1|Page
HFMA CSPR EXAM NEWEST 2025/2026 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED||
Which piece of information is NOT necessary for claims
processing?
A) Provider or referring provider identification
B) Family medical history
C) Type of service
D) Procedure code - ANSWER-B) Family medical history
Which option is NOT true concerning the Consolidated Omnibus
Budget Reconciliation ACT (COBRA)?
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
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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 - ANSWER-
A) COBRA beneficiaries generally are eligible for group coverage
during a maximum of 48 months for qualifying events
Which of the following is a managed care trend that can reduce
utilization and costs because patients pay higher out-of-pockeet
amounts?
A) Requirements for participation in Medicare managed care
plans
B) Growth in high-deductible health plans with a Health Savings
(HSA) option
C) Growth in participation in Medicaid managed care plans
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D) Growth in participation in Medicare managed care plans -
ANSWER-B) Growth in high-deductible health plans with a Health
Savings (HSA) option
A Medicare Advanced Beneficiary Notice (ABN) provides the
following:
A) Notifies member of alternative covered services
B) Notifies member of a non-authorized procedure
C) Notifies member of non-covered service
D) Notifies member of guaranteed payment - ANSWER-C)
Notifies member of non-covered service
The appropriate addition of some risk in the exchange of health
care to a patient for some form of remuneration, is also known as:
A) Diagnosis-related groups (DRG's)
B) Per diems
C) Fee-for-Service reimbursement
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D) Aligning incentives - ANSWER-B) Per diems
The federal government pays a share of the medical assistance
expenditures under each state's Medicaid program. How is that
share, known as the federal medical assistance percentage
(FMAP), determined?
A) None of the above
B) By using a formula that compares the states average per
capita income level with the national income average
C) By ranking states according to the percentage of residents at
the poverty level
D) By averaging the percentage paid in the five previous years -
ANSWER-B) By using a formula that compares the states
average per capita income level with the national income average
The different rates charged on the basis of the number and
relationships of the people covered under one employee's plan is
known as:
HFMA CSPR EXAM NEWEST 2025/2026 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED||
Which piece of information is NOT necessary for claims
processing?
A) Provider or referring provider identification
B) Family medical history
C) Type of service
D) Procedure code - ANSWER-B) Family medical history
Which option is NOT true concerning the Consolidated Omnibus
Budget Reconciliation ACT (COBRA)?
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
,2|Page
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 - ANSWER-
A) COBRA beneficiaries generally are eligible for group coverage
during a maximum of 48 months for qualifying events
Which of the following is a managed care trend that can reduce
utilization and costs because patients pay higher out-of-pockeet
amounts?
A) Requirements for participation in Medicare managed care
plans
B) Growth in high-deductible health plans with a Health Savings
(HSA) option
C) Growth in participation in Medicaid managed care plans
,3|Page
D) Growth in participation in Medicare managed care plans -
ANSWER-B) Growth in high-deductible health plans with a Health
Savings (HSA) option
A Medicare Advanced Beneficiary Notice (ABN) provides the
following:
A) Notifies member of alternative covered services
B) Notifies member of a non-authorized procedure
C) Notifies member of non-covered service
D) Notifies member of guaranteed payment - ANSWER-C)
Notifies member of non-covered service
The appropriate addition of some risk in the exchange of health
care to a patient for some form of remuneration, is also known as:
A) Diagnosis-related groups (DRG's)
B) Per diems
C) Fee-for-Service reimbursement
, 4|Page
D) Aligning incentives - ANSWER-B) Per diems
The federal government pays a share of the medical assistance
expenditures under each state's Medicaid program. How is that
share, known as the federal medical assistance percentage
(FMAP), determined?
A) None of the above
B) By using a formula that compares the states average per
capita income level with the national income average
C) By ranking states according to the percentage of residents at
the poverty level
D) By averaging the percentage paid in the five previous years -
ANSWER-B) By using a formula that compares the states
average per capita income level with the national income average
The different rates charged on the basis of the number and
relationships of the people covered under one employee's plan is
known as:
