Healthcare Financial Management Association
HFMA
HFMA Certified Specialist Payment & Reimbursement (CSPR)
HFMA CSPR Online Module Assessments and HFMA CSPR
Certification Exam
Course Title and Number: HFMA CSPR Certification Exams
Exam Title: Midterm, Finals, Certification and Assessment
Exam Date: Exam 2025- 2026
Instructor: ____ [Insert Instructor’s Name] _______
Student Name: ___ [Insert Student’s Name] _____
Student ID: ____ [Insert Student ID] _____________
Examination
Time: - ____ Hours: ___ Minutes
Instructions:
1. Read each question carefully and Answer All Questions
2. Use the provided answer sheet to mark your responses.
3. Please Ensure all you answer each question below and click Submit
when you have completed the Exam.
4. This test has a time limit, The test will save and submit automatically
when the time expires
5. This is Exam which will assess your knowledge on the course
Learning Resources.
Good Luck……...!
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HFMA CSPR Certification Final Exam Review HFMA Certified
Specialist Payment & Reimbursement (CSPR) Exam Questions
and Answers | 100% Pass Guaranteed | Graded A+ |
2025- 2026
HFMA CSPR Online Module Assessments and HFMA CSPR
Certification Exam
HFMA Certified Specialist Payment & Reimbursement (CSPR)
Healthcare Financial Management Association HFMA.
Read All Instructions Carefully and Answer All the
Questions Correctly Good Luck: -
Which of the following statements regarding employer-based
health insurance in the United States is true? - =Answer>>
The real advent of employer-based insurance came through
Blue Cross, which was started by hospital associations during
the Depression.
The Health Maintenance Organization (HMO) Act of 1973 gave
qualified HMOs the right to "mandate" an employer under
certain conditions, meaning employers: - =Answer>> Would
have to offer HMO plans along side traditional fee-for-service
medical plans.
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Which of the following is an anticipated change in the
relationships between consumers and providers? -
=Answer>> Providers will face many new service demands
and consumers will have virtually unfettered access to those
services
What transition began as a result of the March 2010 healthcare
reform legislation? - =Answer>> A transition toward new
models of health care delivery with corresponding changes
system financing and provider reimbursement.
Which statement is false concerning ABNs? - =Answer>>
ABN began establishing new requirements for managed care
plans participating in the Medicare program.
Which Statement is TRUE concerning ABNs? - =Answer>> -
ABNs are not required for services that are never covered by
Medicare.
-An ABN form notifies the patient before he or she receives the
service that it may not be
covered by Medicare and that he or she will need to pay out of
pocket.
-Although ABNs can have significant financial implications for
the physician, they also
serve an important fraud and abuse compliance function.
What is the overall function of Medicaid? - =Answer>> The
pay for medical assistance for certain individuals and low-
income families
Medical Cost Ratio (MCR) or Medical Loss Ratio (MLR) is defined
as: - =Answer>> Total Medical Expenses divided by Total
Premiums
Provider service organizations (PSOs) function like health
maintenance organizations (HMOs) in all of the following ways,
EXCEPT: - =Answer>> Ties to the healthcare delivery
industry rather than the insurance industry
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Provider service organizations (PSOs) function like health
maintenance organizations (HMOs) in all of the following ways:
- =Answer>> -Risk pooling
-Capitalization
-Network management
Which of the following is a service provided by a well-managed
third-party administrator (TPA)? - =Answer>> -
Administrative
-Utilization review (UR)
-Claims processing
What is tiering? - =Answer>> The ranking or classifying of
one or more of the provider delivery system components
Which option is a practice used to control costs of managed
care? - =Answer>> -Making advance payment to providers
for all services needed to care for a member
-Combining services provided and bundling the associated
charges
-Agreement between the payer and provider on reasonable
payment for each service.
Which option is a risk involved in per diem payments? -
=Answer>> -The risk to the insurance company or health
plan
-The risk to the hospital
-The risk when embracing per diem payments in complex case
Diagnosis-related group (DRG) is: - =Answer>> A payment
category
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
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HFMA
HFMA Certified Specialist Payment & Reimbursement (CSPR)
HFMA CSPR Online Module Assessments and HFMA CSPR
Certification Exam
Course Title and Number: HFMA CSPR Certification Exams
Exam Title: Midterm, Finals, Certification and Assessment
Exam Date: Exam 2025- 2026
Instructor: ____ [Insert Instructor’s Name] _______
Student Name: ___ [Insert Student’s Name] _____
Student ID: ____ [Insert Student ID] _____________
Examination
Time: - ____ Hours: ___ Minutes
Instructions:
1. Read each question carefully and Answer All Questions
2. Use the provided answer sheet to mark your responses.
3. Please Ensure all you answer each question below and click Submit
when you have completed the Exam.
