HFMA CRCR EXAM LATEST EXAM PREPARATION
WITH 170+ QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) 2025/2026
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
In addition to being supported by information found in the patient's chart, a CMS
1500 claim must be coded using what? - Answer-HCPCS (Healthcare Common
Procedure Coding system)
What results from a denied claim? - Answer-The provider incurs rework and
appeal costs
Why does the financial counselor need pricing for services? - Answer-To calculate
the patient's financial responsibility
What type of provider bills third-party payers using CMS 1500 form - Answer-
Hospital-based mammography centers
How are disputes with nongovernmental payers resolved? - Answer-Appeal
conditions specified in the individual payer's contract
, The important message from Medicare provides beneficiaries with information
concerning what? - Answer-Right to appeal a discharge decision if the patient
disagrees with the services
Why do managed care plans have agreements with hospitals, physicians, and
other healthcare providers to offer a range of services to plan members? -
Answer-To improve access to quality healthcare
If a patient remains an inpatient of an SNF (skilled nursing facility for more than 30
days, what is the SNF permitted to do? - Answer-Submit interim bills to the
Medicare program.
90. MSP (Medicare Secondary Payer) rules allow providers to bill Medicare for
liability claims after what happens? - Answer-120 days passes, but the claim then
be withdrawn from the liability carrier
What data are required to establish a new MPI entry? - Answer-The patient's full
legal name, date of birth, and sex
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
WITH 170+ QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) 2025/2026
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
In addition to being supported by information found in the patient's chart, a CMS
1500 claim must be coded using what? - Answer-HCPCS (Healthcare Common
Procedure Coding system)
What results from a denied claim? - Answer-The provider incurs rework and
appeal costs
Why does the financial counselor need pricing for services? - Answer-To calculate
the patient's financial responsibility
What type of provider bills third-party payers using CMS 1500 form - Answer-
Hospital-based mammography centers
How are disputes with nongovernmental payers resolved? - Answer-Appeal
conditions specified in the individual payer's contract
, The important message from Medicare provides beneficiaries with information
concerning what? - Answer-Right to appeal a discharge decision if the patient
disagrees with the services
Why do managed care plans have agreements with hospitals, physicians, and
other healthcare providers to offer a range of services to plan members? -
Answer-To improve access to quality healthcare
If a patient remains an inpatient of an SNF (skilled nursing facility for more than 30
days, what is the SNF permitted to do? - Answer-Submit interim bills to the
Medicare program.
90. MSP (Medicare Secondary Payer) rules allow providers to bill Medicare for
liability claims after what happens? - Answer-120 days passes, but the claim then
be withdrawn from the liability carrier
What data are required to establish a new MPI entry? - Answer-The patient's full
legal name, date of birth, and sex
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
