HFMA CRCR EXAM 500 QUESTIONS WITH

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HFMA CRCR EXAM 500+ QUESTIONS WITH

ANSWERS 2025,

ANSWERS (2025 UPDATE)

Sue Smith came into the hospital. Her insurance provider sent an EFT directly into the hospital's account at the bank. John, the hospital representative, receives an electronic Level 2 ERA. What should he do next? - CORRECT ANSWER>>**A. Manually match the ERA to the patient account.

• Nothing unless there is an error.

What is EFT? - CORRECT ANSWER>>**A. The electronic transfer of funds from payer to payee through the banking system.

• The establishment of internal audits by personnel outside the involved department.
• A standardized healthcare claim payment/advice known as the 835 format.
• A process that requires the separation of duties when processing patient payments.

Which statement is false regarding credit balances? - CORRECT ANSWER>>A. A small credit policy should be matched by a similar policy for small debit balances.

• Tracking reports should be developed to identify internal charge credits versus external

charge credits.

• Hospital gene statements should be sent to patients regarding small credit balances.

**D. There are no CMS hospital compliance requirements regarding credit balances.

Which option is NOT a type of denial? - CORRECT ANSWER>>A. Technical

• Clinical
• Underpayment

**D. Contr Adjustment

Which option is NOT a lien type? - CORRECT ANSWER>>A. Judicial **B. Subrogation

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• Statutory
• Agreement (Consensus)

Based on what you have just read, which activity is not considered when initiating self-pay follow-up and account resolution activities? - CORRECT ANSWER>>A. Poverty Guidelines

• Financial Profile
• Presumptive Financial Assistance Determination

**D. Patient Open Balance Billing

Which option is NOT a required component of a FAP? - CORRECT ANSWER>>A. Eligibility criteria

• Application process
• Application assistance

**D. Out-of-network providers

Which option is NOT a bankruptcy type governed by the 1979 Bankruptcy Act? - CORRECT ANSWER>>A. Straight bankruptcy

• Debtor reorganization

**C. Creditor priority

• Debtor rehabilitation

Which evaluation criteria demonstrates reputation expectations: - CORRECT ANSWER>>A. The agency's Yelp score and consumer comments.

• The amount of monies collected monthly.

**C. The employment of staff who have documented experience working in financial areas of health care.

• The high turnover rate for entry level employees.

Agency fees are: - CORRECT ANSWER>>A. Paid by patients.

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**B. The cost to the provider for collection agency monies offset by the return on baddebt accounts.

• Only reported annually to the provider.
• Waived for accounts aged greater than one year from date of service.

The correct way to handle the retention and payment of agency fees is: - CORRECT ANSWER>>A. The agency provides an annual settlement of monies received by the health care provider and the agency.

• Compare estimated collection costs to costs incurred.
• Validate bank deposits weekly as funds are received from the agency.

**D. Follow the contr agreement between the agency and the provider as to how monies sent to the agency will be handled.

Patient relations include: - CORRECT ANSWER>>**A. The ability to sensitively deal with patients or individuals while managing collection efficiency.

• Applying hard-core techniques to collect monies owed regardless of what the patient or

individual states during the call.

• Ignoring all patient complaint calls.
• Referring all patient complaint calls to the healthcare provider.

Collection agency reports should be provided: - CORRECT ANSWER>>A. Whenever staff have the time to generate them.

• Whenever an account is cancelled.

**C. In at least two formats regarding accounts assigned on a routine basis.

• As needed to prove recovery rates.

Collection results are: - CORRECT ANSWER>>A. Always by the collection agency.**B. Accurately calculated to demonstrate the recovery percentage rate.

• Calculated using agency's private formula.

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• Never reported except during contract negotiations.

Which option is NOT a HFMA best practice? - CORRECT ANSWER>>A. Coordinate the resolution of bad debt accounts with a law firm

• Establish policies and ensure that they are followed

NOT - C. Coordinate account resolution activities with business affiliates

• Report back to credit bureaus when an account is resolved

What are collection agency fees based on? - CORRECT ANSWER>>A percentage of dollars collected

Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - CORRECT ANSWER>>Birthday

In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - CORRECT ANSWER>>Case rates

What customer service improvements might improve the patient accounts department? - CORRECT ANSWER>>Holding staff accountable for customer service during performance reviews

What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do? - CORRECT ANSWER>>Inform a Medicare beneficiary that Medicare may not pay for the order or service

What type of account adjustment results from the patient's unwillingness to pay for a self-pay balance? - CORRECT ANSWER>>Bad debt adjustment

What is the initial hospice benefit? - CORRECT ANSWER>>Two 90-day periods and an unlimited number of subsequent periods