CRCR EXAM 2026\2027 brand new version with
complete questions and verified answers \\pass !!!
Under Medicare rules, certain outpatient services that are provided within three days of
the admission date, by hospitals or by entities owned or controlled by hospitals, must be
billed as part of an inpatient stay. -answer-TRUE
The OIG has issued compliance guidance/model compliance plans for all of the
following entities: -answer-hospices. physician practices. ambulance providers
Providers who are found to be in violation of CMS regulations are subject to: -answer-
Corporate integrity agreements
What MSP situation requires LGHP -answer-Disability
Which of the following statements are true of HFMA's Financial Communications Best
Practices -answer-The best practices were developed specifically to help patients
understand the cost of services, their individual insurance benefits, and their
responsibility for balances after insurance, if any.
The patient experience includes all of the following except: -answer-The average
number of positive mentions received by the health system or practice and the public
comments refuting unfriendly posts on social media sites.
Corporate compliance programs play an important role in protecting the integrity of
operations and ensuring compliance with federal and state requirements. The code of
conduct is: -answer-All of the above
Specific to Medicare fee-for-service patients, which of the following payers have always
been liable for payment? -answer-Public health service programs, Federal grant
programs, veteran affairs programs, black lung program services and work-related
injuries and accidents (worker' compensation claims)
,Provider policies and procedures should be in place to reduce the risk of ethics
violations. Examples of ethics violations include: -answer-All of the above
Providers are now being reimbursed with a focus on the value of the services provided,
rather than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery system
for a population of patients? -answer-To eliminate duplicate services, prevent medical
errors and ensure appropriateness of care.
Historically, revenue cycle has delt with contractual adjustments, bad debt and charity
deductions from gross revenue. Although deductions continue to exist, the definition of
net revenue has been modified through the implementation of ASC 606. Developed by
the Financial Accounting Standards Board (FASB), this change became effective in
2018.
What is the new terminology now employed in the calculation of net patient services
revenues? -answer-Explicit prices concessions and implicit price concessions
Key performance indicators set standards for A/R and provide a method for measuring
the control and collection of A/R.
What are the two KPIs used to monitor performance related to the production and
submission of claims to third party payers and patients (self-pay)? -answer-Elapsed
days from discharge to final bill and elapsed days from final bill to claim/bill submission.
Consents are signed as part of the post-services process. -answer-True
**False
Patient service costs are calculated in the pre-service process for schedule patients -
answer-**True
False
The patient is scheduled and registered for service is a time-of-service activity -answer-
True
**False
The patient account is monitored for payment is a time-of-service activity -answer-True
**False
Case management and discharge planning services are a post-service activty -answer-
True
**False
Sending the bill electronically to the health plan is a time-of-service activity -answer-
True
,**False
What happens during the post-service stage? -answer-**A. Final coding of all services,
preparation and submission of claims, payment processing and balance billing and
resolution.
B. Orders are entered, results are reported, charges are generated, and diagnostic and
procedural coding is initiated.
C. The encounter record is generated, and the patient and guarantor information is
obtained and/or updated as required.
D. The focus is on the patient and his/her financial care, in addition to the clinical care
provided for the patient.
The following statements describe best practices established by the Medical Debt Task
Force. Check the box next to the True statements -answer-**Educate Patients
**Coordinate to avoid duplicate patient contacts
Exercise moderate judgement when communicating with providers about scheduled
services
**Be consistent in key aspects of account resolution
Report to healthcare plans when the patient's account is transferred to collection agency
**Follow best practices for communication
Which option is NOT a main HFMA Healthcare Dollars & Sense® revenue cycle
initiative? -answer-A. Patient Financial Communications
B. Price Transparency
C. Medical Account Resolution
**D. Process Compliance
What is the objective of the HCAHPS initiative? -answer-**A. To provide a standardized
method for evaluating patients' perspective on hospital care.
B. To provide clear communication and good customer service, which will give the
provider a competitive edge.
