CSBI HFMA COMPREHENSIVE EXAM
SCRIPT 2026 FULL QUESTIONS AND
ANSWERS
◉ How is the term carve-out used when discussing managed care?
Answer: To refer to specific benefits or services
◉ What is the term Coordination of Benefits (COB)?
Answer: A term used to describe how payment is coordinated for
patients who have coverage through two insurance policies
◉ Which three components are used to determine the total RVU
value for a service?
Answer: -Malpractice expense
-Lowest market price for services used
-Medicare discounts
◉ A fixed payment amount based upon the number of members
assigned to a provider, and does not vary based upon the number of
services rendered, is known as:
Answer: Capitation
, ◉ Aligning incentives has come to mean _________.
Answer: The appropriate addition of some risk in the exchange of
health care to a patient for some form of remuneration.
◉ According to MedPAC, which option is a benefit or undesirable
consequence of bundling
payments?
Answer: -It allows Medicare to pay a set fee per hospitalization
episode.
-It would provide the potential to improve efficiency and quality
-It would lead to underutilization of services
◉ As the healthcare industry moves to control growth in medical
spending, what initiative can help hospitals maintain their margins?
Answer: Contract standardization
◉ Identify which initiatives are focused on in an effort to help
increase an organization's revenue/profit /margins.
Answer: -Health plan consolidation
-Payment policing and standardization of contract requirements
-Shift in volume and cost risk to hospitals
-Contract performance modeling
SCRIPT 2026 FULL QUESTIONS AND
ANSWERS
◉ How is the term carve-out used when discussing managed care?
Answer: To refer to specific benefits or services
◉ What is the term Coordination of Benefits (COB)?
Answer: A term used to describe how payment is coordinated for
patients who have coverage through two insurance policies
◉ Which three components are used to determine the total RVU
value for a service?
Answer: -Malpractice expense
-Lowest market price for services used
-Medicare discounts
◉ A fixed payment amount based upon the number of members
assigned to a provider, and does not vary based upon the number of
services rendered, is known as:
Answer: Capitation
, ◉ Aligning incentives has come to mean _________.
Answer: The appropriate addition of some risk in the exchange of
health care to a patient for some form of remuneration.
◉ According to MedPAC, which option is a benefit or undesirable
consequence of bundling
payments?
Answer: -It allows Medicare to pay a set fee per hospitalization
episode.
-It would provide the potential to improve efficiency and quality
-It would lead to underutilization of services
◉ As the healthcare industry moves to control growth in medical
spending, what initiative can help hospitals maintain their margins?
Answer: Contract standardization
◉ Identify which initiatives are focused on in an effort to help
increase an organization's revenue/profit /margins.
Answer: -Health plan consolidation
-Payment policing and standardization of contract requirements
-Shift in volume and cost risk to hospitals
-Contract performance modeling
