvbalance?v-vvcorrectvanswersvBadvdebtvadjustment



Whatvisvthevinitialvhospicevbenefit?v-vvcorrectvanswersvTwov90-
dayvperiodsvandvanvunlimitedvnumbervofvsubsequentvperiods



WhenvdoesvavhospitalvaddvambulancevchargesvtovthevMedicarevinpatientvclaim?v-
vvcorrectvanswersvIfvthevpatientvrequiresvambulancevtransportation vtovavskilledvnursingvfacility




Howvshouldvavprovidervresolvevavlate-chargevcreditvpostedvaftervanvaccountvisvbilled?v-
vvcorrectvanswersvPostvavlate-chargevadjustmentvtovthevaccount




anvincreasevinvthevdollarsvagedvgreatervthanv90vdaysvfromvdatevofvservicevindicatevwhatvaboutvacco
untsv-vvcorrectvanswersvTheyvarevnotvbeingvprocessedvinvavtimelyvmanner



Whatvisvanvadvantagevofvavpreregistrationvprogram?v-
vvcorrectvanswersvItvreducesvprocessingvtimesvatvthevtimevofvservice




Whatvarevthevtwovstatutoryvexclusionsvfromvhospicevcoverage?v-
vvcorrectvanswersvMedicallyvunnecessaryvservicesvandvcustodialvcare




Whatvcorevfinancialvactivitiesvarevresolvedvwithinvpatientvaccess?v-
vvcorrectvanswersvScheduling,vinsurancevverification,vdischargevprocessing,vandvpaymentvofvpoint-


of-servicevreceipts

,Whatvstatementvappliesvtovthevscheduledvoutpatient?v-
vvcorrectvanswersvThevservicesvdovnotvinvolvevanvovernightvstay




Howvisvavmis-postedvcontractualvallowancevresolved?v-
vvcorrectvanswersvComparingvthevcontractvreimbursementvratesvwithvthevcontractvonvthevadmittan


cevadvicevtovidentifyvthevcorrectvamount



Whatvtypevofvpatientvstatusvisvusedvtovevaluatevthevpatient'svneedvforvinpatientvcare?v-
vvcorrectvanswersvObservation




CoveragevrulesvforvMedicarevbeneficiariesvreceivingvskilledvnursingvcarevrequirevthatvthevbeneficia
ryvhasvreceivedvwhat?v-
vvcorrectvanswersvMedicallyvnecessaryvinpatientvhospitalvservicesvforvatvleastv3vconsecutivevdaysvb


eforevthevskilledvnursingvcarevadmission



Whenvisvthevwordv"SAME"venteredvonvthevCMSv1500vbillingvformvinvFieldv0$?v-
vvcorrectvanswersvWhenvthevpatientvisvthevinsured




Whatvarevnon-
emergencyvpatientsvwhovcomevforvservicevwithoutvpriorvnotificationvtovthevprovidervcalled?v-
vvcorrectvanswersvUnscheduledvpatients




Ifvthevinsurancevverificationvresponsevreportsvthatvavsubscribervhasvavsinglevpolicy,vwhatvisvthevstat
usvofvthevsubscriber'svspouse?v-vvcorrectvanswersvNeithervenrolledvnotventitledvtovbenefits



RegulationvZvofvthevConsumervCreditvProtectionvAct,valsovknownvasvthevTruthvinvLendingvAct,vestab
lishesvwhat?v-vvcorrectvanswersvDisclosurevrulesvforvconsumervcreditvsalesvandvconsumervloans



Whatvisvavprincipalvdiagnosis?v-vvcorrectvanswersvPrimaryvreasonvforvthevpatient'svadmission

, Collectingvpatientvliabilityvdollarsvaftervservicevleadsvtovwhat?v-
vvcorrectvanswersvLowervaccountsvreceivablevlevels




Whatvisvthevdailyvout-of-pocketvamountvforveachvlifetimevreservevdayvused?v-
vvcorrectvanswersv50%vofvthevcurrentvdeductiblevamount




WhatvservicevprovidedvtovavMedicarevbeneficiaryvinvavruralvhealthvclinicv(RHC)visvnotvbillablevasvanv
RHCvservices?v-vvcorrectvanswersvInpatientvcare



Whatvcodevindicatesvthevdispositionvofvthevpatientvatvthevconclusionvofvservice?v-
vvcorrectvanswersvPatientvdischargevstatusvcode




WhatvarevhospitalsvrequiredvtovdovforvMedicarevcreditvbalancevaccounts?v-
vvcorrectvanswersvTheyvresultvinvlostvreimbursementvandvadditionalvcostvtovcollect




Whenvanvunduevdelayvofvpaymentvresultsvfromvavdisputevbetweenvthevpatientvandvthevthirdvpartyv
payer,vwhovisvresponsiblevforvpayment?v-vvcorrectvanswersvPatient



MedicarevguidelinesvrequirevthatvwhenvavtestvisvorderedvforvavLCDvorvNCDvexists,vthevinformationvp
rovidedvonvthevordervmustvinclude:v-vvcorrectvanswersvAvvalidvCPTvorvHCPCSvcode



Withvadvancesvinvinternetvsecurityvandvencryption,vrevenue-
cyclevprocessesvarevexpandingvtovallowvpatientsvtovdovwhat?v-
vvcorrectvanswersvAccessvtheirvinformationvandvperformvfunctionsvon-line




WhatvdatevisvrequiredvonvallvCMSv1500vclaimvforms?v-
vvcorrectvanswersvonsetvdatevofvcurrentvillness

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Institution
HFMA CRCR 2025
Course
HFMA CRCR 2025

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Uploaded on
October 9, 2025
Number of pages
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