CRC Chapter 13 Exam 2 – 2025/2026 | 15 Verified Questions with Answers | Claim Processing, RA, Secondary Billing, Medicare Edits

This document contains 15 verified multiple-choice questions and correct answers for Chapter 13 of the Certified Risk Adjustment Coder (CRC) Exam, covering content for the 2025/2026 testing cycle. The material is sourced from actual coursework and has been graded A+, making it a trusted and accurate reference for students preparing for CRC certification. It focuses on the claims processing workflow, payer rules, and post-payment procedures relevant to Medicare and private insurance systems. Key topics include: Initial claim edits and screening for missing information or errors Downcoding based on documentation standards Remittance Advice (RA) and Explanation of Benefits (EOB) interpretation Coordination of benefits and Medicare Secondary Payer (MSP) rules Electronic Funds Transfer (EFT) and code-level payment validation MOA codes for Medicare payment decisions Timely filing and appeals processes This document is ideal for: CRC exam candidates studying Chapter 13 content Medical billing and coding students preparing for assessments Healthcare administration learners focused on payer processes and reimbursement Instructors and tutors needing ready-made quiz or test material Each question is paired with a concise and correct answer, making this a highly efficient tool for review and self-assessment. It's especially useful for mastering secondary billing scenarios, Medicare rules, and CPT code-level claim reconciliation. Keywords: CRC exam, Chapter 13 questions, claim processing, remittance advice, EOB, Medicare secondary payer, MOA codes, CPT billing, insurance eligibility, appeals filing, downcoding, EFT, healthcare reimbursement, coding exam prep