C. To conduct evaluations concerning patients' perspective on hospital care.
D. To make certain that during registration key information is verified by means of a
picture ID and an insurance card.
Which option is NOT a department that supports and collaborates with the revenue
cycle? -answer-A. Information Technology
B. Clinical Services
C. Finance
**D. Assisted Living Services
, Which option is NOT a continuum of care provider? -answer-A. Physician
**B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
Which of the following are essential elements of an effective compliance program? -
answer-**Reasonable methods to achieve compliance with standards, including
monitoring systems and hotlines
**Established compliance standards and procedures
Automatic dismissal of any employee excluded from participation in a federal healthcare
program
**Designation of a compliance officer employed within the Billing Department
**Oversight of personnel by high-level personnel.
Annually, the OIG publishes a work plan of compliance issues and objectives that will
be focused on throughout the following year. Identify which option is NOT a work plan
task mentioned in this course. -answer-A. Payments to Physicians for Co-Surgery
Procedures
B. Denials and Appeals in Medicare Part D
C. Medicare Hospital Payments for Claims Involving the Acute- and Post-Acute-Care
Transfer Policies
**D. Standard Unique Employer Identifier
In order to promote the use of correct coding methods on a national basis and prevent
payment errors due to improper coding, CMS developed what? -answer-**A. The
Correct Coding Initiative (CCI)
B. The Advance Beneficiary Notice of Noncoverage (ABN)
C. The Medicare Secondary Payer (MSP)
D. Modifiers
Indicate if the activity is described by the appropriate description of the violation
involved: -answer-True - A staff member receives cash in the mail and does not
immediately report the case to the manager for special handling. This is an example of
financial misconduct
False - A mother sees a charge on her hospital bill for a circumcision for a newborn girl.
This is an example of falsifying medical records to boost reimbursement.
True - A patient access staff member takes several file folders and highlighters home for
personal use. This is an example of theft of property.
complete questions and verified answers \\pass !!!
Under Medicare rules, certain outpatient services that are provided within three days of
the admission date, by hospitals or by entities owned or controlled by hospitals, must be
billed as part of an inpatient stay. -answer-TRUE
The OIG has issued compliance guidance/model compliance plans for all of the
following entities: -answer-hospices. physician practices. ambulance providers
Providers who are found to be in violation of CMS regulations are subject to: -answer-
Corporate integrity agreements
What MSP situation requires LGHP -answer-Disability
Which of the following statements are true of HFMA's Financial Communications Best
Practices -answer-The best practices were developed specifically to help patients
understand the cost of services, their individual insurance benefits, and their
responsibility for balances after insurance, if any.
The patient experience includes all of the following except: -answer-The average
number of positive mentions received by the health system or practice and the public
comments refuting unfriendly posts on social media sites.
Corporate compliance programs play an important role in protecting the integrity of
operations and ensuring compliance with federal and state requirements. The code of
conduct is: -answer-All of the above
Specific to Medicare fee-for-service patients, which of the following payers have always
been liable for payment? -answer-Public health service programs, Federal grant
programs, veteran affairs programs, black lung program services and work-related
injuries and accidents (worker' compensation claims)
,Provider policies and procedures should be in place to reduce the risk of ethics
violations. Examples of ethics violations include: -answer-All of the above
Providers are now being reimbursed with a focus on the value of the services provided,
rather than volume, which requires collaboration among providers.
What is the intended outcome of collaborations made through an ACO delivery system
for a population of patients? -answer-To eliminate duplicate services, prevent medical
errors and ensure appropriateness of care.
Historically, revenue cycle has delt with contractual adjustments, bad debt and charity
deductions from gross revenue. Although deductions continue to exist, the definition of
net revenue has been modified through the implementation of ASC 606. Developed by
the Financial Accounting Standards Board (FASB), this change became effective in
2018.
