HFMA CRCR EXAM QUESTIONS AND CORRECT ANSWERS

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HFMA CRCR EXAM 2023/2024 QUESTIONS AND CORRECT ANSWERS

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• 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

5. 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 1 / 4

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• What type of account adjustment results from the patient's unwillingness to pay

for a self-pay balance?: Bad debt adjustment

7. What is the initial hospice benefit?: Two 90-day periods and an

unlimited number of subsequent periods

8. When does a hospital add ambulance charges to the Medicare inpatient claim?:

If the patient requires ambulance transportation to a skilled nursing facility

• 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

11. What is an advantage of a preregistration program?: It reduces

processing times at the time of service 2 / 4

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12. What are the two statutory exclusions from hospice coverage?:

Medically unnecessary services and custodial care

13. What core financial activities are resolved within patient access?: Sched-

uling, insurance verification, discharge processing, and payment of point-of-ser- vice receipts

14. What statement applies to the scheduled outpatient?: The services do not

involve an overnight stay

15. 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 3 / 4

• 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

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