1|Page
HFMA CRCR (CERTIFIED REVENUE CYCLE
REPRESENTATIVE) EXAM WITH 140 ACCURATE
AND VERIFIED QUESTIONS COVERING REVENUE
CYCLE OPERATIONS, PATIENT ACCESS, BILLING,
COMPLIANCE, AND REIMBURSEMENT.
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 - CORRECT 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
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c) A payment review
d) A Medicare determination appeal - CORRECT 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
c) Improve outcomes
d) Obtain higher compensation for physicians - CORRECT 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
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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
- CORRECT ANSWER✔✔a) When providers re-bill claims based on
nonpayment from the initial bill submission
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 -
CORRECT ANSWER✔✔d) Reduced internal staffing costs and a reliance on
outsourced staff
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
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d) Review by the Medicare Appeals Council (Appeals Council) - CORRECT
ANSWER✔✔b) Judicial review by a federal district court
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 - CORRECT ANSWER✔✔a) The principles
and standards by which organizations operate
A portion of the accounts receivable inventory which has NOT qualified for
billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency - CORRECT ANSWER✔✔a)
Charitable pledges
Local Coverage Determinations (LCD) and National Coverage
Determinations (NCD) are
HFMA CRCR (CERTIFIED REVENUE CYCLE
REPRESENTATIVE) EXAM WITH 140 ACCURATE
AND VERIFIED QUESTIONS COVERING REVENUE
CYCLE OPERATIONS, PATIENT ACCESS, BILLING,
COMPLIANCE, AND REIMBURSEMENT.
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 - CORRECT 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
,2|Page
c) A payment review
d) A Medicare determination appeal - CORRECT 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
c) Improve outcomes
d) Obtain higher compensation for physicians - CORRECT 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
,3|Page
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
- CORRECT ANSWER✔✔a) When providers re-bill claims based on
nonpayment from the initial bill submission
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 -
CORRECT ANSWER✔✔d) Reduced internal staffing costs and a reliance on
outsourced staff
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
, 4|Page
d) Review by the Medicare Appeals Council (Appeals Council) - CORRECT
ANSWER✔✔b) Judicial review by a federal district court
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 - CORRECT ANSWER✔✔a) The principles
and standards by which organizations operate
A portion of the accounts receivable inventory which has NOT qualified for
billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but held within the suspense period
d) Accounts assigned to a pre-collection agency - CORRECT ANSWER✔✔a)
Charitable pledges
Local Coverage Determinations (LCD) and National Coverage
Determinations (NCD) are
