MSPQ EXAM QUESTIONS AND ANSWERS
SECTION 1: MSPQ BASICS & PURPOSE (Questions 1–20)
Question 1
What is the MSPQ?
• A) A Medicare Advantage Plan enrollment form
• B) A federally mandated series of questions that Medicare patients are
asked to determine if Medicare would be the primary payer or if the patient
has other insurance that would be primary
• C) A questionnaire to determine patient satisfaction
• D) A form used to apply for Medicaid
Answer: B
Rationale: The MSPQ is a federally mandated series of questions asked of Medicare
patients to determine whether Medicare is the primary or secondary payer .
Question 2
Who created the MSPQ?
• A) The Department of Veterans Affairs
• B) The Social Security Administration
• C) The Centers for Medicare and Medicaid Services (CMS)
• D) The World Health Organization
,Answer: C
Rationale: The MSPQ was created by CMS and is a federal requirement .
Question 3
What is the primary purpose of the MSPQ?
• A) To determine patient eligibility for Medicare
• B) To determine the proper order of payers when a patient has other
insurance coverage
• C) To collect patient demographic information
• D) To verify patient identity
Answer: B
Rationale: The MSPQ helps determine whether Medicare is the primary payer or if
another entity has primary payment responsibility .
Question 4
How often must the MSPQ be completed for a patient using traditional Medicare A or
B?
• A) Once per year
• B) Every 90 days
• C) Every visit
• D) Only at initial enrollment
Answer: C
Rationale: The MSPQ must be completed for every inpatient admission and outpatient
encounter for all Medicare patients .
,Question 5
Who is responsible for completing the MSPQ?
• A) The physician
• B) The insurance company
• C) Patient Access associates
• D) The billing department
Answer: C
Rationale: Patient Access associates are responsible for completing the MSPQ .
Question 6
What happens if the MSPQ is not completed accurately?
• A) Nothing, it is optional
• B) Payment of claims may be reduced or even denied
• C) The patient is discharged
• D) The hospital is fined immediately
Answer: B
Rationale: Failure to complete the MSPQ accurately can result in reduced or denied
reimbursement .
Question 7
What is a "primary payer"?
• A) The insurance that pays last
• B) The insurance that is billed first
• C) The insurance with the lowest deductible
• D) Medicare
Answer: B
, Rationale: The primary payer is the insurance that is billed first, before any secondary
payers .
Question 8
What is the "secondary payer"?
• A) The insurance billed first
• B) The insurance billed after the primary payer has paid
• C) The patient
• D) Medicaid
Answer: B
Rationale: The secondary payer is billed after the primary payer receives payment .
Question 9
What are MSP provisions?
• A) Rules for Medicare enrollment
• B) Criteria that determine the proper order of payers and whether another
payer is primary to Medicare
• C) Guidelines for patient discharge
• D) Rules for Medicare Advantage Plans
Answer: B
Rationale: MSP provisions help determine the proper order of payers and make certain
payers primary to Medicare .
Question 10
If the criteria for an MSP provision is met, what is the result?
• A) Medicare remains primary
SECTION 1: MSPQ BASICS & PURPOSE (Questions 1–20)
Question 1
What is the MSPQ?
• A) A Medicare Advantage Plan enrollment form
• B) A federally mandated series of questions that Medicare patients are
asked to determine if Medicare would be the primary payer or if the patient
has other insurance that would be primary
• C) A questionnaire to determine patient satisfaction
• D) A form used to apply for Medicaid
Answer: B
Rationale: The MSPQ is a federally mandated series of questions asked of Medicare
patients to determine whether Medicare is the primary or secondary payer .
Question 2
Who created the MSPQ?
• A) The Department of Veterans Affairs
• B) The Social Security Administration
• C) The Centers for Medicare and Medicaid Services (CMS)
• D) The World Health Organization
,Answer: C
Rationale: The MSPQ was created by CMS and is a federal requirement .
Question 3
What is the primary purpose of the MSPQ?
• A) To determine patient eligibility for Medicare
• B) To determine the proper order of payers when a patient has other
insurance coverage
• C) To collect patient demographic information
• D) To verify patient identity
Answer: B
Rationale: The MSPQ helps determine whether Medicare is the primary payer or if
another entity has primary payment responsibility .
Question 4
How often must the MSPQ be completed for a patient using traditional Medicare A or
B?
• A) Once per year
• B) Every 90 days
• C) Every visit
• D) Only at initial enrollment
Answer: C
Rationale: The MSPQ must be completed for every inpatient admission and outpatient
encounter for all Medicare patients .
,Question 5
Who is responsible for completing the MSPQ?
• A) The physician
• B) The insurance company
• C) Patient Access associates
• D) The billing department
Answer: C
Rationale: Patient Access associates are responsible for completing the MSPQ .
Question 6
What happens if the MSPQ is not completed accurately?
• A) Nothing, it is optional
• B) Payment of claims may be reduced or even denied
• C) The patient is discharged
• D) The hospital is fined immediately
Answer: B
Rationale: Failure to complete the MSPQ accurately can result in reduced or denied
reimbursement .
Question 7
What is a "primary payer"?
• A) The insurance that pays last
• B) The insurance that is billed first
• C) The insurance with the lowest deductible
• D) Medicare
Answer: B
, Rationale: The primary payer is the insurance that is billed first, before any secondary
payers .
Question 8
What is the "secondary payer"?
• A) The insurance billed first
• B) The insurance billed after the primary payer has paid
• C) The patient
• D) Medicaid
Answer: B
Rationale: The secondary payer is billed after the primary payer receives payment .
Question 9
What are MSP provisions?
• A) Rules for Medicare enrollment
• B) Criteria that determine the proper order of payers and whether another
payer is primary to Medicare
• C) Guidelines for patient discharge
• D) Rules for Medicare Advantage Plans
Answer: B
Rationale: MSP provisions help determine the proper order of payers and make certain
payers primary to Medicare .
Question 10
If the criteria for an MSP provision is met, what is the result?
• A) Medicare remains primary
