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Is the CRCR Exam Open Book? What You Can & Can't Use

Everything you need to know about the CRCR open-note policy, what materials are permitted, and how to create notes that actually help you pass.

📅 Updated January 2026 ⏱️ 8 min read 📋 Exam Format
Quick Answer
Yes, the CRCR Exam is Open-Note
You can use your own personal notes, but there are important restrictions on what materials are allowed.

One of the most common questions candidates ask before taking the CRCR (Certified Revenue Cycle Representative) exam is whether they can use reference materials during the test. The good news is that the CRCR exam is open-note—but this doesn't mean you can use just anything.

Understanding exactly what's allowed and what's prohibited is crucial for your exam preparation strategy. This guide covers everything you need to know about the CRCR open-note policy and how to use it to your advantage.

📋 Table of Contents

The Official CRCR Open-Note Policy

HFMA (Healthcare Financial Management Association) allows candidates to reference personal notes during the CRCR certification exam. However, this policy comes with specific limitations designed to test your actual understanding of revenue cycle concepts rather than your ability to copy from textbooks.

The core principle is simple: you can reference notes you've personally created, but you cannot use official course materials, textbooks, or any resources that weren't made by you.

💡 Key Understanding

The open-note policy is designed to reduce test anxiety and allow you to reference specific details you might forget under pressure. It is not designed to let unprepared candidates pass by looking up every answer. The time constraints make this impossible anyway.

What You CAN Use During the CRCR Exam

✅ ALLOWED
  • Your own handwritten notes
  • Your own typed/printed notes
  • Personal study guides you created
  • Flashcards you made yourself
  • Summaries written in your own words
  • Charts and diagrams you created
  • Your own glossary of terms
  • Personal cheat sheets
🚫 PROHIBITED
  • HFMA course materials/slides
  • Key Concepts Guide PDF
  • Textbooks or reference books
  • Internet searches
  • Notes from other people
  • Purchased study guides
  • Phone or tablet
  • Any electronic device

What You CANNOT Use: Detailed Breakdown

Understanding what's prohibited is just as important as knowing what's allowed. Here's a detailed breakdown:

HFMA Official Course Materials

The online course you complete before the exam includes slides, videos, and learning modules. None of these materials can be used during the exam. This includes:

  • Course slide decks (even if you print them)
  • Course PDFs or downloads
  • Screenshots from the course
  • The video transcripts

The Key Concepts Guide

HFMA provides a "Key Concepts Guide" PDF as part of your course materials. This document is an excellent study resource, but you cannot use it during the exam. The guide is meant to help you study and create your own notes—it's not a reference document for the test itself.

⚠️ Common Confusion

Many candidates assume the Key Concepts Guide is their "open book" reference. It's not. If you want information from the Key Concepts Guide available during your exam, you must rewrite it in your own words in your personal notes.

Electronic Devices

The exam is proctored (monitored via webcam), and you cannot use:

  • Smartphones or tablets
  • Second computers or monitors
  • Smart watches
  • Any device that could access the internet

Third-Party Materials

Even if you purchase a CRCR study guide from another company, you cannot use it during the exam. Only materials you personally created qualify as "your notes."

Why is the CRCR Exam Open-Note?

HFMA's decision to make the CRCR exam open-note reflects a practical approach to professional certification:

  1. Real-world relevance: In actual revenue cycle work, professionals have access to reference materials, policies, and documentation. The exam simulates this reality.
  2. Reduced test anxiety: Knowing you have a backup reduces stress and allows candidates to perform closer to their true ability level.
  3. Focus on understanding: The time constraints ensure that only candidates who truly understand the material can use notes effectively. You can't look up every answer.
  4. Note-taking as learning: The process of creating notes reinforces learning. HFMA recognizes that candidates who create good notes have already engaged deeply with the material.

The Time Reality: Why Notes Are Backup, Not Primary

Here's the math that every CRCR candidate needs to understand:

75
Questions
90
Minutes Total
72
Seconds Per Question

With just 72 seconds per question, you simply don't have time to look up most answers. Consider this breakdown:

  • Reading the question: 15-20 seconds
  • Reading all answer choices: 15-20 seconds
  • Thinking and selecting: 20-30 seconds
  • Time remaining: 0-20 seconds

If you need to flip through notes, find the right section, locate the specific information, and verify your answer, you'll quickly fall behind. Most successful candidates report using their notes for only 10-15 questions—typically for specific details like exact percentages, regulatory requirements, or technical definitions.

✅ The Winning Strategy

Know the material well enough to answer 80% of questions from memory. Use your notes as a safety net for the remaining 20%—specific details, exact figures, and topics you find difficult to memorize. This approach lets you maintain good time management while still having backup for tricky questions.

How to Create Effective Exam Notes

The best exam notes are concise, organized, and easy to navigate quickly. Here's how to create notes that actually help during the exam:

1. Keep It Short

Quality over quantity. Most successful candidates use 4-8 pages of well-organized notes. More than that becomes difficult to navigate under time pressure.

