1|P age
HFMA CRCR EXAM ACTUAL EXAM WITH
QUESTIONS AND DETAILED ANSWERS THE LATEST
UPDATED EXAM BANK INCLUDING EXPERT
VERIFIED SOLUTIONS FOR A SURE PASS
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons based on a
monthly fee is known as a
a) MSO
b) HMO
c) PPO
d) GPO - - ANSWER: ☑☑B
In a Chapter 7 Straight Bankruptcy filing
a) The court liquidates the debtor's nonexempt property, pays creditors, and
discharges the debtor from the debt
b) The court liquidates the debtor's nonexempt property, pays creditors, and begins
to pay off the largest claims first. All claims are paid some portion of the amount
owed
c) The court vacates all claims against a debtor with the understanding that the
debtor may not apply for credit without court supervision
d) The court establishes a creditor payment schedule with the longest outstanding
claims paid first - - ANSWER: ☑☑A
The core financial activities resolved within patient access include:
a) Scheduling, pre-registration, insurance verification and managed care processing
,2|P age
b) Scheduling, insurance verification, clinical discharge processing and payment
posting of point of service receipts
c) Scheduling, registration, charge entry and managed care processing
d) Scheduling, pre-registration, registration, medical necessity screening and
patient refunds - - ANSWER: ☑☑A
Which of the following is NOT contained in a collection agency agreement?
a) A clear understanding that the provider retains ownership of any outsourced
activities
b) Specific language as to who will pay legal fees, if needed
c) An annual renewal clause
d) A mutual hold-harmless clause - - ANSWER: ☑☑D
Maintaining routine contact with the health plan or liability payer, making sure all
required information is provided and all needed approvals are obtained is the
responsibility of:
a) Patient Accounts
b) Managed Care Contract Staff
c) HIM staff
d) Case Management - - ANSWER: ☑☑D
,3|P age
What is required for the UB-04/837-I, used by Rural Health Clinics to generate
payment from Medicare?
a) Revenue codes
b) Correct Part A and B procedural codes
c) The CMS 1500 Part B attachment
d) Medical necessity documentation - - ANSWER: ☑☑A
Before classifying and subsequently writing off an account to financial assistance
or bad debt, the hospital must establish policy, define appropriate criteria,
implement procedures for identifying and processing accounts:
a) Monitor compliance
b) Have the account triaged for any partial payment possibilities
c) Assist in arranging for a commercial bank loan
d) Obtain the patients income tax statements from the prior 2 years - - ANSWER:
☑☑A
For routine scenarios, such as patients with insurance coverage or a known ability
to pay, financial discussions:
a) Are optional
b) Should take place between the patient or guarantor and properly trained provider
representatives
c) May take place between the patient and discharge planning
d) Are focused on verifying required third-party payer information - - ANSWER:
☑☑B
, 4|P age
The disadvantages of outsourcing include all of the following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff - -
ANSWER: ☑☑D
The Medicare fee-for service appeal process for both beneficiaries and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for
Medicare
d) Review by the Medicare Appeals Council (Appeals Council) - - ANSWER:
☑☑B
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
HFMA CRCR EXAM ACTUAL EXAM WITH
QUESTIONS AND DETAILED ANSWERS THE LATEST
UPDATED EXAM BANK INCLUDING EXPERT
VERIFIED SOLUTIONS FOR A SURE PASS
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons based on a
monthly fee is known as a
a) MSO
b) HMO
c) PPO
d) GPO - - ANSWER: ☑☑B
In a Chapter 7 Straight Bankruptcy filing
a) The court liquidates the debtor's nonexempt property, pays creditors, and
discharges the debtor from the debt
b) The court liquidates the debtor's nonexempt property, pays creditors, and begins
to pay off the largest claims first. All claims are paid some portion of the amount
owed
c) The court vacates all claims against a debtor with the understanding that the
debtor may not apply for credit without court supervision
d) The court establishes a creditor payment schedule with the longest outstanding
claims paid first - - ANSWER: ☑☑A
The core financial activities resolved within patient access include:
a) Scheduling, pre-registration, insurance verification and managed care processing
,2|P age
b) Scheduling, insurance verification, clinical discharge processing and payment
posting of point of service receipts
c) Scheduling, registration, charge entry and managed care processing
d) Scheduling, pre-registration, registration, medical necessity screening and
patient refunds - - ANSWER: ☑☑A
Which of the following is NOT contained in a collection agency agreement?
a) A clear understanding that the provider retains ownership of any outsourced
activities
b) Specific language as to who will pay legal fees, if needed
c) An annual renewal clause
d) A mutual hold-harmless clause - - ANSWER: ☑☑D
Maintaining routine contact with the health plan or liability payer, making sure all
required information is provided and all needed approvals are obtained is the
responsibility of:
a) Patient Accounts
b) Managed Care Contract Staff
c) HIM staff
d) Case Management - - ANSWER: ☑☑D
,3|P age
What is required for the UB-04/837-I, used by Rural Health Clinics to generate
payment from Medicare?
a) Revenue codes
b) Correct Part A and B procedural codes
c) The CMS 1500 Part B attachment
d) Medical necessity documentation - - ANSWER: ☑☑A
Before classifying and subsequently writing off an account to financial assistance
or bad debt, the hospital must establish policy, define appropriate criteria,
implement procedures for identifying and processing accounts:
a) Monitor compliance
b) Have the account triaged for any partial payment possibilities
c) Assist in arranging for a commercial bank loan
d) Obtain the patients income tax statements from the prior 2 years - - ANSWER:
☑☑A
For routine scenarios, such as patients with insurance coverage or a known ability
to pay, financial discussions:
a) Are optional
b) Should take place between the patient or guarantor and properly trained provider
representatives
c) May take place between the patient and discharge planning
d) Are focused on verifying required third-party payer information - - ANSWER:
☑☑B
, 4|P age
The disadvantages of outsourcing include all of the following EXCEPT:
a) The impact of customer service or patient relations
b) The impact of loss of direct control of accounts receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance on outsourced staff - -
ANSWER: ☑☑D
The Medicare fee-for service appeal process for both beneficiaries and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles claims for
Medicare
d) Review by the Medicare Appeals Council (Appeals Council) - - ANSWER:
☑☑B
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
