CSPR Certification Pre-Test questions and
answers with solutions 2026
Medical Cost Ratio(MCR)/Medical Loss Ratio(MLR) - CORRECT
ANSWER -Total Expenses divided by total premiums
PSOs differ from HMOs - CORRECT ANSWER - Delivery instead of insurance
Coinsurance refers to - CORRECT ANSWER - Provision to limit the amount of coverage, usually 80%
Process of tiering - CORRECT ANSWER - ranking of one or more delivery system components
Tired network - CORRECT ANSWER -Facilities and providers who control costs while providing
efficient care
Used to control costs of manage care - CORRECT ANSWER -combining services and bundling charges
reasonable payment agreements between payer and provider
reimbursement based upon the discretion of the provider
Not a risk involved in per diem payments - CORRECT ANSWER - risk of internal efficinecy
aligning incentives - CORRECT ANSWER -
Addition of some risk in the exchange of health care and remuneration
Standard contracts - CORRECT ANSWER - can help facilites maintain thier margins
rating tiers - CORRECT ANSWER - different rates charged based upon the number and relationships
reinsurance - CORRECT ANSWER -Limits to insured's liability for catastrophic claims
answers with solutions 2026
Medical Cost Ratio(MCR)/Medical Loss Ratio(MLR) - CORRECT
ANSWER -Total Expenses divided by total premiums
PSOs differ from HMOs - CORRECT ANSWER - Delivery instead of insurance
Coinsurance refers to - CORRECT ANSWER - Provision to limit the amount of coverage, usually 80%
Process of tiering - CORRECT ANSWER - ranking of one or more delivery system components
Tired network - CORRECT ANSWER -Facilities and providers who control costs while providing
efficient care
Used to control costs of manage care - CORRECT ANSWER -combining services and bundling charges
reasonable payment agreements between payer and provider
reimbursement based upon the discretion of the provider
Not a risk involved in per diem payments - CORRECT ANSWER - risk of internal efficinecy
aligning incentives - CORRECT ANSWER -
Addition of some risk in the exchange of health care and remuneration
Standard contracts - CORRECT ANSWER - can help facilites maintain thier margins
rating tiers - CORRECT ANSWER - different rates charged based upon the number and relationships
reinsurance - CORRECT ANSWER -Limits to insured's liability for catastrophic claims
