HFMA CRCR EXAM, CERTIFICATION EXAM, STUDY GUIDE LATEST2024
ACTUAL EXAM 600 QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
1. Why is it important to have high-quality registration standards?
a) Inaccurate or incomplete patient data will delay payment or cause denials
b) Incomplete registrations will lead to Medicare exclusion
c) Inaccurate registration may cause early discharge before full treatment
d) Incomplete registrations will improve satisfaction scores for the hospital
Answer: A
2. When recovery audit contractors (RAC) identify overpayments, what must the claims
processing contractor do?
a) Take legal responsibility for repaying the overpayment
b) Make recovering the overpayment the top priority
c) Send a demand letter to the provider for repayment
d) Audit all claims for the provider from the past 12 months
Answer: C
3. Internal controls for coding and reimbursement changes help prevent what issue?
a) Underpayments
b) Denials
c) Compliance fraud by upcoding
d) Charge master errors
Answer: C
4. When does the patient discharge process begin?
a) When the physician writes discharge orders
b) After clinical services are completed and billing information is ready
c) When discharge orders are written, and payer approval is obtained
d) When clinical services and billing processes are complete and financial responsibilities are
resolved
Answer: A
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5. How do most major health plans, including Medicare and Medicaid, offer insurance
verification?
a) Toll-free hotlines available 24/7
b) Electronic and/or web portal verification
c) Patient "verification of benefits" cards
d) A grace period for verification within 72 hours of treatment
Answer: B
6. Who is the physician responsible for a patient's treatment during an inpatient stay?
a) The patient’s personal physician
b) The primary care physician
c) The attending physician
d) The physician patient care director
Answer: C
7. What does "originating site" mean in healthcare?
a) Location where the patient’s bill is created
b) Location of the patient when receiving the service
c) Site that generates reimbursement for the claim
d) Location of the medical treatment provider
Answer: B
8. HFMA best practices suggest discussing financial responsibilities with patients at which
time?
a) As early as possible, before any financial obligation
b) During the registration process
c) Before scheduling services
d) No later than the evening of admission day
Answer: A
9. HFMA guidelines recommend informing patients about which aspect of service
providers?
a) Explanation for why certain services are not provided
b) Typical providers involved, such as radiologists or pathologists
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c) Satisfaction surveys related to service providers
d) Service prices billed to their health plan
Answer: B
10. How does telemedicine aim to improve patient health?
a) By enabling real-time, two-way communication between patient and clinician
b) By using high-compression fiber optics for medical data transmission
c) By providing on-demand consumer medical education
d) By giving doctors access to the latest medical research
Answer: A
11. What causes a large number of credit balances besides overpayments?
a) Posting errors in the patient accounting system
b) Incorrect claim submissions
c) Inadequate staff training
d) Banking transaction errors
Answer: A
12. If a patient consents to discuss finances during a medical encounter to speed up
discharge, what is HFMA’s best practice?
a) Provide a financial responsibilities kit with all forms and instructions
b) Ensure staff can answer questions and gather necessary financial data
c) Support this choice as long as it doesn’t interfere with care or flow
d) Decline the request to avoid disruptions to patient care or flow
Answer: C
13. How often does the Office of Inspector General (OIG) publish its compliance work
plan?
a) Monthly
b) Quarterly
c) Semi-annually
d) Annually
Answer: D
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14. What are collection agency fees typically based on?
a) A flat rate per account
b) A percentage of dollars collected
c) The total number of accounts handled
d) The agency's hourly rate
Answer: B
15. Self-funded benefit plans may coordinate benefits using either the "gender rule" or
what other rule?
a) Priority rule
b) Age rule
c) Birthday rule
d) Household rule
Answer: C
16. In what payment method is a single lump sum payment negotiated for all services
provided?
a) Fee-for-service
b) Bundled payments
c) Case rates
d) Capitation
Answer: C
17. What customer service improvement could benefit the patient accounts department?
a) Hiring additional staff
b) Faster response times
c) Using customer service feedback
d) Holding staff accountable in performance reviews
Answer: D
18. What is the purpose of an ABN (Advance Beneficiary Notice of Non-coverage)?
a) Inform a Medicare beneficiary about a service's expected cost
b) Notify a Medicare beneficiary that Medicare may not cover the service
c) Authorize a patient’s service coverage
d) Approve the patient’s choice of provider
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