HFMA CSPR Actual Exam
HFMA CSPR Actual Exam / HFMA CSPR
Exam Predictor/HFMA CSPR Practice Exam
With Complete Questions And Correct
Answers with Deatailed Rationales Graded A+
Reporting initiative including: Required Nation Performance Measurement, Voluntary National
Performance Measurement, and Employer Coalition Performance Measure, are all:
A) Group advocacy goals intended to reduced consumer spending
B) Consumer advocacy and healthcare value efforts
C) Healthcare report cards available to the public
D) Reports that contain public information regarding all healthcare issues - Correct Answer :C)
Healthcare report cards available to the public
Identify which option is NOT a payment type that comprises a large percentage of Medicare
expenditures.
A) Inpatient prospective Payment Systems
B) Outpatient Prospective Payment System
C) Medicare payments to physicians
D) MS-DRG payment - Correct Answer :C) Medicare payments to physicians
Which option is NOT a practice used to control the costs of managed care?
A+ TEST BANK 1
, HFMA CSPR Actual Exam
A) Delivering services that are reasonable, and payers agree on medical necessity and reimburse
for services
B) Combining services, bundling associated charges, determining an appropriate charge the that
set of services
C) Making advance payment to providers for all services needed to care for a member
D) The payer and provider agreeing on a reasonable payment for each service - Correct Answer
:C) Making advance payment to providers for all services needed to care for a member
Under Title XIX of the Social Security Act, Medicaid:
A) Mandates medical services for certain individuals and low-income families
B) Advocates medical assistance for certain individuals and low-come families
C) Pays for medical assistance for certain individuals and low-income families
D) Provides medical referrals for certain individuals and low-income families - Correct Answer :C)
Pays for medical assistance for certain individuals and low-income families
Choice of providers and plans, which is a patient protection for managed Medicare enrollees,
involes:
A) Requiring physicians to disclose to Medicare any financial arrangements that create incentives
limiting care
B) Requiring emergency services to be covered when and where the need arises
C) Requiring plans to provide critical information to consumers, both annually and upon request
A+ TEST BANK 2
, HFMA CSPR Actual Exam
D) Requiring that medically necessary services be available to beneficiaries 24 hours a day, 7
days a week - Correct Answer :C) Requiring plans to provide critical information to consumers,
both annually and upon request
The CMS hopital Value-Based Purchasing (VBP) program links a percentage of a hospital's
payment to performance on quality measures. A component of the hospital's VBP total
performance score is:
A) Patient Experience
B) Access to care
C) Case mix indexes
D) Net margin per case - Correct Answer :A) Patient Experience
All of the following are true regarding a non-direct PPO, EXCEPT:
A) Many providers sign such agreements, without understanding that there is little volume
promised in exchange for any preferred rates
B) Many providers sign such agreements, without understanding that there is no specific
steerage to contracted providers
C) The arrangements does not discount provider fees with no incentives for patients to access
the provider's services
D) Such PPO's or networks are national networks - Correct Answer :C) The arrangements does
not discount provider fees with no incentives for patients to access the provider's services
A+ TEST BANK 3
, HFMA CSPR Actual Exam
Which fixed-rate payment method uses a single price for an inpatient stay, outpatient
procedure, or outpatient diagnosis if charges exceed a threshold dollar amount?
A) Per diem payments
B) Carve-outs
C) Inpatient Stop-Loss
D) Case rate payments - Correct Answer :D) Case rate payments
RBRVS is:
A) The relative weight for calculating MS-DRG payments
B) The relative weight for calculating OPPS payments
C) Mediare physician payment relative weights
D) Acronym for Real Based Reference Verification System - Correct Answer :C) Mediare physician
payment relative weights
When explaining managed care, the most appropriate time refers to:
A) The least costly
B) The right amount of care provided (and will be billed and paid for)
C) Medical intervention at the earliest possible time to prevent a bad situation from becoming
unnecessarily worse
D) The least intensive setting required to provide the care appropriately - Correct Answer :D) The
least intensive setting required to provide the care appropriately
Detailed contract performance assessments; negotiating-strategy planning briefs; and financial
and volume analysis models are all:
A+ TEST BANK 4
HFMA CSPR Actual Exam / HFMA CSPR
Exam Predictor/HFMA CSPR Practice Exam
With Complete Questions And Correct
Answers with Deatailed Rationales Graded A+
Reporting initiative including: Required Nation Performance Measurement, Voluntary National
Performance Measurement, and Employer Coalition Performance Measure, are all:
A) Group advocacy goals intended to reduced consumer spending
B) Consumer advocacy and healthcare value efforts
C) Healthcare report cards available to the public
D) Reports that contain public information regarding all healthcare issues - Correct Answer :C)
Healthcare report cards available to the public
Identify which option is NOT a payment type that comprises a large percentage of Medicare
expenditures.
