CSPR - Certified Specialist Payment Rep (HFMA) Exam 2025-
2026 Actual Complete Real Exam Questions And Correct
Answers (Verified Answers) Already Graded A+ / Newest
Exam / Just Released!!
Which of the following statements is true regarding The
Leapfrog Group? -
ANSWER-The Leapfrog Group was started in the late
1990s to engage
consumers and clinicians in the discussion to
improve care quality.
Which option is included in the set of new value propositions
and tools that emerged in the early 2000s? - ANSWER--Product
development focused on employee contribution strategies,
network access, and funding options. -Medical management
philosophies based on retrospective evaluation of care, rather
than prospective review and management.
-A proliferation of self-service technologies to reduce
administrative costs.
Identify which option(s) is a benefit for CDHP consumers. -
ANSWER-Coverage
-Choice
-Access
,Identify which options are a benefit for HSA consumers. -
ANSWER--It is transportable, allowing workers access from one
job to the next.
-Both employees and employers can contribute pretax dollars
to the qualified account.
-They are available to everyone, not just employees of small
businesses or the self- employed.
What is an ACO? - ANSWER-A system of providers and facilities
that can work
in concert to care for a given patient
population
What is the purpose of the comprehension accreditation
process? - ANSWER-
To evaluate an organization's compliance with the CMS COP
standards and
other accreditation
requirements
What was the aim of the HMO Act of 1973? - ANSWER-To
change the system
of health care
delivery.
To be eligible for COBRA coverage, an employee must have: -
ANSWER-Been
enrolled in an employer's health plan while working and the
health plan must
,continue to be in effect for active
employees.
What is the purpose of Consolidated Omnibus Budget
Reconciliation Act (COBRA) legislation? - ANSWER-To provide
continuation of group health coverage that otherwise might be
terminated
What is one purpose of the Emergency Medical Treatment and
Active Labor Act
(EMTALA)? - ANSWER-To govern when and how a patient
presenting at a
hospital may be refused
treatment
What is the purpose of the URAC? - ANSWER-To promote
healthcare quality
through accreditation and certification
programs
Which options are a focus of the HIPAA Title II series of laws? -
ANSWER--
Health care access, portability, and renewability
-To maintain the efficiency and effectiveness of the electronic
transmission of health information.
-Health care claim professional (837P), health care claim dental
(837D), and health care claim payment/advice (835)
, What was the expectation of the 2010 Patient Protection and
Affordable Care
Act (PPACA)? - ANSWER-To bring coverage to millions of
Americans who
could not or would not purchase health
insurance
What is Managed Care? - ANSWER-Managed care organizations
(MCO) exist primarily in four forms:
-Health Maintenance Organizations (HMO)
-Preferred Provider Organizations (PPO)
-Point of Service (POS) Organizations
-Exclusive Provider Organizations (EPO)
Which of the following is an anticipated change in the
relationships between
consumers and providers? - ANSWER-Providers will face
many new service
demands and consumers will have virtually unfettered access
to those services
What transition began as a result of the March 2010
healthcare reform
legislation? - ANSWER-A transition toward new models of
health care delivery
with corresponding changes system financing and provider
reimbursement.
2026 Actual Complete Real Exam Questions And Correct
Answers (Verified Answers) Already Graded A+ / Newest
Exam / Just Released!!
Which of the following statements is true regarding The
Leapfrog Group? -
ANSWER-The Leapfrog Group was started in the late
1990s to engage
consumers and clinicians in the discussion to
improve care quality.
Which option is included in the set of new value propositions
and tools that emerged in the early 2000s? - ANSWER--Product
development focused on employee contribution strategies,
network access, and funding options. -Medical management
philosophies based on retrospective evaluation of care, rather
than prospective review and management.
-A proliferation of self-service technologies to reduce
administrative costs.
Identify which option(s) is a benefit for CDHP consumers. -
ANSWER-Coverage
-Choice
-Access
,Identify which options are a benefit for HSA consumers. -
ANSWER--It is transportable, allowing workers access from one
job to the next.
-Both employees and employers can contribute pretax dollars
to the qualified account.
-They are available to everyone, not just employees of small
businesses or the self- employed.
What is an ACO? - ANSWER-A system of providers and facilities
that can work
in concert to care for a given patient
population
What is the purpose of the comprehension accreditation
process? - ANSWER-
To evaluate an organization's compliance with the CMS COP
standards and
other accreditation
requirements
What was the aim of the HMO Act of 1973? - ANSWER-To
change the system
of health care
delivery.
To be eligible for COBRA coverage, an employee must have: -
ANSWER-Been
enrolled in an employer's health plan while working and the
health plan must
,continue to be in effect for active
employees.
What is the purpose of Consolidated Omnibus Budget
Reconciliation Act (COBRA) legislation? - ANSWER-To provide
continuation of group health coverage that otherwise might be
terminated
What is one purpose of the Emergency Medical Treatment and
Active Labor Act
(EMTALA)? - ANSWER-To govern when and how a patient
presenting at a
hospital may be refused
treatment
What is the purpose of the URAC? - ANSWER-To promote
healthcare quality
through accreditation and certification
programs
Which options are a focus of the HIPAA Title II series of laws? -
ANSWER--
Health care access, portability, and renewability
-To maintain the efficiency and effectiveness of the electronic
transmission of health information.
-Health care claim professional (837P), health care claim dental
(837D), and health care claim payment/advice (835)
, What was the expectation of the 2010 Patient Protection and
Affordable Care
Act (PPACA)? - ANSWER-To bring coverage to millions of
Americans who
could not or would not purchase health
insurance
What is Managed Care? - ANSWER-Managed care organizations
(MCO) exist primarily in four forms:
-Health Maintenance Organizations (HMO)
-Preferred Provider Organizations (PPO)
-Point of Service (POS) Organizations
-Exclusive Provider Organizations (EPO)
Which of the following is an anticipated change in the
relationships between
consumers and providers? - ANSWER-Providers will face
many new service
demands and consumers will have virtually unfettered access
to those services
What transition began as a result of the March 2010
healthcare reform
legislation? - ANSWER-A transition toward new models of
health care delivery
with corresponding changes system financing and provider
reimbursement.
