HFMA CRCR EXAM COMPLETE SOLUTION
STUDY PAPER WITH TESTED QUESTIONS
AND ANSWERS 2026
⩥ What is the purpose OIG work plant?. Answer: Identify Acceptable
compliance programs in various provider setting
⩥ If a Medicare patient is admitted on Friday, what services fall within
the three-day DRG window rule?. Answer: Non-diagnostic service
provided on Tuesday through Friday
⩥ What does a modifier allow a provider to do?. Answer: Report a
specific circumstance that affected a procedure or service without
changing the code or its definition
⩥ IF outpatient diagnostic services are provided within three days of the
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective
Payment System) hospital, what must happen to these charges. Answer:
They must be billed separately to the part B Carrier
⩥ what is a recurring or series registration?. Answer: One registration
record is created for multiple days of service
,⩥ What are nonemergency patients who come for service without prior
notification to the provider called?. Answer: Unscheduled patients
⩥ Which of the following statement apply to the observation patient
type?. Answer: It is used to evaluate the need for an inpatient admission
⩥ which services are hospice programs required to provide around the
clock patient. Answer: Physician, Nursing, Pharmacy
⩥ Scheduler instructions are used to prompt the scheduler to do what?.
Answer: Complete the scheduling process correctly based on service
requeste
⩥ The Time needed to prepare the patient before service is the difference
between the patients arrival time and which of the following?. Answer:
Procedure time
⩥ Medicare guidelines require that when a test is ordered for a LCD or
NCD exists, the information provided on the order must include:.
Answer: Documentation of the medical necessity for the test
⩥ What is the advantage of a pre-registration program. Answer: It
reduces processing times at the time of service
, ⩥ What date are required to establish a new MPI(Master patient Index)
entry. Answer: The responsible party's full legal name, date of birth, and
social security number
⩥ Which of the following statements is true about third-party
payments?. Answer: The payments are received by the provider from the
payer responsible for reimbursing the provider for the patient's covered
services.
⩥ Which provision protects the patient from medical expenses that
exceed the pre-set level. Answer: stop loss
⩥ what documentation must a primary care physician send to HMO
patient to authorize a visit to a specialist for additional testing or care?.
Answer: Referral
⩥ Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance
information if it would delay what?. Answer: Medical screening and
stabilizing treatment
⩥ Which of the following is a step in the discharge process?. Answer:
Have a case management service complete the discharge plan
STUDY PAPER WITH TESTED QUESTIONS
AND ANSWERS 2026
⩥ What is the purpose OIG work plant?. Answer: Identify Acceptable
compliance programs in various provider setting
⩥ If a Medicare patient is admitted on Friday, what services fall within
the three-day DRG window rule?. Answer: Non-diagnostic service
provided on Tuesday through Friday
⩥ What does a modifier allow a provider to do?. Answer: Report a
specific circumstance that affected a procedure or service without
changing the code or its definition
⩥ IF outpatient diagnostic services are provided within three days of the
admission of a Medicare beneficiary to an IPPS (Inpatient Prospective
Payment System) hospital, what must happen to these charges. Answer:
They must be billed separately to the part B Carrier
⩥ what is a recurring or series registration?. Answer: One registration
record is created for multiple days of service
,⩥ What are nonemergency patients who come for service without prior
notification to the provider called?. Answer: Unscheduled patients
⩥ Which of the following statement apply to the observation patient
type?. Answer: It is used to evaluate the need for an inpatient admission
⩥ which services are hospice programs required to provide around the
clock patient. Answer: Physician, Nursing, Pharmacy
⩥ Scheduler instructions are used to prompt the scheduler to do what?.
Answer: Complete the scheduling process correctly based on service
requeste
⩥ The Time needed to prepare the patient before service is the difference
between the patients arrival time and which of the following?. Answer:
Procedure time
⩥ Medicare guidelines require that when a test is ordered for a LCD or
NCD exists, the information provided on the order must include:.
Answer: Documentation of the medical necessity for the test
⩥ What is the advantage of a pre-registration program. Answer: It
reduces processing times at the time of service
, ⩥ What date are required to establish a new MPI(Master patient Index)
entry. Answer: The responsible party's full legal name, date of birth, and
social security number
⩥ Which of the following statements is true about third-party
payments?. Answer: The payments are received by the provider from the
payer responsible for reimbursing the provider for the patient's covered
services.
⩥ Which provision protects the patient from medical expenses that
exceed the pre-set level. Answer: stop loss
⩥ what documentation must a primary care physician send to HMO
patient to authorize a visit to a specialist for additional testing or care?.
Answer: Referral
⩥ Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance
information if it would delay what?. Answer: Medical screening and
stabilizing treatment
⩥ Which of the following is a step in the discharge process?. Answer:
Have a case management service complete the discharge plan
