HFMA CSPR Exam | Questions with 100% Correct
Answers | Verified | Latest Update 2026
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Terms in this set (76)
The No Surprise Act was a product D) The Affordable Care Act
of:
A) The Health Insurance Portability
Act
B) The Consolidation Appropriations
Act
C) The Treaty of Algeron
D) The Affordable Care Act
Which of the following is an D) Providers can work directly with employers to
advantage of direct contracting? reduce the cost of providing insurance
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
,Accountable Care Organizations B) Financial incentive for quantity of care
(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
The Emergency Treatment and Active A) Life threatening
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
STAR ratings are used to indicate the B) Medicare Advantage health plan performance
quality of:
A) Accountable Care Organizations
performance
B) Medicare Advantage health plan
performance
C) Services provided by hospitals
D) Services provided by physicians
,To evaluate an organization's A) A comprehensive accreditation process
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
What is tiering? D) The ranking or classifying of one or more of the
provider delivery system components to influence
A) Typically fixed dollar amounts choice
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
, Which piece of information is NOT B) Family medical history
necessary for claims processing?
A) Provider or referring provider
identification
B) Family medical history
C) Type of service
D) Procedure code
Which option is NOT true concerning A) COBRA beneficiaries generally are eligible for
the Consolidated Omnibus Budget group coverage during a maximum of 48 months
Reconciliation ACT (COBRA)? for qualifying events
A) COBRA beneficiaries generally
are eligible for group coverage
during a maximum of 48 months for
qualifying events
B) COBRA coverage begins on the
date that healthcare coverage would
otherwise have been lost because of
a qualifying event
C) COBRA establishes specific
criteria for plans, qualified
beneficiaries, and qualifying events
to be eligible for benefits
D) Group health coverage for
COBRA participants is usually more
expensive than health coverage for
active employee
Answers | Verified | Latest Update 2026
Save
Terms in this set (76)
The No Surprise Act was a product D) The Affordable Care Act
of:
A) The Health Insurance Portability
Act
B) The Consolidation Appropriations
Act
C) The Treaty of Algeron
D) The Affordable Care Act
Which of the following is an D) Providers can work directly with employers to
advantage of direct contracting? reduce the cost of providing insurance
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
,Accountable Care Organizations B) Financial incentive for quantity of care
(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
The Emergency Treatment and Active A) Life threatening
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
STAR ratings are used to indicate the B) Medicare Advantage health plan performance
quality of:
A) Accountable Care Organizations
performance
B) Medicare Advantage health plan
performance
C) Services provided by hospitals
D) Services provided by physicians
,To evaluate an organization's A) A comprehensive accreditation process
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
What is tiering? D) The ranking or classifying of one or more of the
provider delivery system components to influence
A) Typically fixed dollar amounts choice
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
, Which piece of information is NOT B) Family medical history
necessary for claims processing?
A) Provider or referring provider
identification
B) Family medical history
C) Type of service
D) Procedure code
Which option is NOT true concerning A) COBRA beneficiaries generally are eligible for
the Consolidated Omnibus Budget group coverage during a maximum of 48 months
Reconciliation ACT (COBRA)? for qualifying events
A) COBRA beneficiaries generally
are eligible for group coverage
during a maximum of 48 months for
qualifying events
B) COBRA coverage begins on the
date that healthcare coverage would
otherwise have been lost because of
a qualifying event
C) COBRA establishes specific
criteria for plans, qualified
beneficiaries, and qualifying events
to be eligible for benefits
D) Group health coverage for
COBRA participants is usually more
expensive than health coverage for
active employee