A) Inpatient prospective Payment Systems
B) Outpatient Prospective Payment System
C) Medicare payments to physicians
D) MS-DRG payment - Correct Answer :C) Medicare payments to physicians
Which option is NOT a practice used to control the costs of managed care?
A+ TEST BANK 1
, HFMA CSPR Actual Exam
A) Delivering services that are reasonable, and payers agree on medical necessity and reimburse
for services
B) Combining services, bundling associated charges, determining an appropriate charge the that
set of services
C) Making advance payment to providers for all services needed to care for a member
D) The payer and provider agreeing on a reasonable payment for each service - Correct Answer
:C) Making advance payment to providers for all services needed to care for a member
Under Title XIX of the Social Security Act, Medicaid:
A) Mandates medical services for certain individuals and low-income families
B) Advocates medical assistance for certain individuals and low-come families
C) Pays for medical assistance for certain individuals and low-income families
D) Provides medical referrals for certain individuals and low-income families - Correct Answer :C)
Pays for medical assistance for certain individuals and low-income families
Choice of providers and plans, which is a patient protection for managed Medicare enrollees,
involes:
A) Requiring physicians to disclose to Medicare any financial arrangements that create incentives
limiting care
B) Requiring emergency services to be covered when and where the need arises
C) Requiring plans to provide critical information to consumers, both annually and upon request
A+ TEST BANK 2
, HFMA CSPR Actual Exam
D) Requiring that medically necessary services be available to beneficiaries 24 hours a day, 7
days a week - Correct Answer :C) Requiring plans to provide critical information to consumers,
both annually and upon request
The CMS hopital Value-Based Purchasing (VBP) program links a percentage of a hospital's
payment to performance on quality measures. A component of the hospital's VBP total
performance score is:
A) Patient Experience
B) Access to care
C) Case mix indexes
D) Net margin per case - Correct Answer :A) Patient Experience
All of the following are true regarding a non-direct PPO, EXCEPT:
A) Many providers sign such agreements, without understanding that there is little volume
promised in exchange for any preferred rates
B) Many providers sign such agreements, without understanding that there is no specific
steerage to contracted providers
C) The arrangements does not discount provider fees with no incentives for patients to access
the provider's services
D) Such PPO's or networks are national networks - Correct Answer :C) The arrangements does
not discount provider fees with no incentives for patients to access the provider's services
A+ TEST BANK 3
, HFMA CSPR Actual Exam
Which fixed-rate payment method uses a single price for an inpatient stay, outpatient
procedure, or outpatient diagnosis if charges exceed a threshold dollar amount?
A) Per diem payments
B) Carve-outs
C) Inpatient Stop-Loss
D) Case rate payments - Correct Answer :D) Case rate payments
RBRVS is:
A) The relative weight for calculating MS-DRG payments
B) The relative weight for calculating OPPS payments
C) Mediare physician payment relative weights
D) Acronym for Real Based Reference Verification System - Correct Answer :C) Mediare physician
payment relative weights
When explaining managed care, the most appropriate time refers to:
A) The least costly
B) The right amount of care provided (and will be billed and paid for)
C) Medical intervention at the earliest possible time to prevent a bad situation from becoming
unnecessarily worse
D) The least intensive setting required to provide the care appropriately - Correct Answer :D) The
least intensive setting required to provide the care appropriately
Detailed contract performance assessments; negotiating-strategy planning briefs; and financial
and volume analysis models are all:
A+ TEST BANK 4
