Certified Revenue Cycle Representative CRCR
EXAM STUDY GUIDE 2026 COMPLETE
QUESTIONS WITH CORRECT DETAILED
ANSWERS || 100% GUARANTEED PASS
<RECENT VERSION>
1. What are collection agency fees based on? - ANSWER ✔ A percentage of
dollars collected
2. Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? - ANSWER ✔ Birthday
3. 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
4. What customer service improvements might improve the patient accounts
department? - ANSWER ✔ Holding staff accountable for customer service
during performance reviews
5. 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
6. What type of account adjustment results from the patient's unwillingness to
pay for a self-pay balance? - ANSWER ✔ Bad debt adjustment
,7. What is the initial hospice benefit? - ANSWER ✔ Two 90-day periods and
an unlimited number of subsequent periods
8. When does a hospital add ambulance charges to the Medicare inpatient
claim? - ANSWER ✔ If the patient requires ambulance transportation to a
skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an account is
billed? - ANSWER ✔ Post a late-charge adjustment to the account
10.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
11.Pricing transparency is defined as readily available information on the price
of healthcare services, that together with other information, help define the
value of those services and enable consumers to - ANSWER ✔ Identify,
compare, and choose providers that offer the desired level of value.
12.Because case managers document the clinical reasons for treatment, they are
- ANSWER ✔ A good resource when developing written appeals and
denials.
13.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.
14.What types of services are classified as non-acute? - ANSWER ✔ Hospice
Care, Clinic Services & Skilled Nursing
,15.The unscheduled "direct" admission represents a patient who: - ANSWER ✔
Is admitted from a physician's office on an urgent basis.
16.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.
17.An advantage of a pre-registration program is - ANSWER ✔ The
opportunity to reduce processing times at the time of service.
18.Claim edits are - ANSWER ✔ Rules developed to verify the accuracy of
claims based on each health plan's policies.
19.Examples of ethic violations that impact the revenue cycle include all of the
following EXCEPT - ANSWER ✔ Seeking payment options for patient self-
pay
20.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.
21.Which of the following is usually covered on a Conditions of Admission
form - ANSWER ✔ Release of information
22.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
, 23.Selecting the wrong insurance plan code can lead to the following problems
or denials, except - ANSWER ✔ Estimating the wrong reimbursement
24.Eliminating mail time and reducing data entry time, electronically
monitoring the receipt of claims and online claim adjudication; more prompt
payment are all benefits achieved by - ANSWER ✔ The electronic
submission of claims using electronic transactions
25.Process observation is a part of what framework of Revenue Cycle? -
ANSWER ✔ Compliance
26.ICD-10-CM and ICD-10-PCS code sets are modifications of - ANSWER ✔
The international ICD-10 codes as developed by the WHO (World Health
Organization)
27.In the balance resolution process, providers should: - ANSWER ✔ Ask the
patient if he or she would like to receive information about payment options
and supportive financial assistance programs
28.A claim is denied for the following reasons, EXCEPT - ANSWER ✔ The
submitted claim does not have the physicians signature
29.What is a component of HFMA's "Healthcare Dollars & Sense" initiative? -
ANSWER ✔ Medical Account Resolution
30.Charges, as the most appropriate measurement of utilization enables -
ANSWER ✔ Accuracy of expense and cost capture in the revenue cycle
EXAM STUDY GUIDE 2026 COMPLETE
QUESTIONS WITH CORRECT DETAILED
ANSWERS || 100% GUARANTEED PASS
<RECENT VERSION>
1. What are collection agency fees based on? - ANSWER ✔ A percentage of
dollars collected
2. Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? - ANSWER ✔ Birthday
3. 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
4. What customer service improvements might improve the patient accounts
department? - ANSWER ✔ Holding staff accountable for customer service
during performance reviews
5. 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
6. What type of account adjustment results from the patient's unwillingness to
pay for a self-pay balance? - ANSWER ✔ Bad debt adjustment
,7. What is the initial hospice benefit? - ANSWER ✔ Two 90-day periods and
an unlimited number of subsequent periods
8. When does a hospital add ambulance charges to the Medicare inpatient
claim? - ANSWER ✔ If the patient requires ambulance transportation to a
skilled nursing facility
9. How should a provider resolve a late-charge credit posted after an account is
billed? - ANSWER ✔ Post a late-charge adjustment to the account
10.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
11.Pricing transparency is defined as readily available information on the price
of healthcare services, that together with other information, help define the
value of those services and enable consumers to - ANSWER ✔ Identify,
compare, and choose providers that offer the desired level of value.
12.Because case managers document the clinical reasons for treatment, they are
- ANSWER ✔ A good resource when developing written appeals and
denials.
13.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.
14.What types of services are classified as non-acute? - ANSWER ✔ Hospice
Care, Clinic Services & Skilled Nursing
,15.The unscheduled "direct" admission represents a patient who: - ANSWER ✔
Is admitted from a physician's office on an urgent basis.
16.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.
17.An advantage of a pre-registration program is - ANSWER ✔ The
opportunity to reduce processing times at the time of service.
18.Claim edits are - ANSWER ✔ Rules developed to verify the accuracy of
claims based on each health plan's policies.
19.Examples of ethic violations that impact the revenue cycle include all of the
following EXCEPT - ANSWER ✔ Seeking payment options for patient self-
pay
20.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.
21.Which of the following is usually covered on a Conditions of Admission
form - ANSWER ✔ Release of information
22.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
, 23.Selecting the wrong insurance plan code can lead to the following problems
or denials, except - ANSWER ✔ Estimating the wrong reimbursement
24.Eliminating mail time and reducing data entry time, electronically
monitoring the receipt of claims and online claim adjudication; more prompt
payment are all benefits achieved by - ANSWER ✔ The electronic
submission of claims using electronic transactions
25.Process observation is a part of what framework of Revenue Cycle? -
ANSWER ✔ Compliance
26.ICD-10-CM and ICD-10-PCS code sets are modifications of - ANSWER ✔
The international ICD-10 codes as developed by the WHO (World Health
Organization)
27.In the balance resolution process, providers should: - ANSWER ✔ Ask the
patient if he or she would like to receive information about payment options
and supportive financial assistance programs
28.A claim is denied for the following reasons, EXCEPT - ANSWER ✔ The
submitted claim does not have the physicians signature
29.What is a component of HFMA's "Healthcare Dollars & Sense" initiative? -
ANSWER ✔ Medical Account Resolution
30.Charges, as the most appropriate measurement of utilization enables -
ANSWER ✔ Accuracy of expense and cost capture in the revenue cycle