4. This test has a time limit, The test will save and submit automatically
when the time expires
5. This is Exam which will assess your knowledge on the course
Learning Resources.
Good Luck……...!
📝
Are you Struggling with University Exams or Job Certification
Assessments?? 📌I Got You Covered 💯.!!!
✍I Specialize in Taking the Exam On your Behalf.
💻 Get Professional Exam Assistance with 100% Pass
Guaranteed.⏬ GET STARTED HERE CLICK LINK BELOW ⏬
https://yourassignmenthandlers.ck.page/92498b9b86
, I can Help BYPASS PROCTORED EXAM 📑
📱Hit Me UP__ Inbox Open 24/7 – 365 …...!!!!
💬 Chat with us here: 📧
Click Here To <<ORDER NOW >> Follow Link
https://yourassignmenthandlers.kit.com/93b2309b47
!!!.ORDER NOW.!!! << TO GET INSTANT EXPERT HELP >> !!!.ORDER
NOW.!!!
HFMA CSPR Certification Final Exam Review HFMA Certified
Specialist Payment & Reimbursement (CSPR) Exam Questions
and Answers | 100% Pass Guaranteed | Graded A+ |
2025- 2026
HFMA CSPR Online Module Assessments and HFMA CSPR
Certification Exam
HFMA Certified Specialist Payment & Reimbursement (CSPR)
Healthcare Financial Management Association HFMA.
Read All Instructions Carefully and Answer All the
Questions Correctly Good Luck: -
Which of the following statements regarding employer-based
health insurance in the United States is true? - =Answer>>
The real advent of employer-based insurance came through
Blue Cross, which was started by hospital associations during
the Depression.
The Health Maintenance Organization (HMO) Act of 1973 gave
qualified HMOs the right to "mandate" an employer under
certain conditions, meaning employers: - =Answer>> Would
have to offer HMO plans along side traditional fee-for-service
medical plans.
Need Writing 📝Help? We've Got You Covered! ✍️
100% NO A I or Plagiarism Guaranteed🎯
💬 Chat with us here: 📧
, I can Help BYPASS PROCTORED EXAM 📑
📱Hit Me UP__ Inbox Open 24/7 – 365 …...!!!!
💬 Chat with us here: 📧
Which of the following is an anticipated change in the
relationships between consumers and providers? -
=Answer>> Providers will face many new service demands
and consumers will have virtually unfettered access to those
services
What transition began as a result of the March 2010 healthcare
reform legislation? - =Answer>> A transition toward new
models of health care delivery with corresponding changes
system financing and provider reimbursement.
Which statement is false concerning ABNs? - =Answer>>
ABN began establishing new requirements for managed care
plans participating in the Medicare program.
Which Statement is TRUE concerning ABNs? - =Answer>> -
ABNs are not required for services that are never covered by
Medicare.
-An ABN form notifies the patient before he or she receives the
service that it may not be
covered by Medicare and that he or she will need to pay out of
pocket.
-Although ABNs can have significant financial implications for
the physician, they also
serve an important fraud and abuse compliance function.
What is the overall function of Medicaid? - =Answer>> The
pay for medical assistance for certain individuals and low-
income families
Medical Cost Ratio (MCR) or Medical Loss Ratio (MLR) is defined
as: - =Answer>> Total Medical Expenses divided by Total
Premiums
Provider service organizations (PSOs) function like health
maintenance organizations (HMOs) in all of the following ways,
EXCEPT: - =Answer>> Ties to the healthcare delivery
industry rather than the insurance industry
Need Writing 📝Help? We've Got You Covered! ✍️
100% NO A I or Plagiarism Guaranteed🎯
💬 Chat with us here: 📧
, I can Help BYPASS PROCTORED EXAM 📑
📱Hit Me UP__ Inbox Open 24/7 – 365 …...!!!!
💬 Chat with us here: 📧
Provider service organizations (PSOs) function like health
maintenance organizations (HMOs) in all of the following ways:
- =Answer>> -Risk pooling
-Capitalization
-Network management
Which of the following is a service provided by a well-managed
third-party administrator (TPA)? - =Answer>> -
Administrative
-Utilization review (UR)
-Claims processing
What is tiering? - =Answer>> The ranking or classifying of
one or more of the provider delivery system components
Which option is a practice used to control costs of managed
care? - =Answer>> -Making advance payment to providers
for all services needed to care for a member
-Combining services provided and bundling the associated
charges
-Agreement between the payer and provider on reasonable
payment for each service.
Which option is a risk involved in per diem payments? -
=Answer>> -The risk to the insurance company or health
plan
-The risk to the hospital
-The risk when embracing per diem payments in complex case
Diagnosis-related group (DRG) is: - =Answer>> A payment
category
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
Need Writing 📝Help? We've Got You Covered! ✍️
100% NO A I or Plagiarism Guaranteed🎯
💬 Chat with us here: 📧
