HFMA CSPR Exam Questions and
Answers (Latest 2026)
The No Surprise Act was a product of:
A) The Health Insurance Portability Act
B) The Consolidation Appropriations Act
C) The Treaty of Algeron
D) The Affordable Care Act - Correct Answers ✅D) The
Affordable Care Act
Which of the following is an advantage of direct contracting?
A) Providers do not have to adjudicate claims for payment
B) Employers can save the cost of working with an insurance
company
C) It allows the patients to have a choice of providers and
physicians
D) Providers can work directly with employers to reduce the
cost of providing insurance - Correct Answers ✅D)
Providers can work directly with employers to reduce the cost
of providing insurance
Accountable Care Organizations (ACOs) have all of the
following characteristics EXCEPT:
A) Patient centric care model
B) Financial incentive for quantity of care
,HFMA CSPR Exam Questions and
Answers (Latest 2026)
C) Integrated care coordination
D) Electronic Medical Record System - Correct Answers
✅B) Financial incentive for quantity of care
The Emergency Treatment and Active Labor Act (EMTALA)
governs when a patient may be transferred from one hospital
to another when in a(n) condition:
A) Life threatening
B) Non-emergency
C) Stable
D) Chronic - Correct Answers ✅A) Life threatening
STAR ratings are used to indicate the quality of:
A) Accountable Care Organizations performance
B) Medicare Advantage health plan performance
C) Services provided by hospitals
D) Services provided by physicians - Correct Answers ✅B)
Medicare Advantage health plan performance
To evaluate an organization's compliance with the CMS COP
standards and other accreditation requirements, is the
purpose of:
,HFMA CSPR Exam Questions and
Answers (Latest 2026)
A) A comprehensive accreditation process
B) Recovery Audits
C) The American Osteopathic Association
D) A clean claim - Correct Answers ✅A) A comprehensive
accreditation process
What is tiering?
A) Typically fixed dollar amounts paid by the insured directly
to the practitioner per episode of care
B) Healthcare coverage products featuring narrow networks,
high cost sharing and very low premiums
C) An effort by insurers to increase premiums and to address
calls from employers and the public for improved quality
D) The ranking or classifying of one or more of the provider
delivery system components to influence choice - Correct
Answers ✅D) The ranking or classifying of one or more of
the provider delivery system components to influence choice
Which piece of information is NOT necessary for claims
processing?
, HFMA CSPR Exam Questions and
Answers (Latest 2026)
A) Provider or referring provider identification
B) Family medical history
C) Type of service
D) Procedure code - Correct Answers ✅B) Family medical
history
Which option is NOT true concerning the Consolidated
Omnibus Budget Reconciliation ACT (COBRA)?
A) COBRA beneficiaries generally are eligible for group
coverage during a maximum of 48 months for qualifying
events
B) COBRA coverage begins on the date that healthcare
coverage would otherwise have been lost because of a
qualifying event
C) COBRA establishes specific criteria for plans, qualified
beneficiaries, and qualifying events to be eligible for benefits
D) Group health coverage for COBRA participants is usually
more expensive than health coverage for active employee -
Correct Answers ✅A) COBRA beneficiaries generally are
eligible for group coverage during a maximum of 48 months
for qualifying events
Answers (Latest 2026)
The No Surprise Act was a product of:
A) The Health Insurance Portability Act
B) The Consolidation Appropriations Act
C) The Treaty of Algeron
D) The Affordable Care Act - Correct Answers ✅D) The
Affordable Care Act
Which of the following is an advantage of direct contracting?
A) Providers do not have to adjudicate claims for payment
B) Employers can save the cost of working with an insurance
company
C) It allows the patients to have a choice of providers and
physicians
D) Providers can work directly with employers to reduce the
cost of providing insurance - Correct Answers ✅D)
Providers can work directly with employers to reduce the cost
of providing insurance
Accountable Care Organizations (ACOs) have all of the
following characteristics EXCEPT:
A) Patient centric care model
B) Financial incentive for quantity of care
,HFMA CSPR Exam Questions and
Answers (Latest 2026)
C) Integrated care coordination
D) Electronic Medical Record System - Correct Answers
✅B) Financial incentive for quantity of care
The Emergency Treatment and Active Labor Act (EMTALA)
governs when a patient may be transferred from one hospital
to another when in a(n) condition:
A) Life threatening
B) Non-emergency
C) Stable
D) Chronic - Correct Answers ✅A) Life threatening
STAR ratings are used to indicate the quality of:
A) Accountable Care Organizations performance
B) Medicare Advantage health plan performance
C) Services provided by hospitals
D) Services provided by physicians - Correct Answers ✅B)
Medicare Advantage health plan performance
To evaluate an organization's compliance with the CMS COP
standards and other accreditation requirements, is the
purpose of:
,HFMA CSPR Exam Questions and
Answers (Latest 2026)
A) A comprehensive accreditation process
B) Recovery Audits
C) The American Osteopathic Association
D) A clean claim - Correct Answers ✅A) A comprehensive
accreditation process
What is tiering?
A) Typically fixed dollar amounts paid by the insured directly
to the practitioner per episode of care
B) Healthcare coverage products featuring narrow networks,
high cost sharing and very low premiums
C) An effort by insurers to increase premiums and to address
calls from employers and the public for improved quality
D) The ranking or classifying of one or more of the provider
delivery system components to influence choice - Correct
Answers ✅D) The ranking or classifying of one or more of
the provider delivery system components to influence choice
Which piece of information is NOT necessary for claims
processing?
, HFMA CSPR Exam Questions and
Answers (Latest 2026)
A) Provider or referring provider identification
B) Family medical history
C) Type of service
D) Procedure code - Correct Answers ✅B) Family medical
history
Which option is NOT true concerning the Consolidated
Omnibus Budget Reconciliation ACT (COBRA)?
A) COBRA beneficiaries generally are eligible for group
coverage during a maximum of 48 months for qualifying
events
B) COBRA coverage begins on the date that healthcare
coverage would otherwise have been lost because of a
qualifying event
C) COBRA establishes specific criteria for plans, qualified
beneficiaries, and qualifying events to be eligible for benefits
D) Group health coverage for COBRA participants is usually
more expensive than health coverage for active employee -
Correct Answers ✅A) COBRA beneficiaries generally are
eligible for group coverage during a maximum of 48 months
for qualifying events
