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HFMA CRCR Certification Exam 2025/2026 – Complete Exam Questions with 100% Verified Correct Answers Exam

HEAL100 Health Care — exam and revision material · Other

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Health Care exam material, 7 pages. Originally published on StudyMerit.

Pages
7
Academic year
2025/2026
Language
English

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HFMA CRCR EXAM--REAL ACTUAL EXAM-LATEST UPDATE 2025 | COMPLETE QUESTIONS WITH CORRECT DETAILED ANSWERS | RATED 100% CORRECT!! ALREADY GRADED A+ Leave the first rating Students also studied Save Groups Flashcard sets Study guides HFMA CRCR EXAM LATEST 2024-20 ... 535 terms lewiisantos08 Preview WGU C213 Final Exam: ACCOUNTIN ... Teacher 143 terms Ramonamaia25 Preview CRCR Exam Prep, Multiple Choice, ... 328 terms jadedkat Preview CRCR P 141 term Lov What are collection agency fees based on? A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? Case rates What customer service improvements might improve the patient accounts department? Holding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non- coverage) required to do? Inform a Medicare beneficiary that Medicare may not pay for the order or service What type of account adjustment results from the patient's unwillingness to pay for a self-pay balance? Bad debt adjustment What is the initial hospice benefit? Two 90-day periods and an unlimited number of subsequent periods When does a hospital add ambulance charges to the Medicare inpatient claim? If the patient requires ambulance transportation to a skilled nursing facility Terms in this set (535) Hide definitions

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How should a provider resolve a late-charge credit posted after an account is billed? Post a late-charge adjustment to the account an increase in the dollars aged greater than 90 days from date of service indicate what about accounts They are not being processed in a timely manner What is an advantage of a preregistration program? It reduces processing times at the time of service What are the two statutory exclusions from hospice coverage? Medically unnecessary services and custodial care What core financial activities are resolved within patient access? Scheduling, insurance verification, discharge processing, and payment of point- of-service receipts What statement applies to the scheduled outpatient? The services do not involve an overnight stay How is a mis-posted contractual allowance resolved? Comparing the contract reimbursement rates with the contract on the admittance advice to identify the correct amount What type of patient status is used to evaluate the patient's need for inpatient care? Observation Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has received what? Medically necessary inpatient hospital services for at least 3 consecutive days before the skilled nursing care admission When is the word "SAME" entered on the CMS 1500 billing form in Field 0$? When the patient is the insured What are non-emergency patients who come for service without prior notification to the provider called? Unscheduled patients If the insurance verification response reports that a subscriber has a single policy, what is the status of the subscriber's spouse? Neither enrolled not entitled to benefits Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes what? Disclosure rules for consumer credit sales and consumer loans What is a principal diagnosis? Primary reason for the patient's admission Collecting patient liability dollars after service leads to what? Lower accounts receivable levels What is the daily out-of-pocket amount for each lifetime reserve day used? 50% of the current deductible amount What service provided to a Medicare beneficiary in a rural health clinic (RHC) is not billable as an RHC services? Inpatient care

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What code indicates the disposition of the patient at the conclusion of service? Patient discharge status code What are hospitals required to do for Medicare credit balance accounts? They result in lost reimbursement and additional cost to collect When an undue delay of payment results from a dispute between the patient and the third party payer, who is responsible for payment? Patient Medicare guidelines require that when a test is ordered for a LCD or NCD exists, the information provided on the order must include: A valid CPT or HCPCS code With advances in internet security and encryption, revenue-cycle processes are expanding to allow patients to do what? Access their information and perform functions on-line What date is required on all CMS 1500 claim forms? onset date of current illness What does scheduling allow provider staff to do Review appropriateness of the service request What code is used to report the provider's most common semiprivate room rate? Condition code Regulations and requirements for coding accountable care organizations, which allows providers to begin creating these organizations, were finalized in: 2012 What is a primary responsibility of the Recover Audit Contractor? To correctly identify proper payments for Medicare Part A & B claims How must providers handle credit balances? Comply with state statutes concerning reporting credit balance Insurance verification results in what? The accurate identification of the patient's eligibility and benefits What form is used to bill Medicare for rural health clinics? CMS 1500 What activities are completed when a scheduled pre- registered patient arrives for service? Registering the patient and directing the patient to the service area In addition to being supported by information found in the patient's chart, a CMS 1500 claim must be coded using what? HCPCS (Healthcare Common Procedure Coding system) What results from a denied claim? The provider incurs rework and appeal costs Why does the financial counselor need pricing for services? To calculate the patient's financial responsibility

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