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HFMA CRCR EXAM 2024/2025 WITH 100% ACCURATE ANSWERS
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HFMA CRCR EXAM 2024/2025 WITH 100% ACCURATE ANSWERS
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ESTUDYHFMA CRCR EXAM 2024/2025 WITH
100% ACCURATE ANSWERS
1. Which of the following is NOT a disadvantage of outsourcing?
a) Negative impact on customer or patient relations
b) Loss of direct control over accounts receivable services
c) Increased costs due to vendor inefficiency
d) Reduced internal staffing costs due to reliance on outsourced staff
Answer: D
2. Which of the following is NOT a part of the Medicare fee-for-service appeal process?
a) Medical necessity review by an independent physician panel
b) Judicial review by a federal district court
c) Redetermination by the claims handler for Medicare
d) Review by the Medicare Appeals Council
Answer: B
3. Business ethics or organizational ethics refer to:
a) Principles and standards guiding how organizations operate
b) Regulations that must be legally followed
c) Definitions of acceptable customer service practices
d) A code of acceptable conduct
Answer: A
4. Which of the following is NOT qualified for billing in accounts receivable?
a) Charitable pledges
b) Accounts created during pre-registration but not activated
c) Accounts coded but on hold within the suspense period
d) Accounts assigned to a pre-collection agency
Answer: A
5. Local Coverage Determinations (LCD) and National Coverage Determinations (NCD)
,ESTUDY
are Medicare guidelines used to determine:
a) Eligibility of Medicare and Medicaid providers
b) Reimbursement rates for Medicare outpatient services
c) Which diagnoses, symptoms, or signs are eligible for reimbursement
d) Whether Medicare or Medicaid should reimburse a claim
Answer: C
6. "Days in Accounts Receivable" (Days in A/R) is calculated based on:
a) The total accounts receivable amount on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect expected revenue
d) Total cash received to date
Answer: C
7. What is a challenge hospitals face when providing cost information to patients in
advance?
a) Hospitals avoid setting prices without knowing the patient’s insurance status and expected
reimbursement
b) Charge master lists show only total charges, not net charges after insurance adjustments
c) Hospitals avoid "guaranteeing" prices due to possible additional treatment charges
d) Reluctance to share proprietary financial information
Answer: B
8. Across all healthcare settings, if a patient agrees to a financial discussion during their
visit to speed up discharge, HFMA best practice is to:
a) Ensure attending staff can answer questions and gather necessary financial information
b) Provide a patient financial kit with all necessary registration forms and instructions
c) Support the choice as long as it doesn’t disrupt patient care or flow
d) Decline the request since financial discussions may interfere with patient care
Answer: C
9. A "Compliance Program" is defined as:
a) An annual legal audit and review for regulation adherence
b) Educating staff on compliance regulations
, ESTUDY
c) Systematic procedures to ensure regulatory requirements by government agencies are met
d) Developing policies that align with regulatory requirements
Answer: C
10. Case Management assigns a case manager to:
a) Patients of any physician requesting case management
b) A selected group of patients
c) Every patient in the facility
d) Specific cases designated by third-party agreements
Answer: B
11. Pricing transparency is defined as easily accessible information on healthcare service
prices that helps consumers:
a) Identify, compare, and select providers based on value
b) Customize healthcare by choosing a mix of providers
c) Negotiate the cost of health plan premiums
d) Verify the cost of individual healthcare providers
Answer: A
12. A healthcare insurance plan offering comprehensive health services to an enrolled
group for a monthly fee is called a:
a) MSO
b) HMO
c) PPO
d) GPO
Answer: B
13. In a Chapter 7 bankruptcy filing, the court:
a) Liquidates nonexempt assets, pays creditors, and discharges the debtor from debt
b) Liquidates assets, pays creditors, and pays off the largest claims first, distributing funds
proportionally
c) Cancels claims against the debtor, who must seek court approval for new credit
d) Sets up a payment plan, prioritizing the longest-standing claims
Answer: A
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