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HFMA CRCR EXAM, CERTIFICATION EXAM, PRACTICE EXAM AND A STUDY GUIDE LATEST 2026 ACTUAL EXAM 600 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
HFMA CRCR EXAM, CERTIFICATION EXAM,
PRACTICE EXAM AND A STUDY GUIDE LATEST
2026 ACTUAL EXAM 600 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
HFMA CRCR EXAM
Hospital can only convert an inpatient case to observation if: -
ANSWER- The hospital utilization review committee
determines before the patient is discharged and prior to billing
that an observation setting would be more appropriate.
Hospital need which of the following information sets to assess
a patient's financial status? - ANSWER- Demographic, Income,
Assets and Expenses.
HIPAA privacy rules require covered entities to take all, of the
following actions EXCEPT: - ANSWER- Use only designated
software platforms to secure patient date.
When Recovery Audit Contractors (RAC) identify improper
payments as overpayment. the claims processing contractor
must: - ANSWER- Send a demand letter to the provider to
recover the over payment amount.
Which HIPPA transaction set provides electronic processing of
8insurance verification requests and responses? - ANSWERThe 270-271 set
Across all care settings, if a patient consents to a financial
discussion during a medical encounter to expedite discharge, the
HFMA best practice is to: - ANSWER- Support that choice,
providing that the discussion does not interfere with patient care
or disrupt patient flow.
A scheduled inpatient represents an opportunity for the provider
to do which of the following? - ANSWER- Complete
registration and insurance approval before service
The Medicare Bundled Payments for Care Initiative (BCP) is
designed to: - ANSWER- Align incentives between hospitals,
physicians, and non-physician providers in-order to better
coordinate patient care.
To maximize the value derived from customer complaints, all
consumer complaints should be: - ANSWER- Tracked and
shared to improve customer experience
The soft cost of a dissatisfied customer is: - ANSWER- The
customer passing on information about their negative experience
to potential patients or through social media channels.
Applying the contracted payment methodology to the total
charges yields: - ANSWER- An estimate price
The importance of medical records maintained by HIM is that
the patient records: - ANSWER- Are the primary source for
clinical data required for reimbursement by health plans and
liability payers
Important Revenue Cycle Activities in the pre-service stage
include: - ANSWER- Obtaining or updating patient and
guarantor information
In the pre-service stage, the cost of the schedule services is
identified and the patient's health plan and benefits are used to
calculate: - ANSWER- The amount the patient may be expected
to pay after insurance.
The disadvantage of outsourcing includes all, of the following
Except - ANSWER- Reduces internal staffing costs and a
reliance on outsourced staff.
Marinating routine contact with health plan or liability payer,
making sure all required information is provided and all needed
approvals are obtained is the responsibility of who: - ANSWERCase Management
A claim is denied for the following reasons EXCEPT: -
ANSWER- The submitted claim does not have the physician
signature
All Hospitals are required to establish a written financial
assistance policy that applies to: - ANSWER- All emergency
and medically necessary care
Examples of ethics violation that impact the revenue cycle
include all of the following EXCEPT: - ANSWER- Seeking
payment options for self-pay
Verbal orders from a physician for a service(s) are: - ANSWERAcceptable if given to "qualified" staff as defined in a hospitals
policies and procedures
Medicare has established guidelines called Local Coverage
Determination (LCD) and National Coverage DeterminationÂ
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