CERTIFIED REVENUE CYCLE REPRESENTATIVE
EXAMINATION TEST 2026 FULL QUESTIONS
AND CORRECT SOLUTIONS
◉ Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct Answer: A
◉ A portion of the accounts receivable inventory which has NOT
qualified for billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency Answer: A
◉ Local Coverage Determinations (LCD) and National Coverage
Determinations (NCD) are
,Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred to
Medicaid Answer: C
◉ Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date Answer: C
◉ Patients are contacting hospitals to proactively inquire about
costs and fees prior to
agreeing to service. The problem for hospitals in providing such
information is:
a) That hospitals don't want to establish a price without knowing if
the patient has insurance and how much reimbursement can be
,expected
b) The fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information Answer: B
◉ Across all care settings, if a patient consents to a financial
discussion during a medical
encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer questions and
assist in obtaining required patient financial data
b) Have a patient financial responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt patient
care and patient flow Answer: C
◉ A comprehensive "Compliance Program" is defined as
, a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of
regulations imposed by a government agency are being met
d) The development of operational policies that correspond to
regulations Answer: C
◉ Case Management requires that a case manager be assigned
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual agreement
Answer: B
◉ 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
EXAMINATION TEST 2026 FULL QUESTIONS
AND CORRECT SOLUTIONS
◉ Business ethics, or organizational ethics represent:
a) The principles and standards by which organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct Answer: A
◉ A portion of the accounts receivable inventory which has NOT
qualified for billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency Answer: A
◉ Local Coverage Determinations (LCD) and National Coverage
Determinations (NCD) are
,Medicare established guideline(s) used to determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are reimbursable
d) What Medicare reimburses and what should be referred to
Medicaid Answer: C
◉ Days in A/R is calculated based on the value of:
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date Answer: C
◉ Patients are contacting hospitals to proactively inquire about
costs and fees prior to
agreeing to service. The problem for hospitals in providing such
information is:
a) That hospitals don't want to establish a price without knowing if
the patient has insurance and how much reimbursement can be
,expected
b) The fact that charge master lists the total charge, not net charges
that reflect charges after a payer's contractual adjustment
c) That hospitals don't want to be put in the position of
"guaranteeing" price without having room for additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary information Answer: B
◉ Across all care settings, if a patient consents to a financial
discussion during a medical
encounter to expedite discharge, the HFMA best practice is to:
a) Make sure that the attending staff can answer questions and
assist in obtaining required patient financial data
b) Have a patient financial responsibilities kit ready for the patient,
containing all of the required registration forms and instructions
c) Support that choice, providing that the discussion does not
interfere with patient care or disrupt patient flow
d) Decline such request as finance discussions can disrupt patient
care and patient flow Answer: C
◉ A comprehensive "Compliance Program" is defined as
, a) Annual legal audit and review for adherence to regulations
b) Educating staff on regulations
c) Systematic procedures to ensure that the provisions of
regulations imposed by a government agency are being met
d) The development of operational policies that correspond to
regulations Answer: C
◉ Case Management requires that a case manager be assigned
a) To patients of any physician requesting case management
b) To a select patient group
c) To every patient
d) To specific cases designated by third party contractual agreement
Answer: B
◉ 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
