HFMA CRCR EXAM QUESTIONS
WITH 100% CORRECT DETAILED
ANSWERS
<2024|2025 VERSION>
The first thing a health plan does when processing a claim is: -
ANSWER Check if the patient is a health plan beneficiary and what is
the coverage
Outsourcing options should be evaluat...
The first thing a health plan does when processing a claim is: -
ANSWER ✔ Check if the patient is a health plan beneficiary and what is
the coverage
Outsourcing options should be evaluated as - ANSWER ✔ Any other
business service purchase
Insurance verification results in which of the following: - ANSWER ✔
The accurate identification of the patient's eligibility and benefits
EMTLA and HFMA best practices specify that in an Emergency
Department setting: - ANSWER ✔ No patient financial discussions
should occur before a patient is screened and stabilized
he HCCAHPS (Hospital Consumer Assessment of Healthcare
Provider's and Systems) initiative was launched to: - ANSWER ✔
Provide a standardized method for evaluation patients' perspective on
hospital care
,All of the following are potential causes of credit balances EXCEPT: -
ANSWER ✔ A patient's choice to build up a credit against future
medical bills
Medicare will only pay for tests and services that: - ANSWER ✔ Can
be demonstrated as necessary
This was developed to promote and ensure healthcare quality and value
and also to protect consumers and workers in the healthcare system. This
directive is called: - ANSWER ✔ Joint Commission for Acceleration of
Healthcare Organizations (JCAHO) safety standards
It is important to calculate reserves to ensure: - ANSWER ✔ A stable
financial operations and accurate financial reporting
An advantage of a pre-registration program in - ANSWER ✔ The
opportunity to reduce processing times at the time of service
To be eligible for Medicaid, an individual must: - ANSWER ✔ Meet
income and asset requirements
The patient discharge process begins when: - ANSWER ✔ The
physician writes the order
Appropriate training for patient financial counseling staff must cover all
of the following EXCEPT: - ANSWER ✔ Documenting the
conversation in the medical records
Patients should be informed that costs presented in a price estimation
may: - ANSWER ✔ Only determine the percentage of the total that the
patients is responsible for and not the actual cost.
,Any healthcare insurance plan that providers or insures comprehensive
health maintenance and services for an enrolled group of persons based
on a monthly fee is known as a - ANSWER ✔ HMO
Chapter 11 Bankruptcy permits a debtor to: - ANSWER ✔ Work out a
court-supervised plan with creditors
A portion of the accounts receivable inventory which has NOT qualified
for billing includes: - ANSWER ✔ Accounts created during pre-
registration but not activated
Overall aggregate payments made to a hospice are subject to a
computed "cap amount" calculated by: - ANSWER ✔ The Medicare
Administrative Contractor (MAC) at the end of the hospice cap period
The ICD-10 code set and CPT/HCPCS code sets combined provide: -
ANSWER ✔ The specificity and coding accuracy needed to support
reimbursement claims
Charges, as the most appropriate measurement of utilization, enables: -
ANSWER ✔ Generation of timely and accurate billing
Days in A/R calculated based on the value of: - ANSWER ✔ The total
account receivable on a specific date
Medicare benefits provide coverage for: - ANSWER ✔ Inpatient
hospital services, skilled nursing care. And home health care
HFMA best practices call for patient financial discussions to be
reinforced: - ANSWER ✔ By issuing a new invoice to the patient
, All of following are steps in safeguarding collections EXCEPT: -
ANSWER ✔ Placing collections in a lock-box for posting review the
next business day
The code indication of the disposition of the patient at the conclusion of
service is called the: - ANSWER ✔ Patient discharge status code
HIPPA has adopted Employer Identification Numbers (EINs) to be used
in standard transactions to identify the employer of an individual
described in a transaction. EINs are created and assigned by: -
ANSWER ✔ The Internal Revenue Service
The purpose of the ACA mandated Community Health Needs
Assessment is: - ANSWER ✔ To provide community benefit outreach to
those without insurance and who have not had a physical within the past
2 years
What is Continuum of Care: - ANSWER ✔ The coordination and
linkage of resource needed to avoid the duplication of services and the
facilitation of seamless movement among care settings.
Account Receivable (A/R) aging reports - ANSWER ✔ Identify past
due accounts likely to become bad debit
Applying the contracted payment amount to the amount of total charges
yields: - ANSWER ✔ An estimated price for the patient's responsibility
Most major health plans including Medicare and Medicaid offer: -
ANSWER ✔ Electronic and/or web portal verification
What are some elements of a board-approved financial assistance
policy: - ANSWER ✔ Eligibility application process and nonpayment
collection activities
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