2. Organize by Unit

Structure your notes to match the exam's four units:

  • Unit 1: Revenue Cycle Fundamentals
  • Unit 2: Pre-Service
  • Unit 3: Time-of-Service
  • Unit 4: Post-Service

3. Use Visual Hierarchy

Make information scannable at a glance:

  • Bold or highlight key terms
  • Use clear section headers
  • Include bullet points, not paragraphs
  • Consider color-coding by topic

4. Focus on High-Value Content

Prioritize information that's hard to memorize but easy to look up:

  • Specific percentages and thresholds
  • Regulatory requirements (501(r), No Surprises Act, HIPAA)
  • Acronyms and their definitions
  • Formulas and calculations
  • Key timelines and deadlines
  • Topics where you consistently struggle

5. Create a Quick Reference Section

On the first page of your notes, create a "cheat sheet" with the most critical facts you might need to look up quickly.

Sample Note Templates

Here are examples of how to structure different sections of your notes:

📝 Sample: Regulatory Quick Reference
501(r) Requirements (Nonprofit Hospitals)
• Financial Assistance Policy (FAP) required
• Written in plain language
• Must notify patients BEFORE discharge
• 240-day notice before collections
• Cannot report to credit agencies during 120-day application period
No Surprises Act (2022)
• Good Faith Estimates required for uninsured/self-pay
• Within 1-3 business days of scheduling
• Can dispute bills >$400 over estimate
• Balance billing prohibited for emergency services
HIPAA Privacy
• PHI = Protected Health Information
• Minimum necessary standard
• 18 identifiers make data PHI
• TPO = Treatment, Payment, Operations (no authorization needed)
📝 Sample: KPI Reference Sheet
Key Revenue Cycle Metrics
• Days in A/R: Total A/R ÷ (Annual Revenue ÷ 365)
  Target: 30-40 days

• Clean Claim Rate: Clean Claims ÷ Total Claims × 100
  Target: >95%

• Denial Rate: Denied Claims ÷ Total Claims × 100
  Target: <5%

• Point-of-Service Collection Rate: POS Collections ÷ Total Patient Responsibility
  Target: >95% of estimated amount

• Net Collection Rate: Payments ÷ (Charges - Adjustments) × 100
  Target: >95%
📝 Sample: Acronym Quick Lookup
Common Revenue Cycle Acronyms
ABN = Advance Beneficiary Notice
COB = Coordination of Benefits
DRG = Diagnosis Related Group
EDI = Electronic Data Interchange
EOB = Explanation of Benefits
ERA = Electronic Remittance Advice
FAP = Financial Assistance Policy
HCPCS = Healthcare Common Procedure Coding System
MSP = Medicare Secondary Payer
POS = Point of Service
RA = Remittance Advice
RCM = Revenue Cycle Management
TOS = Time of Service
UB-04 = Uniform Billing form (institutional claims)

Common Mistakes to Avoid

❌ Mistake #1: Creating Too Many Notes

Some candidates bring 20+ pages of notes and spend more time searching than thinking. If you can't find information within 10 seconds, it's not helping you.

❌ Mistake #2: Copying the Course Materials

Simply retyping the HFMA content doesn't help you learn, and it creates notes that are too detailed to use quickly. Summarize in your own words.

❌ Mistake #3: Not Organizing by Topic

Random notes scattered across pages are useless under time pressure. Organize clearly so you know exactly where to look for specific topics.

❌ Mistake #4: Relying on Notes Instead of Studying

The open-note policy is not a substitute for preparation. Candidates who think "I'll just look it up" consistently run out of time and fail.

❌ Mistake #5: Bringing Prohibited Materials

Using the Key Concepts Guide, course materials, or other prohibited resources can result in exam termination and potential certification revocation. Don't risk it.

Frequently Asked Questions

❓ Can I use the HFMA Key Concepts Guide during the exam?
No. The Key Concepts Guide is a study resource, not an exam reference. If you want specific information from the guide available during your exam, you must rewrite it in your own notes in your own words.
❓ How many pages of notes should I bring?
Most successful candidates use 4-8 pages of well-organized notes. Quality and organization matter more than quantity. If your notes are too long, you won't be able to find information quickly enough to be useful.
❓ Can I print notes from my computer?
Yes, you can use typed and printed notes as long as you created the content yourself. The key requirement is that the notes are your own work—not copies of course materials, textbooks, or third-party study guides.
❓ Are flashcards allowed?
Yes, if you created them yourself. However, consider whether flashcards are the most efficient format for quick reference during a timed exam. Many candidates find organized note pages faster to navigate than flipping through individual cards.
❓ Can I use notes on the recertification exam too?
Yes, the recertification exam (taken every 2 years to maintain your credential) also allows personal notes under the same rules as the initial certification exam.
❓ Will the proctor check my notes?
The exam is proctored via webcam, and proctors can observe what materials you're using. While they may not physically inspect your notes, using prohibited materials (like the Key Concepts Guide) can result in exam termination. Stick to your personal notes to avoid any issues.
❓ What if I don't want to use notes at all?
That's completely fine. Notes are optional, not required. Some candidates prefer to rely entirely on their studied knowledge. If you feel confident without notes, you can take the exam without any reference materials.
🎯 Bottom Line

The CRCR exam's open-note policy is a helpful safety net, not a shortcut to passing. Prepare as if the exam were closed-book, then use your notes as backup for specific details you might forget under pressure. This approach gives you the best chance of passing on your first attempt while still taking advantage of the open-note policy.

Ready to Start Preparing for the CRCR Exam?

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Disclaimer: This article is for informational purposes only. Exam policies may change—always verify current rules directly with HFMA before your exam. CRCR® and HFMA® are registered trademarks of the Healthcare Financial Management Association. This website is not affiliated with or endorsed by HFMA.

Last Updated: January 2026