CERTIFIED REVENUE CYCLE REPRESENTATIVE CRCR EXAM ACTUAL TEST PAPER
QUESTIONS CORRECT ANSWERS GRADED A PLUS
Certified Revenue Cycle Representative CRCR
EXAM 2026/2027 Questions Questions and Answers
Verified Solutions Latest Update
Question:
What is the purpose OIG work plant?
Answer:
Identify Acceptable compliance programs in various provider setting
Question:
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window
rule?
Answer:
Non-diagnostic service provided on Tuesday through Friday
Question:
What does a modifier allow a provider to do?
Answer:
Report a specific circumstance that affected a procedure or service without changing the code or its
definition
Question:
IF outpatient diagnostic services are provided within three days of the admission of a Medicare
beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these
charges
Answer:
They must be billed separately to the part B Carrier
,Question:
what is a recurring or series registration?
Answer:
One registration record is created for multiple days of service
Question:
What are nonemergency patients who come for service without prior notification to the provider
called?
Answer:
Unscheduled patients
Question:
Which of the following statement apply to the observation patient type?
Answer:
It is used to evaluate the need for an inpatient admission
Question:
which services are hospice programs required to provide around the clock patient
Answer:
Physician, Nursing, Pharmacy
Question:
Scheduler instructions are used to prompt the scheduler to do what?
Answer:
Complete the scheduling process correctly based on service requeste
,Question:
The Time needed to prepare the patient before service is the difference between the patients arrival
time and which of the following?
Answer:
Procedure time
Question:
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
provided on the order must include:
Answer:
Documentation of the medical necessity for the test
Question:
What is the advantage of a pre-registration program
Answer:
It reduces processing times at the time of service
Question:
What date are required to establish a new MPI(Master patient Index) entry
Answer:
The responsible party's full legal name, date of birth, and social security number
Question:
Which of the following statements is true about third-party payments?
Answer:
The payments are received by the provider from the payer responsible for reimbursing the provider
for the patient's covered services.
, Question:
Which provision protects the patient from medical expenses that exceed the pre-set level
Answer:
stop loss
Question:
what documentation must a primary care physician send to HMO patient to authorize a visit to a
specialist for additional testing or care?
Answer:
Referral
Question:
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not
ask about a patient's insurance information if it would delay what?
Answer:
Medical screening and stabilizing treatment
Question:
Which of the following is a step in the discharge process?
Answer:
Have a case management service complete the discharge plan
Question:
The hospital has a APC based contract for the payment of outpatient services. Total anticipated
charges for the visit are $2,380. The approved APC payment rate is $780. Where will the patients
benefit package be applied?
Answer:
QUESTIONS CORRECT ANSWERS GRADED A PLUS
Certified Revenue Cycle Representative CRCR
EXAM 2026/2027 Questions Questions and Answers
Verified Solutions Latest Update
Question:
What is the purpose OIG work plant?
Answer:
Identify Acceptable compliance programs in various provider setting
Question:
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window
rule?
Answer:
Non-diagnostic service provided on Tuesday through Friday
Question:
What does a modifier allow a provider to do?
Answer:
Report a specific circumstance that affected a procedure or service without changing the code or its
definition
Question:
IF outpatient diagnostic services are provided within three days of the admission of a Medicare
beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these
charges
Answer:
They must be billed separately to the part B Carrier
,Question:
what is a recurring or series registration?
Answer:
One registration record is created for multiple days of service
Question:
What are nonemergency patients who come for service without prior notification to the provider
called?
Answer:
Unscheduled patients
Question:
Which of the following statement apply to the observation patient type?
Answer:
It is used to evaluate the need for an inpatient admission
Question:
which services are hospice programs required to provide around the clock patient
Answer:
Physician, Nursing, Pharmacy
Question:
Scheduler instructions are used to prompt the scheduler to do what?
Answer:
Complete the scheduling process correctly based on service requeste
,Question:
The Time needed to prepare the patient before service is the difference between the patients arrival
time and which of the following?
Answer:
Procedure time
Question:
Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information
provided on the order must include:
Answer:
Documentation of the medical necessity for the test
Question:
What is the advantage of a pre-registration program
Answer:
It reduces processing times at the time of service
Question:
What date are required to establish a new MPI(Master patient Index) entry
Answer:
The responsible party's full legal name, date of birth, and social security number
Question:
Which of the following statements is true about third-party payments?
Answer:
The payments are received by the provider from the payer responsible for reimbursing the provider
for the patient's covered services.
, Question:
Which provision protects the patient from medical expenses that exceed the pre-set level
Answer:
stop loss
Question:
what documentation must a primary care physician send to HMO patient to authorize a visit to a
specialist for additional testing or care?
Answer:
Referral
Question:
Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not
ask about a patient's insurance information if it would delay what?
Answer:
Medical screening and stabilizing treatment
Question:
Which of the following is a step in the discharge process?
Answer:
Have a case management service complete the discharge plan
Question:
The hospital has a APC based contract for the payment of outpatient services. Total anticipated
charges for the visit are $2,380. The approved APC payment rate is $780. Where will the patients
benefit package be applied?
Answer:
