HFMA CERTIFIED REVENUE CYCLE
REPRESENTATIVE COMPREHENSIVE EXAM
2026 FULL QUESTIONS AND VERIFIED
ANSWERS GRADED A+
⩥ Because case managers document the clinical reasons for treatment,
they are Answer: A good resource when developing written appeals and
denials.
⩥ All of the following information describe claim edits EXCEPT
Answer: The claim editing process slowed down the receipt of
payments, increases account receivable outstanding, and decreases cash
flow.
⩥ What types of services are classified as non-acute? Answer: Hospice
Care, Clinic Services & Skilled Nursing
⩥ The unscheduled "direct" admission represents a patient who: Answer:
Is admitted from a physician's office on an urgent basis.
⩥ The process of creating the pre-registration record ensures Answer:
That access staff will have complete and valid information needed to
finalize any remaining pre-access activities.
, ⩥ An advantage of a pre-registration program is Answer: The
opportunity to reduce processing times at the time of service.
⩥ Claim edits are Answer: Rules developed to verify the accuracy of
claims based on each health plan's policies.
⩥ Examples of ethic violations that impact the revenue cycle include all
of the following EXCEPT Answer: Seeking payment options for patient
self-pay
⩥ EMTALA and HFMA best practices specify that, in an Emergency
Department setting Answer: No patient financial discussions should
occur before a patient is screened and stabilized.
⩥ Which of the following is usually covered on a Conditions of
Admission form Answer: Release of information
⩥ The nuanced data resulting from detailed ICD-10 coding allows senior
leadership to work with physicians to do all of the following EXCEPT
Answer: Obtain higher compensation for physicians
⩥ Selecting the wrong insurance plan code can lead to the following
problems or denials, except Answer: Estimating the wrong
reimbursement
REPRESENTATIVE COMPREHENSIVE EXAM
2026 FULL QUESTIONS AND VERIFIED
ANSWERS GRADED A+
⩥ Because case managers document the clinical reasons for treatment,
they are Answer: A good resource when developing written appeals and
denials.
⩥ All of the following information describe claim edits EXCEPT
Answer: The claim editing process slowed down the receipt of
payments, increases account receivable outstanding, and decreases cash
flow.
⩥ What types of services are classified as non-acute? Answer: Hospice
Care, Clinic Services & Skilled Nursing
⩥ The unscheduled "direct" admission represents a patient who: Answer:
Is admitted from a physician's office on an urgent basis.
⩥ The process of creating the pre-registration record ensures Answer:
That access staff will have complete and valid information needed to
finalize any remaining pre-access activities.
, ⩥ An advantage of a pre-registration program is Answer: The
opportunity to reduce processing times at the time of service.
⩥ Claim edits are Answer: Rules developed to verify the accuracy of
claims based on each health plan's policies.
⩥ Examples of ethic violations that impact the revenue cycle include all
of the following EXCEPT Answer: Seeking payment options for patient
self-pay
⩥ EMTALA and HFMA best practices specify that, in an Emergency
Department setting Answer: No patient financial discussions should
occur before a patient is screened and stabilized.
⩥ Which of the following is usually covered on a Conditions of
Admission form Answer: Release of information
⩥ The nuanced data resulting from detailed ICD-10 coding allows senior
leadership to work with physicians to do all of the following EXCEPT
Answer: Obtain higher compensation for physicians
⩥ Selecting the wrong insurance plan code can lead to the following
problems or denials, except Answer: Estimating the wrong
reimbursement
