1|Page
CSPR CERTIFIED SPECIALIST PAYMENT REP
HFMA ACTUAL EXAM NEWEST 2025 COMPLETE
200 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
What are collection agency fees based on? -
.....ANSWER ...✔✔ A percentage of dollars collected
Self-funded benefit plans may choose to coordinate
benefits using the gender rule or what other rule? -
.....ANSWER ...✔✔ Birthday
In what type of payment methodology is a lump sum or
bundled payment negotiated between the payer and
some or all providers? - .....ANSWER ...✔✔ Case
rates
What customer service improvements might improve the
patient accounts department? - .....ANSWER ...✔✔
Holding staff accountable for customer service during
performance reviews
,2|Page
What is an ABN (Advance Beneficiary Notice of Non-
coverage) required to do? - .....ANSWER ...✔✔
Inform a Medicare beneficiary that Medicare may not
pay for the order or service
What type of account adjustment results from the
patient's unwillingness to pay for a self-pay balance? -
.....ANSWER ...✔✔ Bad debt adjustment
What is the initial hospice benefit? - .....ANSWER
...✔✔ Two 90-day periods and an unlimited number
of subsequent periods
When does a hospital add ambulance charges to the
Medicare inpatient claim? - .....ANSWER ...✔✔ If the
patient requires ambulance transportation to a skilled
nursing facility
How should a provider resolve a late-charge credit
posted after an account is billed? - .....ANSWER
...✔✔ Post a late-charge adjustment to the account
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an increase in the dollars aged greater than 90 days
from date of service indicate what about accounts -
.....ANSWER ...✔✔ They are not being processed in a
timely manner
What is an advantage of a preregistration program? -
.....ANSWER ...✔✔ It reduces processing times at the
time of service
What are the two statutory exclusions from hospice
coverage? - .....ANSWER ...✔✔ Medically
unnecessary services and custodial care
What core financial activities are resolved within patient
access? - .....ANSWER ...✔✔ Scheduling, insurance
verification, discharge processing, and payment of
point-of-service receipts
What statement applies to the scheduled outpatient? -
.....ANSWER ...✔✔ The services do not involve an
overnight stay
How is a mis-posted contractual allowance resolved? -
.....ANSWER ...✔✔ Comparing the contract
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reimbursement rates with the contract on the admittance
advice to identify the correct amount
What type of patient status is used to evaluate the
patient's need for inpatient care? - .....ANSWER
...✔✔ Observation
Coverage rules for Medicare beneficiaries receiving
skilled nursing care require that the beneficiary has
received what? - .....ANSWER ...✔✔ Medically
necessary inpatient hospital services for at least 3
consecutive days before the skilled nursing care
admission
When is the word "SAME" entered on the CMS 1500
billing form in Field 0$? - .....ANSWER ...✔✔ When
the patient is the insured
What are non-emergency patients who come for service
without prior notification to the provider called? -
.....ANSWER ...✔✔ Unscheduled patients
If the insurance verification response reports that a
subscriber has a single policy, what is the status of the
CSPR CERTIFIED SPECIALIST PAYMENT REP
HFMA ACTUAL EXAM NEWEST 2025 COMPLETE
200 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
What are collection agency fees based on? -
.....ANSWER ...✔✔ A percentage of dollars collected
Self-funded benefit plans may choose to coordinate
benefits using the gender rule or what other rule? -
.....ANSWER ...✔✔ Birthday
In what type of payment methodology is a lump sum or
bundled payment negotiated between the payer and
some or all providers? - .....ANSWER ...✔✔ Case
rates
What customer service improvements might improve the
patient accounts department? - .....ANSWER ...✔✔
Holding staff accountable for customer service during
performance reviews
,2|Page
What is an ABN (Advance Beneficiary Notice of Non-
coverage) required to do? - .....ANSWER ...✔✔
Inform a Medicare beneficiary that Medicare may not
pay for the order or service
What type of account adjustment results from the
patient's unwillingness to pay for a self-pay balance? -
.....ANSWER ...✔✔ Bad debt adjustment
What is the initial hospice benefit? - .....ANSWER
...✔✔ Two 90-day periods and an unlimited number
of subsequent periods
When does a hospital add ambulance charges to the
Medicare inpatient claim? - .....ANSWER ...✔✔ If the
patient requires ambulance transportation to a skilled
nursing facility
How should a provider resolve a late-charge credit
posted after an account is billed? - .....ANSWER
...✔✔ Post a late-charge adjustment to the account
,3|Page
an increase in the dollars aged greater than 90 days
from date of service indicate what about accounts -
.....ANSWER ...✔✔ They are not being processed in a
timely manner
What is an advantage of a preregistration program? -
.....ANSWER ...✔✔ It reduces processing times at the
time of service
What are the two statutory exclusions from hospice
coverage? - .....ANSWER ...✔✔ Medically
unnecessary services and custodial care
What core financial activities are resolved within patient
access? - .....ANSWER ...✔✔ Scheduling, insurance
verification, discharge processing, and payment of
point-of-service receipts
What statement applies to the scheduled outpatient? -
.....ANSWER ...✔✔ The services do not involve an
overnight stay
How is a mis-posted contractual allowance resolved? -
.....ANSWER ...✔✔ Comparing the contract
, 4|Page
reimbursement rates with the contract on the admittance
advice to identify the correct amount
What type of patient status is used to evaluate the
patient's need for inpatient care? - .....ANSWER
...✔✔ Observation
Coverage rules for Medicare beneficiaries receiving
skilled nursing care require that the beneficiary has
received what? - .....ANSWER ...✔✔ Medically
necessary inpatient hospital services for at least 3
consecutive days before the skilled nursing care
admission
When is the word "SAME" entered on the CMS 1500
billing form in Field 0$? - .....ANSWER ...✔✔ When
the patient is the insured
What are non-emergency patients who come for service
without prior notification to the provider called? -
.....ANSWER ...✔✔ Unscheduled patients
If the insurance verification response reports that a
subscriber has a single policy, what is the status of the
