HFMA CSPR Exam Questions +
Verified Answers 100% correct, Update
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 answer ✅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 answer ✅D) Providers can work directly with employers to
reduce the cost of providing insurance
,HFMA CSPR Exam Questions +
Verified Answers 100% correct, Update
2026
Accountable Care Organizations (ACOs) 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 -
correct answer ✅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 answer ✅A) Life threatening
STAR ratings are used to indicate the quality of:
,HFMA CSPR Exam Questions +
Verified Answers 100% correct, Update
2026
A) Accountable Care Organizations performance
B) Medicare Advantage health plan performance
C) Services provided by hospitals
D) Services provided by physicians -
correct answer ✅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 -
correct answer ✅A) A comprehensive accreditation process
What is tiering?
, HFMA CSPR Exam Questions +
Verified Answers 100% correct, Update
2026
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 answer ✅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
Verified Answers 100% correct, Update
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 answer ✅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 answer ✅D) Providers can work directly with employers to
reduce the cost of providing insurance
,HFMA CSPR Exam Questions +
Verified Answers 100% correct, Update
2026
Accountable Care Organizations (ACOs) 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 -
correct answer ✅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 answer ✅A) Life threatening
STAR ratings are used to indicate the quality of:
,HFMA CSPR Exam Questions +
Verified Answers 100% correct, Update
2026
A) Accountable Care Organizations performance
B) Medicare Advantage health plan performance
C) Services provided by hospitals
D) Services provided by physicians -
correct answer ✅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 -
correct answer ✅A) A comprehensive accreditation process
What is tiering?
, HFMA CSPR Exam Questions +
Verified Answers 100% correct, Update
2026
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 answer ✅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
