HFMA CSPR EXAM QUESTIONS AND ANSWERS
GRADED A+ LATEST UPDATE.
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 ANS >> 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 ANS >> D) Providers can work directly with
employers to reduce the cost of providing insurance
Accountable Care Organizations (Arcos) have all of the following
characteristics EXCEPT:
A) Patient centric care model
B) Financial incentive for quantity of care
C) Integrated care coordination
D) Electronic Medical Record System ANS >> 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 ANS >> 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 ANS >> 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:
A) A comprehensive accreditation process
B) Recovery Audits
C) The American Osteopathic Association
D) A clean claim ANS >> 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 ANS >> 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?
A) Provider or referring provider identification
B) Family medical history
C) Type of service
GRADED A+ LATEST UPDATE.
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 ANS >> 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 ANS >> D) Providers can work directly with
employers to reduce the cost of providing insurance
Accountable Care Organizations (Arcos) have all of the following
characteristics EXCEPT:
A) Patient centric care model
B) Financial incentive for quantity of care
C) Integrated care coordination
D) Electronic Medical Record System ANS >> 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 ANS >> 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 ANS >> 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:
A) A comprehensive accreditation process
B) Recovery Audits
C) The American Osteopathic Association
D) A clean claim ANS >> 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 ANS >> 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?
A) Provider or referring provider identification
B) Family medical history
C) Type of service
