1|Page
HFMA CSPR EXAM LATEST 2025/2026 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
Key differences to consider between inpatient and outpatient
services when contracting include all of the following EXCEPT:
A) Site of service differentials
B) Payment methodologies
C) Patient experience and satisfaction
D) Operational policies and processes - ANSWER-C) Patient
experience and satisfaction
Which of the following is not an example of an objective criteria
set that may be applied in utilization management?
A) InterQual
B) HEDIS
C) Milliman
D) NCQA - ANSWER-C) Milliman
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Which of the following is a trend in payment for healthcare
services?
A) Bundled payment
B) Cost-based payments
C) Care coordination
D) Capitation - ANSWER-A) Bundled payment
Integrated healthcare delivery systems are most capable of
successfully managing which type of payer agreement?
A) Monthly management fee
B) Specialist fee for service
C) Hospital fee for service
D) Global capitation - ANSWER-D) Global capitation
A clean claim is:
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A) A properly completed billing form, ICD-10 or CPT-4
B) A properly completed billing form, UB-04 or CMS 1500
C) A properly completed billing form, CMS 1500
D) A properly completed billing form, ICD-10 or CMS 1500 -
ANSWER-B) A properly completed billing form, UB-04 or CMS
1500
To ensure that patients have the education, tools, and support
they need to make decisions and participate in their own care is
the goal of:
A) The Patient Protection and Affordable Care Act (PPACA)
B) A patient-centered medical home (PCMH)
C) Accountable care organizations (ACO's)
D) Managed care organizations (MCO's) - ANSWER-B) A patient-
centered medical home (PCMH)
Accountable Care Organizations are designed with the following
criteria:
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A) To make providers independent of each other
B) To provide no financial incentives for provider cooperation
C) To save money by avoiding unnecessary tests
D) To increase the use of emergency room services - ANSWER-
C) To save money by avoiding unnecessary tests
Prospective performance and Retrospective performances are
considered:
A) Private health plans
B) Contract performance models
C) Rating tiers
D) Consumer Directed Health Plans (CDHP) - ANSWER-B)
Contract performance models
Reporting initiative including: Required Nation Performance
Measurement, Voluntary National Performance Measurement,
and Employer Coalition Performance Measure, are all:
HFMA CSPR EXAM LATEST 2025/2026 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
Key differences to consider between inpatient and outpatient
services when contracting include all of the following EXCEPT:
A) Site of service differentials
B) Payment methodologies
C) Patient experience and satisfaction
D) Operational policies and processes - ANSWER-C) Patient
experience and satisfaction
Which of the following is not an example of an objective criteria
set that may be applied in utilization management?
A) InterQual
B) HEDIS
C) Milliman
D) NCQA - ANSWER-C) Milliman
,2|Page
Which of the following is a trend in payment for healthcare
services?
A) Bundled payment
B) Cost-based payments
C) Care coordination
D) Capitation - ANSWER-A) Bundled payment
Integrated healthcare delivery systems are most capable of
successfully managing which type of payer agreement?
A) Monthly management fee
B) Specialist fee for service
C) Hospital fee for service
D) Global capitation - ANSWER-D) Global capitation
A clean claim is:
,3|Page
A) A properly completed billing form, ICD-10 or CPT-4
B) A properly completed billing form, UB-04 or CMS 1500
C) A properly completed billing form, CMS 1500
D) A properly completed billing form, ICD-10 or CMS 1500 -
ANSWER-B) A properly completed billing form, UB-04 or CMS
1500
To ensure that patients have the education, tools, and support
they need to make decisions and participate in their own care is
the goal of:
A) The Patient Protection and Affordable Care Act (PPACA)
B) A patient-centered medical home (PCMH)
C) Accountable care organizations (ACO's)
D) Managed care organizations (MCO's) - ANSWER-B) A patient-
centered medical home (PCMH)
Accountable Care Organizations are designed with the following
criteria:
, 4|Page
A) To make providers independent of each other
B) To provide no financial incentives for provider cooperation
C) To save money by avoiding unnecessary tests
D) To increase the use of emergency room services - ANSWER-
C) To save money by avoiding unnecessary tests
Prospective performance and Retrospective performances are
considered:
A) Private health plans
B) Contract performance models
C) Rating tiers
D) Consumer Directed Health Plans (CDHP) - ANSWER-B)
Contract performance models
Reporting initiative including: Required Nation Performance
Measurement, Voluntary National Performance Measurement,
and Employer Coalition Performance Measure, are all:
