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HFMA CSPR Exam 2025 — Certified Specialist in Patient
Revenue Study Guide & Practice Test
Prepare for the HFMA CSPR Exam 2025 with a complete study guide, practice questions,
and exam review materials. Master essential patient revenue cycle management, healthcare
finance principles, billing and coding compliance, reimbursement strategies, and financial
operations to pass your Certified Specialist in Patient Revenue exam and advance your
healthcare finance career.
• HFMA CSPR exam 2025
• Certified Specialist in Patient Revenue study guide
• HFMA CSPR practice test question
The CMS hopital Value-Based Purchasing (VBP) program links a percentage of a hospital's payment to
performance on quality measures. A component of the hospital's VBP total performance score is:
A) Patient Experience
B) Access to care
C) Case mix indexes
D) Net margin per case - ANSWER-A) Patient Experience
All of the following are true regarding a non-direct PPO, EXCEPT:
A) Many providers sign such agreements, without understanding that there is little volume promised in
exchange for any preferred rates
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B) Many providers sign such agreements, without understanding that there is no specific steerage to
contracted providers
C) The arrangements does not discount provider fees with no incentives for patients to access the
provider's services
D) Such PPO's or networks are national networks - ANSWER-C) The arrangements does not discount
provider fees with no incentives for patients to access the provider's services
Which fixed-rate payment method uses a single price for an inpatient stay, outpatient procedure, or
outpatient diagnosis if charges exceed a threshold dollar amount?
A) Per diem payments
B) Carve-outs
C) Inpatient Stop-Loss
D) Case rate payments - ANSWER-D) Case rate payments
RBRVS is:
A) The relative weight for calculating MS-DRG payments
B) The relative weight for calculating OPPS payments
C) Mediare physician payment relative weights
D) Acronym for Real Based Reference Verification System - ANSWER-C) Mediare physician payment
relative weights
Identify which option is NOT a payment type that comprises a large percentage of Medicare
expenditures.
A) Inpatient prospective Payment Systems
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B) Outpatient Prospective Payment System
C) Medicare payments to physicians
D) MS-DRG payment - ANSWER-C) Medicare payments to physicians
Which option is NOT a practice used to control the costs of managed care?
A) Delivering services that are reasonable, and payers agree on medical necessity and reimburse for
services
B) Combining services, bundling associated charges, determining an appropriate charge the that set of
services
C) Making advance payment to providers for all services needed to care for a member
D) The payer and provider agreeing on a reasonable payment for each service - ANSWER-C) Making
advance payment to providers for all services needed to care for a member
Under Title XIX of the Social Security Act, Medicaid:
A) Mandates medical services for certain individuals and low-income families
B) Advocates medical assistance for certain individuals and low-come families
C) Pays for medical assistance for certain individuals and low-income families
D) Provides medical referrals for certain individuals and low-income families - ANSWER-C) Pays for
medical assistance for certain individuals and low-income families
Choice of providers and plans, which is a patient protection for managed Medicare enrollees, involes:
A) Requiring physicians to disclose to Medicare any financial arrangements that create incentives limiting
care
HFMA CSPR Exam 2025 — Certified Specialist in Patient
Revenue Study Guide & Practice Test
Prepare for the HFMA CSPR Exam 2025 with a complete study guide, practice questions,
and exam review materials. Master essential patient revenue cycle management, healthcare
finance principles, billing and coding compliance, reimbursement strategies, and financial
operations to pass your Certified Specialist in Patient Revenue exam and advance your
healthcare finance career.
• HFMA CSPR exam 2025
• Certified Specialist in Patient Revenue study guide
• HFMA CSPR practice test question
The CMS hopital Value-Based Purchasing (VBP) program links a percentage of a hospital's payment to
performance on quality measures. A component of the hospital's VBP total performance score is:
A) Patient Experience
B) Access to care
C) Case mix indexes
D) Net margin per case - ANSWER-A) Patient Experience
All of the following are true regarding a non-direct PPO, EXCEPT:
A) Many providers sign such agreements, without understanding that there is little volume promised in
exchange for any preferred rates
,2|Page
B) Many providers sign such agreements, without understanding that there is no specific steerage to
contracted providers
C) The arrangements does not discount provider fees with no incentives for patients to access the
provider's services
D) Such PPO's or networks are national networks - ANSWER-C) The arrangements does not discount
provider fees with no incentives for patients to access the provider's services
Which fixed-rate payment method uses a single price for an inpatient stay, outpatient procedure, or
outpatient diagnosis if charges exceed a threshold dollar amount?
A) Per diem payments
B) Carve-outs
C) Inpatient Stop-Loss
D) Case rate payments - ANSWER-D) Case rate payments
RBRVS is:
A) The relative weight for calculating MS-DRG payments
B) The relative weight for calculating OPPS payments
C) Mediare physician payment relative weights
D) Acronym for Real Based Reference Verification System - ANSWER-C) Mediare physician payment
relative weights
Identify which option is NOT a payment type that comprises a large percentage of Medicare
expenditures.
A) Inpatient prospective Payment Systems
, 3|Page
B) Outpatient Prospective Payment System
C) Medicare payments to physicians
D) MS-DRG payment - ANSWER-C) Medicare payments to physicians
Which option is NOT a practice used to control the costs of managed care?
A) Delivering services that are reasonable, and payers agree on medical necessity and reimburse for
services
B) Combining services, bundling associated charges, determining an appropriate charge the that set of
services
C) Making advance payment to providers for all services needed to care for a member
D) The payer and provider agreeing on a reasonable payment for each service - ANSWER-C) Making
advance payment to providers for all services needed to care for a member
Under Title XIX of the Social Security Act, Medicaid:
A) Mandates medical services for certain individuals and low-income families
B) Advocates medical assistance for certain individuals and low-come families
C) Pays for medical assistance for certain individuals and low-income families
D) Provides medical referrals for certain individuals and low-income families - ANSWER-C) Pays for
medical assistance for certain individuals and low-income families
Choice of providers and plans, which is a patient protection for managed Medicare enrollees, involes:
A) Requiring physicians to disclose to Medicare any financial arrangements that create incentives limiting
care