What is the new terminology now employed in the calculation of net patient services
revenues? -answer-Explicit prices concessions and implicit price concessions
Key performance indicators set standards for A/R and provide a method for measuring
the control and collection of A/R.
What are the two KPIs used to monitor performance related to the production and
submission of claims to third party payers and patients (self-pay)? -answer-Elapsed
days from discharge to final bill and elapsed days from final bill to claim/bill submission.
Consents are signed as part of the post-services process. -answer-True
**False
Patient service costs are calculated in the pre-service process for schedule patients -
answer-**True
False
The patient is scheduled and registered for service is a time-of-service activity -answer-
True
**False
The patient account is monitored for payment is a time-of-service activity -answer-True
**False
Case management and discharge planning services are a post-service activty -answer-
True
**False
Sending the bill electronically to the health plan is a time-of-service activity -answer-
True
,**False
What happens during the post-service stage? -answer-**A. Final coding of all services,
preparation and submission of claims, payment processing and balance billing and
resolution.
B. Orders are entered, results are reported, charges are generated, and diagnostic and
procedural coding is initiated.
C. The encounter record is generated, and the patient and guarantor information is
obtained and/or updated as required.
D. The focus is on the patient and his/her financial care, in addition to the clinical care
provided for the patient.
The following statements describe best practices established by the Medical Debt Task
Force. Check the box next to the True statements -answer-**Educate Patients
**Coordinate to avoid duplicate patient contacts
Exercise moderate judgement when communicating with providers about scheduled
services
**Be consistent in key aspects of account resolution
Report to healthcare plans when the patient's account is transferred to collection agency
**Follow best practices for communication
Which option is NOT a main HFMA Healthcare Dollars & Sense® revenue cycle
initiative? -answer-A. Patient Financial Communications
B. Price Transparency
C. Medical Account Resolution
**D. Process Compliance
What is the objective of the HCAHPS initiative? -answer-**A. To provide a standardized
method for evaluating patients' perspective on hospital care.
B. To provide clear communication and good customer service, which will give the
provider a competitive edge.
C. To conduct evaluations concerning patients' perspective on hospital care.
D. To make certain that during registration key information is verified by means of a
picture ID and an insurance card.
Which option is NOT a department that supports and collaborates with the revenue
cycle? -answer-A. Information Technology
B. Clinical Services
C. Finance
**D. Assisted Living Services
, Which option is NOT a continuum of care provider? -answer-A. Physician
**B. Health Plan Contracting
C. Hospice
D. Skilled Nursing Facility
Which of the following are essential elements of an effective compliance program? -
answer-**Reasonable methods to achieve compliance with standards, including
monitoring systems and hotlines
**Established compliance standards and procedures
Automatic dismissal of any employee excluded from participation in a federal healthcare
program
**Designation of a compliance officer employed within the Billing Department
**Oversight of personnel by high-level personnel.
Annually, the OIG publishes a work plan of compliance issues and objectives that will
be focused on throughout the following year. Identify which option is NOT a work plan
task mentioned in this course. -answer-A. Payments to Physicians for Co-Surgery
Procedures
B. Denials and Appeals in Medicare Part D
C. Medicare Hospital Payments for Claims Involving the Acute- and Post-Acute-Care
Transfer Policies
**D. Standard Unique Employer Identifier
In order to promote the use of correct coding methods on a national basis and prevent
payment errors due to improper coding, CMS developed what? -answer-**A. The
Correct Coding Initiative (CCI)
B. The Advance Beneficiary Notice of Noncoverage (ABN)
C. The Medicare Secondary Payer (MSP)
D. Modifiers
Indicate if the activity is described by the appropriate description of the violation
involved: -answer-True - A staff member receives cash in the mail and does not
immediately report the case to the manager for special handling. This is an example of
financial misconduct
False - A mother sees a charge on her hospital bill for a circumcision for a newborn girl.
This is an example of falsifying medical records to boost reimbursement.
True - A patient access staff member takes several file folders and highlighters home for
personal use. This is an example of theft of property.
