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HFMA CRCR EXAM FINAL EXAM AND PRACTICE EXAM
LATEST 2024-2025 COMPLETE 300 QUESTIONS AND
CORRECT DETAILED ANSWERS JUST RELEASED
HFMA CRCR FINAL EXAM
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
a) A beneficiary appeal
b) A Medicare supplemental review
c) A payment review
d) A Medicare determination appeal - ANSWER-A
The nuanced data resulting from detailed ICD-10 coding allows senior leadership to
work with physicians to do all of the following EXCEPT:
a) Drive significant improvements in the areas of quality and the
patient experience
b) Embrace new reimbursement models 1 / 4
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c) Improve outcomes
d) Obtain higher compensation for physicians - ANSWER-D
Duplicate payments occur:
a) When providers re-bill claims based on nonpayment from the
initial bill submission
b) When service departments do not process charges with the
organization's suspense days
c) When the payer's coordination of benefits is not captured
correctly at the time of patient registration
d) When there are other healthcare claims in process and the
anticipated deductibles and co-insurance amounts still show open but will be met by the in-process claims - ANSWER-a
The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals and small businesses can
a) Purchase qualified health benefit plans regardless of insured's 2 / 4
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b) Obtain price estimates for medical services
c) Negotiate the price of medical services with providers
d) Meet federal mandates for insurance coverage and obtain the
corresponding tax deduction - ANSWER-A
The most common resolution methods for credit balances include all of the following
EXCEPT:
a) Designate the overpayment for charity care
b) Submit the corrected claim to the payer incorporating credits
c) Either send a refund or complete a takeback form as directed by
the payer
d) Determine the correct primary payer and notify incorrect payer of
overpayment - ANSWER-A
EFT (electronic funds transfer) is
a) An electronic claim submission 3 / 4
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b) The record of payments in the hospital's accounting system
c) An electronic confirmation that a payment is due
d) An electronic transfer of funds from payer to payee - ANSWER-D
Revenue cycle activities occurring at the point-of-service include all of the following
EXCEPT:
a) The monitoring of charges
b) The provision of case management and discharge planning
services
c) Providing charges to the third-party payer as they are incurred
d) The generation of charges - ANSWER-C
Medicare beneficiaries remain in the same "benefit period"
a) Up to hospitalization discharge
b) Until the beneficiary is "hospitalization and/or skilled nursing
facility-free" for 60 consecutive days
c) Each calendar year
d) Up to 60 days - ANSWER-B
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