CRCR EXAM PREP| 145 ACTUAL QUESTIONS &CORRECT
ANSWERS | 2025 LATEST UPDATE
1. Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? CORRECT ANSWERS >> Birthday
2. In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? CORRECT
ANSWERS >> Case rates
3. What customer service improvements might improve the patient accounts
department? CORRECT ANSWERS >> Holding staff accountable for customer
service during performance reviews
4. What is an ABN (Advance Beneficiary Notice of Non-coverage) required
to do? CORRECT ANSWERS >> Inform a Medicare beneficiary that Medicare may
not pay for the order or service
5. What type of account adjustment results from the patient's unwillingness
to pay for a self-pay balance? CORRECT ANSWERS >> Bad debt adjustment
6. What is the initial hospice benefit? CORRECT ANSWERS >> Two 90-day
periods and an unlimited number of subsequent periods
7. When does a hospital add ambulance charges to the Medicare inpatient
claim? CORRECT ANSWERS >> If the patient requires ambulance transportation to
a skilled nursing facility
1 N/ N
18
,8. How should a provider resolve a late-charge credit posted after an account
is billed? CORRECT ANSWERS >> Post a late-charge adjustment to the account
9. an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts CORRECT ANSWERS >> They are not being
processed in a timely manner
10. What is an advantage of a preregistration program? CORRECT ANSWERS
>> It reduces processing times at the time of service
11. What are the two statutory exclusions from hospice coverage? CORRECT
ANSWERS >> Medically unnecessary services and custodial care
12. What core financial activities are resolved within patient access?
CORRECT ANSWERS >> Sched- uling, insurance verification, discharge processing,
and payment of point-of-service receipts
13. What statement applies to the scheduled outpatient? CORRECT ANSWERS
>> The services do not involve an overnight stay
14. How is a mis-posted contractual allowance resolved? CORRECT ANSWERS
>> Comparing the con- tract reimbursement rates with the contract on the
admittance advice to identify the correct amount
15. What type of patient status is used to evaluate the patient's need for
inpatient care? CORRECT ANSWERS >> Observation
16. Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? CORRECT ANSWERS >>
Medically necessary inpatient hospital services for at least 3 consecutive days
before the skilled nursing care admission
2 N/ N
18
, 17. When is the word "SAME" entered on the CMS 1500 billing form in
N N N N N N N N N N N N
Field 0$? CORRECT ANSWERS >> When the patient is the insured
N N N N N NN N N N N N
18. What are non-emergency patients who come for service without
N N N N N N N N
prior notification to the provider called? CORRECT ANSWERS >>
N N N N N N N N N N
Unscheduled patients
N N
19. If the insurance verification response reports that a subscriber has a single
N N N N N N N N N N N
policy, what is the status of the subscriber's spouse? CORRECT ANSWERS
N N N N N N N N N N N
>> Neither enrolled not entitled to benefits
N NN N N N N N
20. Regulation Z of the Consumer Credit Protection Act, also known as N N N N N N N N N N
the Truth in Lending Act, establishes what? CORRECT ANSWERS >>
N N N N N N N N N N N
Disclosure rules for consumer credit sales and consumer loans
N N N N N N N N N
21. What is a principal diagnosis? CORRECT ANSWERS >> Primary reason f
N N N N N N N N N N N
the patient's admission
N N N
22. Collecting patient liability dollars after service leads to what? CORRECT
N N N N N N N N N
ANSWERS >> Lower ac- counts receivable levels
N N NN N N N N
23. What is the daily out-of-pocket amount for each lifetime reserve day used?-
N N N N N N N N N N N
N CORRECT ANSWERS >> 50% of the current deductible amount
N N NN N N N N N
24. What service provided to a Medicare beneficiary in a rural health
N N N N N N N N N N
clinic (RHC) is not billable as an RHC services? CORRECT ANSWERS >>
N N N N N N N N N N N N N
Inpatient care
N N
25. What code indicates the disposition of the patient at the conclusion
N N N N N N N N N N
of service? CORRECT ANSWERS >> Patient discharge status code
N N N N N NN N N N
26. What are hospitals required to do for Medicare credit balance accounts?-
N N N N N N N N N N
N CORRECT ANSWERS >> They result in lost reimbursement and additional cost to
N N NN N N N N N N N N
