HFMA CSPR Exam Questions and Answers
with Verified Solutions | Latest Updated 2026
The No Surprise Act was a D) The Affordable Care Act
product
of:
A) The Health Insurance
Portability
Act
B) The Consolidation
Appropriations
Act
C) The Treaty of Algeron
D) The Affordable Care Act
Accountable Care Organizations B) Financial incentive for quantity of care
(ACOs) have all of the following
characteristics EXCEPT:
A) Patient centric care model
B) Financial incentive for quantity
of
care
C) Integrated care coordination
D) Electronic Medical Record
System
,The Emergency Treatment and A) Life threatening
Active
Labor Act (EMTALA) governs
when a
patient may be transferred from
one
hospital to another when in a(n)
condition:
A) Life threatening
B) Non-emergency
C) Stable
D) Chronic
STAR ratings are used to indicate B) Medicare Advantage health plan
the performance
quality of:
A) Accountable Care
Organizations
performance
B) Medicare Advantage health
plan
performance
C) Services provided by hospitals
D) Services provided by
physicians
,To evaluate an organization's A) A comprehensive accreditation process
compliance with the CMS COP
standards and other accreditation
requirements, is the purpose of:
A) A comprehensive accreditation
process
B) Recovery Audits
C) The American Osteopathic
Association
D) A clean claim
What is tiering? D) The ranking or classifying of one or
A) Typically fixed dollar amounts more of the
paid by the insured directly to the provider delivery system components to
practitioner per episode of care influence
B) Healthcare coverage products choice
featuring narrow networks, high
cost
sharing and very low premiums
C) An effort by insurers to increase
premiums and to address calls
from
employers and the public for
improved quality
D) The ranking or classifying of
one
or more of the provider delivery
system components to influence
choice
, Which piece of information is NOT B) Family medical history
necessary for claims processing?
A) Provider or referring provider
identification
B) Family medical history
C) Type of service
D) Procedure code
Which option is NOT true A) COBRA beneficiaries generally are
concerning eligible for
the Consolidated Omnibus Budget group coverage during a maximum of 48
Reconciliation ACT (COBRA)? months
A) COBRA beneficiaries generally for qualifying events
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
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
with Verified Solutions | Latest Updated 2026
The No Surprise Act was a D) The Affordable Care Act
product
of:
A) The Health Insurance
Portability
Act
B) The Consolidation
Appropriations
Act
C) The Treaty of Algeron
D) The Affordable Care Act
Accountable Care Organizations B) Financial incentive for quantity of care
(ACOs) have all of the following
characteristics EXCEPT:
A) Patient centric care model
B) Financial incentive for quantity
of
care
C) Integrated care coordination
D) Electronic Medical Record
System
,The Emergency Treatment and A) Life threatening
Active
Labor Act (EMTALA) governs
when a
patient may be transferred from
one
hospital to another when in a(n)
condition:
A) Life threatening
B) Non-emergency
C) Stable
D) Chronic
STAR ratings are used to indicate B) Medicare Advantage health plan
the performance
quality of:
A) Accountable Care
Organizations
performance
B) Medicare Advantage health
plan
performance
C) Services provided by hospitals
D) Services provided by
physicians
,To evaluate an organization's A) A comprehensive accreditation process
compliance with the CMS COP
standards and other accreditation
requirements, is the purpose of:
A) A comprehensive accreditation
process
B) Recovery Audits
C) The American Osteopathic
Association
D) A clean claim
What is tiering? D) The ranking or classifying of one or
A) Typically fixed dollar amounts more of the
paid by the insured directly to the provider delivery system components to
practitioner per episode of care influence
B) Healthcare coverage products choice
featuring narrow networks, high
cost
sharing and very low premiums
C) An effort by insurers to increase
premiums and to address calls
from
employers and the public for
improved quality
D) The ranking or classifying of
one
or more of the provider delivery
system components to influence
choice
, Which piece of information is NOT B) Family medical history
necessary for claims processing?
A) Provider or referring provider
identification
B) Family medical history
C) Type of service
D) Procedure code
Which option is NOT true A) COBRA beneficiaries generally are
concerning eligible for
the Consolidated Omnibus Budget group coverage during a maximum of 48
Reconciliation ACT (COBRA)? months
A) COBRA beneficiaries generally for qualifying events
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
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
