Certified Revenue Cycle Representative CRCR Certification
Exam Prep Test Bank with a Review of 350 Latest Questions
and Correct Answers/ Newest CRCR Exam Prep (Correctly
Answered Practice Test 2026-2027)
Ambulance services are billed directly to the health plan for
a) All pre-admission emergency transports
b) Services provided before a patient is admitted and for ambulance
rides arranged to pick up the patient from the hospital after
discharge to take him/her home or to another facility
c) The portion of the bill outside of the patient's self-pay
d) Transports deemed medically necessary by the attending paramedic-ambulance
crew - ANSWER-c) The portion of the bill outside of the patient's self-pay
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is
known as
a) A beneficiary appeal
b) A Medicare supplemental review
c) A payment review
d) A Medicare determination appeal - ANSWER-a) A beneficiary appeal
The nuanced data resulting from detailed ICD-10 coding allows senior leadership
to work with physicians to do all of the following EXCEPT:
a) Drive significant improvements in the areas of quality and the patient experience
b) Embrace new reimbursement models
1
,c) Improve outcomes
d) Obtain higher compensation for physicians - ANSWER-d) Obtain higher
compensation for physicians
Duplicate payments occur:
a) When providers re-bill claims based on nonpayment from the initial bill
submission
b) When service departments do not process charges with the organization's
suspense days
c) When the payer's coordination of benefits is not captured correctly at the time of
patient
registration
d) When there are other healthcare claims in process and the anticipated
deductibles and co-
insurance amounts still show open but will be met by the in-process claims -
ANSWER-a) When providers re-bill claims based on nonpayment from the initial
bill submission
The Affordable Care Act legislated the development of Health Insurance
Exchanges,
where individuals and small businesses can
a) Purchase qualified health benefit plans regardless of insured's health status
b) Obtain price estimates for medical services
c) Negotiate the price of medical services with providers
d) Meet federal mandates for insurance coverage and obtain the corresponding tax
deduction - ANSWER-a) Purchase qualified health benefit plans regardless of
insured's health status
The most common resolution methods for credit balances include all the following
2
,EXCEPT:
a) Designate the overpayment for charity care
b) Submit the corrected claim to the payer incorporating credits
c) Either send a refund or complete a takeback form as directed by the payer
d) Determine the correct primary payer and notify incorrect payer of overpayment
- ANSWER-a) Designate the overpayment for charity care
EFT (electronic funds transfer) is
a) An electronic claim submission
b) The record of payments in the hospital's accounting system
c) An electronic confirmation that a payment is due
d) An electronic transfer of funds from payer to payee - ANSWER-d) An
electronic transfer of funds from payer to payee
Revenue cycle activities occurring at the point-of-service include all the following
EXCEPT:
a) The monitoring of charges
b) The provision of case management and discharge planning services
c) Providing charges to the third-party payer as they are incurred
d) The generation of charges - ANSWER-c) Providing charges to the third-party
payer as they are incurred
Medicare beneficiaries remain in the same "benefit period"
a) Up to hospitalization discharge
b) Until the beneficiary is "hospitalization and/or skilled nursing
facility-free" for 60 consecutive days
c) Each calendar year
3
, d) Up to 60 days - ANSWER-b) Until the beneficiary is "hospitalization and/or
skilled nursing facility-free" for 60 consecutive days
Key Performance Indicators (KPIs) set standards for accounts receivables (A/R)
and
a) Provide evidence of financial status
b) Provide a method of measuring the collection and control of A/R
c) Establish productivity targets
d) Make allowance for accurate revenue forecasting - ANSWER-b) Provide a
method of measuring the collection and control of A/R
Recognizing that health coverage is complicated and not all patients are able to
navigate this terrain, HFMA best practices specify that
a) The patient accounts staff have someone assigned to research coverage on
behalf of patients
b) Patients should be given the opportunity to request a patient advocate, family
member, or other designee to help them in these discussions
c) Patient coverage education may need to be provided by the health plan
d) A representative of the health plan be included in the patient financial
responsibilities
discussion - ANSWER-b) Patients should be given the opportunity to request a
patient advocate, family member, or other designee to help them in these
discussions
When there is a request for service, the scheduling staff member must confirm the
patient's unique identification information to
a) Check if there is any patient balance due
b) Verify the patient's insurance coverage if the patient is a returning customer
c) Confirm that physician orders have been received
4
