CSPR Certification Pre-Test questions and
answers with solutions 2026-2027
Medical Cost Ratio(MCR)/Medical Loss Ratio(MLR) - correct answer-
Total Expenses divided by total premiums
PSOs differ from HMOs - correct answer-Delivery instead of insurance
Coinsurance refers to - correct answer-Provision to limit the amount of coverage, usually 80%
Process of tiering - correct answer-ranking of one or more delivery system components
Tired network - correct answer-Facilities and providers who control costs while providing efficient care
Used to control costs of manage care - correct answer-combining services and bundling charges
reasonable payment agreements between payer and provider
reimbursement based upon the discretion of the provider
Not a risk involved in per diem payments - correct answer-risk of internal efficinecy
aligning incentives - correct answer-
Addition of some risk in the exchange of health care and remuneration
Standard contracts - correct answer-can help facilites maintain thier margins
rating tiers - correct answer-different rates charged based upon the number and relationships
reinsurance - correct answer-Limits to insured's liability for catastrophic claims
answers with solutions 2026-2027
Medical Cost Ratio(MCR)/Medical Loss Ratio(MLR) - correct answer-
Total Expenses divided by total premiums
PSOs differ from HMOs - correct answer-Delivery instead of insurance
Coinsurance refers to - correct answer-Provision to limit the amount of coverage, usually 80%
Process of tiering - correct answer-ranking of one or more delivery system components
Tired network - correct answer-Facilities and providers who control costs while providing efficient care
Used to control costs of manage care - correct answer-combining services and bundling charges
reasonable payment agreements between payer and provider
reimbursement based upon the discretion of the provider
Not a risk involved in per diem payments - correct answer-risk of internal efficinecy
aligning incentives - correct answer-
Addition of some risk in the exchange of health care and remuneration
Standard contracts - correct answer-can help facilites maintain thier margins
rating tiers - correct answer-different rates charged based upon the number and relationships
reinsurance - correct answer-Limits to insured's liability for catastrophic claims
