HFMA CRCR EXAM 500 QUESTIONS WITH

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HFMA CRCR EXAM 500+ QUESTIONS WITH

ANSWERS 2025,100% CORRECT VERIFIED

ANSWERS ALREADY GRADED A (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 generated 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. Contractual 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 actual costs incurred.
• Validate bank deposits weekly as funds are received from the agency.

**D. Follow the contractual 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 guaranteed by the collection agency.**B. Accurately calculated to demonstrate the actual 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