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Examen

CRCR Certification Exam 2025 – 100+ Questions with Answers – Revenue Cycle, Medicare, Compliance, EMTALA – HFMA Program

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Subido en
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Escrito en
2025/2026

This document is a complete exam prep guide for the Certified Revenue Cycle Representative (CRCR) Certification Exam covering the 2025/2026 exam cycle. It includes over 100 questions with accurate and verified answers, organized to reflect real exam topics and requirements as outlined by the Healthcare Financial Management Association (HFMA). The content spans all key areas of revenue cycle operations, including patient registration, insurance verification, medical necessity, claims processing, payment posting, denial management, and collections. It provides thorough coverage of Medicare and Medicaid rules (e.g., LCD/NCD, Part A and B responsibilities), Affordable Care Act implications, UB-04 and 1500 billing forms, HIPAA compliance, EMTALA regulations, and billing standards for Rural Health Clinics. It also explores topics like key performance indicators (KPIs), pricing transparency, revenue codes, appeals process, financial counseling, charity care policy, and fraud prevention through internal controls. This guide is ideal for professionals seeking to pass the CRCR exam or build foundational expertise in revenue cycle management. It is especially useful for those working in hospital finance, billing departments, patient access, compliance, health insurance, or medical practice management. Relevant for: Healthcare finance professionals pursuing CRCR certification Staff in hospital billing offices, patient access, medical insurance, healthcare administration, and revenue cycle teams Students or trainees in healthcare management, healthcare compliance, or healthcare revenue operations programs Professionals preparing for exams under HFMA credentialing Keywords: CRCR exam, revenue cycle, HFMA certification, billing and coding, Medicare, Medicaid, EMTALA, UB-04, CPT codes, ICD-10, compliance, claims management, patient access, medical necessity, financial counseling, denial management, pricing transparency, healthcare regulations, fraud prevention, insurance verification, appeals process, medical billing, healthcare reimbursement, revenue codes, financial assistance, KPIs

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Subido en
29 de septiembre de 2025
Número de páginas
34
Escrito en
2025/2026
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Examen
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CRCR Certification 2025/2026 Exam
Questions and Answers | A+ Score
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Overall aggregate payments made to a hospice are subject to a computed

"cap amount" calculated by - 🧠 ANSWER ✔✔The Medicare Administrative

Contractor (MAC) at the end of the hospice cap period

Which of the following is required for participation in Medicaid - 🧠 ANSWER

✔✔Meet Income and Assets Requirements


In choosing a setting for patient financial discussions, organizations should

first and foremost - 🧠 ANSWER ✔✔Respect the patients privacy


A nightly room charge will be incorrect if the patient's - 🧠 ANSWER

✔✔Transfer from ICU (intensive care unit) to the Medical/Surgical


floor is not reflected in the registration system

,The Affordable Care Act legislated the development of Health Insurance

Exchanges, where individuals and small businesses can - 🧠 ANSWER

✔✔Purchase qualified health benefit plans regardless of insured's


health status

A portion of the accounts receivable inventory which has NOT qualified for

billing includes: - 🧠 ANSWER ✔✔Charitable pledges


What is required for the UB-04/837-I, used by Rural Health Clinics to

generate payment from Medicare? - 🧠 ANSWER ✔✔Revenue codes


This directive was developed to promote and ensure healthcare quality and

value and also to protect consumers and workers in the healthcare system.

This directive is called - 🧠 ANSWER ✔✔Patient bill of rights


The activity which results in the accurate recording of patient bed and level

of care assessment, patient transfer and patient discharge status on a real-

time basis is known as - 🧠 ANSWER ✔✔Case management


Which statement is an EMTALA (Emergency Medical Treatment and Active

Labor Act) violation? - 🧠 ANSWER ✔✔Registration staff may routinely

contact managed are plans for prior authorizations before the patient is

seen by the on-duty physician

,HIPAA had adopted Employer Identification Numbers (EIN) to be used in

standard transactions to identify the employer of an individual described in

a transaction EIN's are


assigned by - 🧠 ANSWER ✔✔The Internal Revenue Service


Checks received through mail, cash received through mail, and lock box

are all examples of - 🧠 ANSWER ✔✔Control points for cash posting


What are some core elements if a board-approved financial assistance

policy? - 🧠 ANSWER ✔✔Eligibility, application process, and nonpayment

collection activities


A recurring/series registration is characterized by - 🧠 ANSWER ✔✔The

creation of one registration record for multiple days of service

With the advent of the Affordable Care Act Health Insurance Marketplaces

and the expansion of Medicaid in some states, it is more important than

ever for hospitals to - 🧠 ANSWER ✔✔Assist patients in understanding their

insurance coverage and their financial obligation


The purpose of a financial report is to: - 🧠 ANSWER ✔✔Present financial

information to decision makers



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, Patient financial communications best practices produce communications

that are - 🧠 ANSWER ✔✔Consistent, clear and transparent


Medicare has established guidelines called the Local Coverage

Determinations (LCD) and National Coverage Determinations (NCD) that

establish - 🧠 ANSWER ✔✔What services or healthcare items are covered

under Medicare

Any provider that has filed a timely cost report may appeal an adverse final

decision received from the Medicare Administrative Contractor (MAC). This

appeal may be filed with - 🧠 ANSWER ✔✔The Provider Reimbursement

Review Board


Concurrent review and discharge planning - 🧠 ANSWER ✔✔Occurs during

service


Duplicate payments occur: - 🧠 ANSWER ✔✔When providers re-bill claims

based on nonpayment from the initial bill submission

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 - 🧠 ANSWER ✔✔A beneficiary appeal
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