CRCR Certification Exam Questions and Answers |Fall
2026/2027 Update | 100% Correct
Question 1
The importance of medical records being maintained by HIM is that the patient records
a) Are the primary source for clinical data required for reimbursement by health plans and liability payers
b) Are the strongest evidence and defense in the event of a Medicare audit
c) Are evidence used in assessing the quality of care
d) Are the evidence cited in quality review
Correct Answer
a) Are the primary source for clinical data required for reimbursement by health plans and liability payers
Question 2
It is important to calculate reserves to ensure
a) Stable financial operations and accurate financial reporting
b) Collateral for credit
c) Expense coverage in the event of a revenue short fall
d) Coverage of B/D write offs and charity care costs
Correct Answer
a) Stable financial operations and accurate financial reporting
Page 1 of 125
,Question 3
Days in A/R calculated based on the value of:
Correct Answer
The total account receivable on a specific date
Question 4
Departments that need to be included in Charge master maintenance include all EXCEPT:
Correct Answer
Quality Assurance
Question 5
The benefit of Medicare Advantage Plan is
a) It is a less costly plan compared to traditional Medicare
b) Patients may retain a primary care physician and see another physician for a second opinion at no charge
c) Patients generally have their Medicare-coverage healthcare through the plan and do not need to worry about "part" or
"part b" benefits
d) Patients receive significant discounting on services contracted by the federal government
Correct Answer
c) Patients generally have their Medicare-coverage healthcare through the plan and do not need to worry about "part" or
"part b" benefits
Page 2 of 125
,Question 6
A claim is denied for the following reasons, EXCEPT:
a) The health plan cannot identify the subscriber
b) The frequency of service was outside the coverage timeline
c) The submitted claim does not have the physicians signature
d) The subscriber was not enrolled at the time of service
Correct Answer
c) The submitted claim does not have the physicians signature
Question 7
A decision on whether a patient should be admitted as an inpatient or become an outpatient observation patient requires
medical judgments based on all of the following EXCEPT:
a) The patient's home care coverage
b) Current medical needs
c) The likelihood of an adverse event occurring to the patient
d) The patient's medical history
Correct Answer
a) The patient's home care coverage
Question 8
What are numbered receipts used for?
Correct Answer
To ensure that all payments are properly accounted for and deposited.
Page 3 of 125
, Question 9
What Is an advantage of a preregistration program?
Correct Answer
It reduces processing times at the time of service
Question 10
What is a co-payment?
Correct Answer
The fixed amount that is due for a specific service?
Question 11
What does a modifier allow a provider to do?
Correct Answer
Report a specific circumstance that affected a procedure or service without changing the
code or its definition.
Page 4 of 125
2026/2027 Update | 100% Correct
Question 1
The importance of medical records being maintained by HIM is that the patient records
a) Are the primary source for clinical data required for reimbursement by health plans and liability payers
b) Are the strongest evidence and defense in the event of a Medicare audit
c) Are evidence used in assessing the quality of care
d) Are the evidence cited in quality review
Correct Answer
a) Are the primary source for clinical data required for reimbursement by health plans and liability payers
Question 2
It is important to calculate reserves to ensure
a) Stable financial operations and accurate financial reporting
b) Collateral for credit
c) Expense coverage in the event of a revenue short fall
d) Coverage of B/D write offs and charity care costs
Correct Answer
a) Stable financial operations and accurate financial reporting
Page 1 of 125
,Question 3
Days in A/R calculated based on the value of:
Correct Answer
The total account receivable on a specific date
Question 4
Departments that need to be included in Charge master maintenance include all EXCEPT:
Correct Answer
Quality Assurance
Question 5
The benefit of Medicare Advantage Plan is
a) It is a less costly plan compared to traditional Medicare
b) Patients may retain a primary care physician and see another physician for a second opinion at no charge
c) Patients generally have their Medicare-coverage healthcare through the plan and do not need to worry about "part" or
"part b" benefits
d) Patients receive significant discounting on services contracted by the federal government
Correct Answer
c) Patients generally have their Medicare-coverage healthcare through the plan and do not need to worry about "part" or
"part b" benefits
Page 2 of 125
,Question 6
A claim is denied for the following reasons, EXCEPT:
a) The health plan cannot identify the subscriber
b) The frequency of service was outside the coverage timeline
c) The submitted claim does not have the physicians signature
d) The subscriber was not enrolled at the time of service
Correct Answer
c) The submitted claim does not have the physicians signature
Question 7
A decision on whether a patient should be admitted as an inpatient or become an outpatient observation patient requires
medical judgments based on all of the following EXCEPT:
a) The patient's home care coverage
b) Current medical needs
c) The likelihood of an adverse event occurring to the patient
d) The patient's medical history
Correct Answer
a) The patient's home care coverage
Question 8
What are numbered receipts used for?
Correct Answer
To ensure that all payments are properly accounted for and deposited.
Page 3 of 125
, Question 9
What Is an advantage of a preregistration program?
Correct Answer
It reduces processing times at the time of service
Question 10
What is a co-payment?
Correct Answer
The fixed amount that is due for a specific service?
Question 11
What does a modifier allow a provider to do?
Correct Answer
Report a specific circumstance that affected a procedure or service without changing the
code or its definition.
Page 4 of 125
