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HFMA CRCR AND PRACTICE EXAM TEST
BANK 2026|COMPLETE QUESTIONS AND
ANSWERS
Mrs. Jones , a Medicare beneficiary was admitted to the hospital on June 20,2010.
As of the admission date, she had only used 8 inpatient days in the current benefit
period. If she is not discharge on what date will Mr jones exhaust her full
coverage days. - correct-answer - August 9, 2010
In order to meet eligibility guidelines for healthcare benefits, Medicaid
beneficiaries must fall into a specified need category and meet what other types
of requirements - correct-answer - Income and assets
Fee for service plans pay claims based on a percentage of charges. How are
patients out of pocket cost calculated? - correct-answer - They are calculated
quarterly
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Indemnity plans usually reimburse what? - correct-answer - A certain percentage
of charges after patient meets policy's annual deductible.
Departments that need to be included in Charge master maintenance include all
EXCEPT - correct-answer - Quality Assurance
Using HIPPA standardized transaction sets allow providers to: - correct-answer -
Submit a standardized transaction to any of the health plans with which it
conducts business.
Which of the following is NOT included in the standardized quality measures? -
correct-answer - Cost of services
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The ACO investment model will test the use of pre-paid shared savings to: -
correct-answer - Encourage new ACOs to form in rural and underserved areas.
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons on a
monthly fee is known as: - correct-answer - HMO
Ambulance services are billed directly to the health plan for: - correct-answer -
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.
Any provider that has filed a timely cost report may appeal in an adverse final
decision received from the Medicare Administrative Contractor (MAC), the appeal
may be filed with: - correct-answer - The Provider Reimbursement Review Board.
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For scheduled payments, important revenue cycle activities in the time-of-service
stage DO Not include: - correct-answer - Obtaining or updating patient and
guarantor information
Hospital can only convert an inpatient case to observation if: - correct-answer -
The hospital utilization review committee determines before the patient is
discharged and prior to billing that an observation setting would be more
appropriate.
Hospital need which of the following information sets to assess a patient's
financial status? - correct-answer - Demographic, Income, Assets and Expenses.
HIPAA privacy rules require covered entities to take all, of the following actions
EXCEPT: - correct-answer - Use only designated software platforms to secure
patient date.
HFMA CRCR AND PRACTICE EXAM TEST
BANK 2026|COMPLETE QUESTIONS AND
ANSWERS
Mrs. Jones , a Medicare beneficiary was admitted to the hospital on June 20,2010.
As of the admission date, she had only used 8 inpatient days in the current benefit
period. If she is not discharge on what date will Mr jones exhaust her full
coverage days. - correct-answer - August 9, 2010
In order to meet eligibility guidelines for healthcare benefits, Medicaid
beneficiaries must fall into a specified need category and meet what other types
of requirements - correct-answer - Income and assets
Fee for service plans pay claims based on a percentage of charges. How are
patients out of pocket cost calculated? - correct-answer - They are calculated
quarterly
,2|Page
Indemnity plans usually reimburse what? - correct-answer - A certain percentage
of charges after patient meets policy's annual deductible.
Departments that need to be included in Charge master maintenance include all
EXCEPT - correct-answer - Quality Assurance
Using HIPPA standardized transaction sets allow providers to: - correct-answer -
Submit a standardized transaction to any of the health plans with which it
conducts business.
Which of the following is NOT included in the standardized quality measures? -
correct-answer - Cost of services
,3|Page
The ACO investment model will test the use of pre-paid shared savings to: -
correct-answer - Encourage new ACOs to form in rural and underserved areas.
Any healthcare insurance plan that provides or ensures comprehensive health
maintenance and treatment services for an enrolled group of persons on a
monthly fee is known as: - correct-answer - HMO
Ambulance services are billed directly to the health plan for: - correct-answer -
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.
Any provider that has filed a timely cost report may appeal in an adverse final
decision received from the Medicare Administrative Contractor (MAC), the appeal
may be filed with: - correct-answer - The Provider Reimbursement Review Board.
, 4|Page
For scheduled payments, important revenue cycle activities in the time-of-service
stage DO Not include: - correct-answer - Obtaining or updating patient and
guarantor information
Hospital can only convert an inpatient case to observation if: - correct-answer -
The hospital utilization review committee determines before the patient is
discharged and prior to billing that an observation setting would be more
appropriate.
Hospital need which of the following information sets to assess a patient's
financial status? - correct-answer - Demographic, Income, Assets and Expenses.
HIPAA privacy rules require covered entities to take all, of the following actions
EXCEPT: - correct-answer - Use only designated software platforms to secure
patient date.