Exam Prep Test Bank with a Review of 350 Latest Questions
and Correct Answers/ Newest CRCR Exam Prep (Correctly
Answered Practice Test 2026-2027)
Ambulance services are billed directly to the health plan for
a) All pre-admission emergency transports
b) Services provided before a patient is admitted and for ambulance
rides arranged to pick up the patient from the hospital after
discharge to take him/her home or to another facility
c) The portion of the bill outside of the patient's self-pay
d) Transports deemed medically necessary by the attending paramedic-ambulance
crew - ANSWER-c) The portion of the bill outside of the patient's self-pay
An individual enrolled in Medicare who is dissatisfied with the government's claim
determination is entitled to reconsideration of the decision. This type of appeal is
known as
a) A beneficiary appeal
b) A Medicare supplemental review
c) A payment review
d) A Medicare determination appeal - ANSWER-a) A beneficiary appeal
The nuanced data resulting from detailed ICD-10 coding allows senior leadership
to work with physicians to do all of the following EXCEPT:
a) Drive significant improvements in the areas of quality and the patient experience
b) Embrace new reimbursement models
1
,c) Improve outcomes
d) Obtain higher compensation for physicians - ANSWER-d) Obtain higher
compensation for physicians
Duplicate payments occur:
a) When providers re-bill claims based on nonpayment from the initial bill
submission
b) When service departments do not process charges with the organization's
suspense days
c) When the payer's coordination of benefits is not captured correctly at the time of
patient
registration
d) When there are other healthcare claims in process and the anticipated
deductibles and co-
insurance amounts still show open but will be met by the in-process claims -
ANSWER-a) When providers re-bill claims based on nonpayment from the initial
bill submission
The Affordable Care Act legislated the development of Health Insurance
Exchanges,
where individuals and small businesses can
a) Purchase qualified health benefit plans regardless of insured's health status
b) Obtain price estimates for medical services
c) Negotiate the price of medical services with providers
d) Meet federal mandates for insurance coverage and obtain the corresponding tax
deduction - ANSWER-a) Purchase qualified health benefit plans regardless of
insured's health status
The most common resolution methods for credit balances include all the following
2
,EXCEPT:
a) Designate the overpayment for charity care
b) Submit the corrected claim to the payer incorporating credits
c) Either send a refund or complete a takeback form as directed by the payer
d) Determine the correct primary payer and notify incorrect payer of overpayment
- ANSWER-a) Designate the overpayment for charity care
EFT (electronic funds transfer) is
a) An electronic claim submission
b) The record of payments in the hospital's accounting system
c) An electronic confirmation that a payment is due
d) An electronic transfer of funds from payer to payee - ANSWER-d) An
electronic transfer of funds from payer to payee
Revenue cycle activities occurring at the point-of-service include all the following
EXCEPT:
a) The monitoring of charges
b) The provision of case management and discharge planning services
c) Providing charges to the third-party payer as they are incurred
d) The generation of charges - ANSWER-c) Providing charges to the third-party
payer as they are incurred
Medicare beneficiaries remain in the same "benefit period"
a) Up to hospitalization discharge
b) Until the beneficiary is "hospitalization and/or skilled nursing
facility-free" for 60 consecutive days
c) Each calendar year
3
, d) Up to 60 days - ANSWER-b) Until the beneficiary is "hospitalization and/or
skilled nursing facility-free" for 60 consecutive days
Key Performance Indicators (KPIs) set standards for accounts receivables (A/R)
and
a) Provide evidence of financial status
b) Provide a method of measuring the collection and control of A/R
c) Establish productivity targets
d) Make allowance for accurate revenue forecasting - ANSWER-b) Provide a
method of measuring the collection and control of A/R
Recognizing that health coverage is complicated and not all patients are able to
navigate this terrain, HFMA best practices specify that
a) The patient accounts staff have someone assigned to research coverage on
behalf of patients
b) Patients should be given the opportunity to request a patient advocate, family
member, or other designee to help them in these discussions
c) Patient coverage education may need to be provided by the health plan
d) A representative of the health plan be included in the patient financial
responsibilities
discussion - ANSWER-b) Patients should be given the opportunity to request a
patient advocate, family member, or other designee to help them in these
discussions
When there is a request for service, the scheduling staff member must confirm the
patient's unique identification information to
a) Check if there is any patient balance due
b) Verify the patient's insurance coverage if the patient is a returning customer
c) Confirm that physician orders have been received
4
