CERTIFIED REVENUE CYCLE REPRESENTATIVE COMPREHENSIVE EXAM SCRIPT
COMPLETE QUESTIONS VERIFIED SOLUTIONS
Certified Revenue Cycle Representative
Comprehensive EXAM 2026/2027 WITH Questions
and Answers Verified Solutions Latest Update
Question:
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule?
Answer:
Birthday
Question:
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
Question:
What customer service improvements might improve the patient accounts department?
Answer:
Holding staff accountable for customer service during performance reviews
Question:
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
,Question:
What type of account adjustment results from the patient's unwillingness to pay for a self-pay
balance?
Answer:
Bad debt adjustment
Question:
What is the initial hospice benefit?
Answer:
Two 90-day periods and an unlimited number of subsequent periods
Question:
When does a hospital add ambulance charges to the Medicare inpatient claim?
Answer:
If the patient requires ambulance transportation to a skilled nursing facility
Question:
How should a provider resolve a late-charge credit posted after an account is billed?
Answer:
Post a late-charge adjustment to the account
Question:
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
,Question:
What is an advantage of a preregistration program?
Answer:
It reduces processing times at the time of service
Question:
What are the two statutory exclusions from hospice coverage?
Answer:
Medically unnecessary services and custodial care
Question:
What core financial activities are resolved within patient access?
Answer:
Scheduling, insurance verification, discharge processing, and payment of point-of-service receipts
Question:
What statement applies to the scheduled outpatient?
Answer:
The services do not involve an overnight stay
Question:
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
Question:
, What type of patient status is used to evaluate the patient's need for inpatient care?
Answer:
Observation
Question:
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
Question:
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
Answer:
When the patient is the insured
Question:
What are non-emergency patients who come for service without prior notification to the provider
called?
Answer:
Unscheduled patients
Question:
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
COMPLETE QUESTIONS VERIFIED SOLUTIONS
Certified Revenue Cycle Representative
Comprehensive EXAM 2026/2027 WITH Questions
and Answers Verified Solutions Latest Update
Question:
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other
rule?
Answer:
Birthday
Question:
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
Question:
What customer service improvements might improve the patient accounts department?
Answer:
Holding staff accountable for customer service during performance reviews
Question:
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
,Question:
What type of account adjustment results from the patient's unwillingness to pay for a self-pay
balance?
Answer:
Bad debt adjustment
Question:
What is the initial hospice benefit?
Answer:
Two 90-day periods and an unlimited number of subsequent periods
Question:
When does a hospital add ambulance charges to the Medicare inpatient claim?
Answer:
If the patient requires ambulance transportation to a skilled nursing facility
Question:
How should a provider resolve a late-charge credit posted after an account is billed?
Answer:
Post a late-charge adjustment to the account
Question:
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
,Question:
What is an advantage of a preregistration program?
Answer:
It reduces processing times at the time of service
Question:
What are the two statutory exclusions from hospice coverage?
Answer:
Medically unnecessary services and custodial care
Question:
What core financial activities are resolved within patient access?
Answer:
Scheduling, insurance verification, discharge processing, and payment of point-of-service receipts
Question:
What statement applies to the scheduled outpatient?
Answer:
The services do not involve an overnight stay
Question:
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
Question:
, What type of patient status is used to evaluate the patient's need for inpatient care?
Answer:
Observation
Question:
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
Question:
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
Answer:
When the patient is the insured
Question:
What are non-emergency patients who come for service without prior notification to the provider
called?
Answer:
Unscheduled patients
Question:
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