N collect
3 N/ N
18
ANSWERS | 2025 LATEST UPDATE
1. Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? CORRECT ANSWERS >> Birthday
2. In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? CORRECT
ANSWERS >> Case rates
3. What customer service improvements might improve the patient accounts
department? CORRECT ANSWERS >> Holding staff accountable for customer
service during performance reviews
4. What is an ABN (Advance Beneficiary Notice of Non-coverage) required
to do? CORRECT ANSWERS >> Inform a Medicare beneficiary that Medicare may
not pay for the order or service
5. What type of account adjustment results from the patient's unwillingness
to pay for a self-pay balance? CORRECT ANSWERS >> Bad debt adjustment
6. What is the initial hospice benefit? CORRECT ANSWERS >> Two 90-day
periods and an unlimited number of subsequent periods
7. When does a hospital add ambulance charges to the Medicare inpatient
claim? CORRECT ANSWERS >> If the patient requires ambulance transportation to
a skilled nursing facility
1 N/ N
18
,8. How should a provider resolve a late-charge credit posted after an account
is billed? CORRECT ANSWERS >> Post a late-charge adjustment to the account
9. an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts CORRECT ANSWERS >> They are not being
processed in a timely manner
10. What is an advantage of a preregistration program? CORRECT ANSWERS
>> It reduces processing times at the time of service
11. What are the two statutory exclusions from hospice coverage? CORRECT
ANSWERS >> Medically unnecessary services and custodial care
12. What core financial activities are resolved within patient access?
CORRECT ANSWERS >> Sched- uling, insurance verification, discharge processing,
and payment of point-of-service receipts
13. What statement applies to the scheduled outpatient? CORRECT ANSWERS
>> The services do not involve an overnight stay
14. How is a mis-posted contractual allowance resolved? CORRECT ANSWERS
>> Comparing the con- tract reimbursement rates with the contract on the
admittance advice to identify the correct amount
15. What type of patient status is used to evaluate the patient's need for
inpatient care? CORRECT ANSWERS >> Observation
16. Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? CORRECT ANSWERS >>
Medically necessary inpatient hospital services for at least 3 consecutive days
before the skilled nursing care admission
2 N/ N
18
, 17. When is the word "SAME" entered on the CMS 1500 billing form in
N N N N N N N N N N N N
Field 0$? CORRECT ANSWERS >> When the patient is the insured
N N N N N NN N N N N N
18. What are non-emergency patients who come for service without
N N N N N N N N
prior notification to the provider called? CORRECT ANSWERS >>
N N N N N N N N N N
Unscheduled patients
N N
19. If the insurance verification response reports that a subscriber has a single
N N N N N N N N N N N
policy, what is the status of the subscriber's spouse? CORRECT ANSWERS
N N N N N N N N N N N
>> Neither enrolled not entitled to benefits
N NN N N N N N
20. Regulation Z of the Consumer Credit Protection Act, also known as N N N N N N N N N N
the Truth in Lending Act, establishes what? CORRECT ANSWERS >>
N N N N N N N N N N N
Disclosure rules for consumer credit sales and consumer loans
N N N N N N N N N
21. What is a principal diagnosis? CORRECT ANSWERS >> Primary reason f
N N N N N N N N N N N
the patient's admission
N N N
22. Collecting patient liability dollars after service leads to what? CORRECT
N N N N N N N N N
ANSWERS >> Lower ac- counts receivable levels
N N NN N N N N
23. What is the daily out-of-pocket amount for each lifetime reserve day used?-
N N N N N N N N N N N
N CORRECT ANSWERS >> 50% of the current deductible amount
N N NN N N N N N
24. What service provided to a Medicare beneficiary in a rural health
N N N N N N N N N N
clinic (RHC) is not billable as an RHC services? CORRECT ANSWERS >>
N N N N N N N N N N N N N
Inpatient care
N N
25. What code indicates the disposition of the patient at the conclusion
N N N N N N N N N N
of service? CORRECT ANSWERS >> Patient discharge status code
N N N N N NN N N N
26. What are hospitals required to do for Medicare credit balance accounts?-
N N N N N N N N N N
N CORRECT ANSWERS >> They result in lost reimbursement and additional cost to
N N NN N N N N N N N N
N collect
3 N/ N
18
