HFMA Certified Healthcare Financial
Professional (CHFP) | 2025/2026 Edition |
Verified Exam Q&A
This document contains expertly verified exam questions and 100% correct answers for
the HFMA Certified Healthcare Financial Professional (CHFP) Examination, updated for
the 2025/2026 certification cycle. It covers core topics including healthcare finance,
revenue cycle management, budgeting, financial reporting, compliance, and strategic
planning. Designed to mirror the official exam format, this resource is ideal for
professionals seeking to achieve CHFP certification with confidence.
Through what document does a hospital establish compliance
standards? - ,,,answer,,,,..code of conduct
What is the purpose OIG work plant? - ,,,answer,,,,..Identify
Acceptable compliance programs in various provider setting
If a Medicare patient is admitted on Friday, what services fall
within the three-day DRG window rule? - ,,,answer,,,,..Non-
diagnostic service provided on Tuesday through Friday
What does a modifier allow a provider to do? - ,,,answer,,,,..Report
a specific circumstance that affected a procedure or service
without changing the code or its definition
IF outpatient diagnostic services are provided within three days of
the admission of a Medicare beneficiary to an IPPS (Inpatient
Prospective Payment System) hospital, what must happen to
these charges - ,,,answer,,,,..They must be billed separately to the
part B Carrier
,what is a recurring or series registration? - ,,,answer,,,,..One
registration record is created for multiple days of service
What are nonemergency patients who come for service without
prior notification to the provider called? - ,,,answer,,,,..Unscheduled
patients
Which of the following statement apply to the observation patient
type? - ,,,answer,,,,..It is used to evaluate the need for an inpatient
admission
which services are hospice programs required to provide around
the clock patient - ,,,answer,,,,..Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do
what? - ,,,answer,,,,..Complete the scheduling process correctly
based on service requeste
The Time needed to prepare the patient before service is the
difference between the patients arrival time and which of the
following? - ,,,answer,,,,..Procedure time
Medicare guidelines require that when a test is ordered for a LCD
or NCD exists, the information provided on the order must
include: - ,,,answer,,,,..Documentation of the medical necessity for
the test
What is the advantage of a pre-registration program -
,,,answer,,,,..It reduces processing times at the time of service
, What date are required to establish a new MPI(Master patient
Index) entry - ,,,answer,,,,..The responsible party's full legal name,
date of birth, and social security number
Which of the following statements is true about third-party
payments? - ,,,answer,,,,..The payments are received by the
provider from the payer responsible for reimbursing the provider
for the patient's covered services.
Which provision protects the patient from medical expenses that
exceed the pre-set level - ,,,answer,,,,..stop loss
what documentation must a primary care physician send to HMO
patient to authorize a visit to a specialist for additional testing or
care? - ,,,answer,,,,..Referral
Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance
information if it would delay what? - ,,,answer,,,,..Medical screening
and stabilizing treatment
Which of the following is a step in the discharge process? -
,,,answer,,,,..Have a case management service complete the
discharge plan
The hospital has a APC based contract for the payment of
outpatient services. Total anticipated charges for the visit are
$2,380. The approved APC payment rate is $780. Where will the
patients benefit package be applied? - ,,,answer,,,,..To the
approved APC payment rate
A patient has met the $200 individual deductible and $900 of the
$1000 co-insurance responsibility. The co-insurance rate is 20%.
The estimated insurance plan responsibility is $1975.00. What
Professional (CHFP) | 2025/2026 Edition |
Verified Exam Q&A
This document contains expertly verified exam questions and 100% correct answers for
the HFMA Certified Healthcare Financial Professional (CHFP) Examination, updated for
the 2025/2026 certification cycle. It covers core topics including healthcare finance,
revenue cycle management, budgeting, financial reporting, compliance, and strategic
planning. Designed to mirror the official exam format, this resource is ideal for
professionals seeking to achieve CHFP certification with confidence.
Through what document does a hospital establish compliance
standards? - ,,,answer,,,,..code of conduct
What is the purpose OIG work plant? - ,,,answer,,,,..Identify
Acceptable compliance programs in various provider setting
If a Medicare patient is admitted on Friday, what services fall
within the three-day DRG window rule? - ,,,answer,,,,..Non-
diagnostic service provided on Tuesday through Friday
What does a modifier allow a provider to do? - ,,,answer,,,,..Report
a specific circumstance that affected a procedure or service
without changing the code or its definition
IF outpatient diagnostic services are provided within three days of
the admission of a Medicare beneficiary to an IPPS (Inpatient
Prospective Payment System) hospital, what must happen to
these charges - ,,,answer,,,,..They must be billed separately to the
part B Carrier
,what is a recurring or series registration? - ,,,answer,,,,..One
registration record is created for multiple days of service
What are nonemergency patients who come for service without
prior notification to the provider called? - ,,,answer,,,,..Unscheduled
patients
Which of the following statement apply to the observation patient
type? - ,,,answer,,,,..It is used to evaluate the need for an inpatient
admission
which services are hospice programs required to provide around
the clock patient - ,,,answer,,,,..Physician, Nursing, Pharmacy
Scheduler instructions are used to prompt the scheduler to do
what? - ,,,answer,,,,..Complete the scheduling process correctly
based on service requeste
The Time needed to prepare the patient before service is the
difference between the patients arrival time and which of the
following? - ,,,answer,,,,..Procedure time
Medicare guidelines require that when a test is ordered for a LCD
or NCD exists, the information provided on the order must
include: - ,,,answer,,,,..Documentation of the medical necessity for
the test
What is the advantage of a pre-registration program -
,,,answer,,,,..It reduces processing times at the time of service
, What date are required to establish a new MPI(Master patient
Index) entry - ,,,answer,,,,..The responsible party's full legal name,
date of birth, and social security number
Which of the following statements is true about third-party
payments? - ,,,answer,,,,..The payments are received by the
provider from the payer responsible for reimbursing the provider
for the patient's covered services.
Which provision protects the patient from medical expenses that
exceed the pre-set level - ,,,answer,,,,..stop loss
what documentation must a primary care physician send to HMO
patient to authorize a visit to a specialist for additional testing or
care? - ,,,answer,,,,..Referral
Under EMTALA (Emergency Medical Treatment and Labor Act)
regulations, the provider may not ask about a patient's insurance
information if it would delay what? - ,,,answer,,,,..Medical screening
and stabilizing treatment
Which of the following is a step in the discharge process? -
,,,answer,,,,..Have a case management service complete the
discharge plan
The hospital has a APC based contract for the payment of
outpatient services. Total anticipated charges for the visit are
$2,380. The approved APC payment rate is $780. Where will the
patients benefit package be applied? - ,,,answer,,,,..To the
approved APC payment rate
A patient has met the $200 individual deductible and $900 of the
$1000 co-insurance responsibility. The co-insurance rate is 20%.
The estimated insurance plan responsibility is $1975.00. What
