CRCR EXAM PREP | NEW 2025/2026 UPDATE |
QUESTIONS AND ANSWERS | WITH COMPLETE
SOLUTION|!!
What are collection agency fees based on? Answer - A percentage of dollars
collected
Self-funded benefit plans may choose to coordinate benefits using the gender
rule or what other rule? Answer - Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? Answer - Case rates
What customer service improvements might improve the patient accounts
department? Answer - Holding staff accountable for customer service during
performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
Answer - Inform a Medicare beneficiary that Medicare may not pay for the
order or service
What type of account adjustment results from the patient's unwillingness to
pay for a self-pay balance? Answer - Bad debt adjustment
What is the initial hospice benefit? Answer - Two 90-day periods and an
unlimited number of subsequent periods
,When does a hospital add ambulance charges to the Medicare inpatient claim?
Answer - If the patient requires ambulance transportation to a skilled nursing
facility
How should a provider resolve a late-charge credit posted after an account is
billed? Answer - Post a late-charge adjustment to the account
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
What is an advantage of a preregistration program? Answer - It reduces
processing times at the time of service
What are the two statutory exclusions from hospice coverage? Answer -
Medically unnecessary services and custodial care
What core financial activities are resolved within patient access? Answer -
Scheduling, insurance verification, discharge processing, and payment of point-
of-service receipts
What statement applies to the scheduled outpatient? Answer - The services do
not involve an overnight stay
How is a mis-posted contractual allowance resolved? Answer - Comparing the
contract reimbursement rates with the contract on the admittance advice to
identify the correct amount
, What type of patient status is used to evaluate the patient's need for inpatient
care? Answer - Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require
that the beneficiary has received what? Answer - Medically necessary
inpatient hospital services for at least 3 consecutive days before the skilled
nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
Answer - When the patient is the insured
What are non-emergency patients who come for service without prior
notification to the provider called? Answer - Unscheduled patients
If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? Answer - Neither enrolled
not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what? Answer - Disclosure rules for consumer credit
sales and consumer loans
What is a principal diagnosis? Answer - Primary reason for the patient's
admission
Collecting patient liability dollars after service leads to what? Answer - Lower
accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used?
Answer - 50% of the current deductible amount
QUESTIONS AND ANSWERS | WITH COMPLETE
SOLUTION|!!
What are collection agency fees based on? Answer - A percentage of dollars
collected
Self-funded benefit plans may choose to coordinate benefits using the gender
rule or what other rule? Answer - Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? Answer - Case rates
What customer service improvements might improve the patient accounts
department? Answer - Holding staff accountable for customer service during
performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
Answer - Inform a Medicare beneficiary that Medicare may not pay for the
order or service
What type of account adjustment results from the patient's unwillingness to
pay for a self-pay balance? Answer - Bad debt adjustment
What is the initial hospice benefit? Answer - Two 90-day periods and an
unlimited number of subsequent periods
,When does a hospital add ambulance charges to the Medicare inpatient claim?
Answer - If the patient requires ambulance transportation to a skilled nursing
facility
How should a provider resolve a late-charge credit posted after an account is
billed? Answer - Post a late-charge adjustment to the account
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
What is an advantage of a preregistration program? Answer - It reduces
processing times at the time of service
What are the two statutory exclusions from hospice coverage? Answer -
Medically unnecessary services and custodial care
What core financial activities are resolved within patient access? Answer -
Scheduling, insurance verification, discharge processing, and payment of point-
of-service receipts
What statement applies to the scheduled outpatient? Answer - The services do
not involve an overnight stay
How is a mis-posted contractual allowance resolved? Answer - Comparing the
contract reimbursement rates with the contract on the admittance advice to
identify the correct amount
, What type of patient status is used to evaluate the patient's need for inpatient
care? Answer - Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care require
that the beneficiary has received what? Answer - Medically necessary
inpatient hospital services for at least 3 consecutive days before the skilled
nursing care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
Answer - When the patient is the insured
What are non-emergency patients who come for service without prior
notification to the provider called? Answer - Unscheduled patients
If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? Answer - Neither enrolled
not entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth in
Lending Act, establishes what? Answer - Disclosure rules for consumer credit
sales and consumer loans
What is a principal diagnosis? Answer - Primary reason for the patient's
admission
Collecting patient liability dollars after service leads to what? Answer - Lower
accounts receivable levels
What is the daily out-of-pocket amount for each lifetime reserve day used?
Answer - 50% of the current deductible amount
