Page 1 of 88
HFMA CSPR EXAM NEWEST VERSION QUESTIONS
AND CORRECT ANSWERS LATEST UPDATE JUST
RELEASED THIS YEAR
Question: 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 ANSWER✔✔A) Life threatening
Question: 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
, Page 2 of 88
D) Services provided by physicians - CORRECT ANSWER✔✔B) Medicare Advantage health plan
performance
Question: 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 - CORRECT ANSWER✔✔A) A comprehensive accreditation process
Question: What is tiering?
A) Typically fixed dollar amounts paid by the insured directly to the practitioner per episode of
care
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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 ANSWER✔✔D) The ranking or classifying of one or more of the
provider delivery system components to influence choice
Question: Which piece of information is NOT necessary for claims processing?
A) Provider or referring provider identification
B) Family medical history
C) Type of service
D) Procedure code - CORRECT ANSWER✔✔B) Family medical history
, Page 4 of 88
Q: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 ANSWER✔✔D) The Affordable Care Act
Question: 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 ANSWER✔✔D) Providers can work directly with employers to reduce the cost of
providing insurance
HFMA CSPR EXAM NEWEST VERSION QUESTIONS
AND CORRECT ANSWERS LATEST UPDATE JUST
RELEASED THIS YEAR
Question: 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 ANSWER✔✔A) Life threatening
Question: 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
, Page 2 of 88
D) Services provided by physicians - CORRECT ANSWER✔✔B) Medicare Advantage health plan
performance
Question: 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 - CORRECT ANSWER✔✔A) A comprehensive accreditation process
Question: What is tiering?
A) Typically fixed dollar amounts paid by the insured directly to the practitioner per episode of
care
, Page 3 of 88
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 ANSWER✔✔D) The ranking or classifying of one or more of the
provider delivery system components to influence choice
Question: Which piece of information is NOT necessary for claims processing?
A) Provider or referring provider identification
B) Family medical history
C) Type of service
D) Procedure code - CORRECT ANSWER✔✔B) Family medical history
, Page 4 of 88
Q: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 ANSWER✔✔D) The Affordable Care Act
Question: 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 ANSWER✔✔D) Providers can work directly with employers to reduce the cost of
providing insurance
