HFMA CSPR EXAM WITH 76 QUESTIONS AND ANSWERS
RATED A+ 2025/2026 NEW!! 100% VERIFIED CORRECT
The No Surprise Act was a product of:
A) The Health Insurance Portability Act
B) The Consolida on Appropria ons Act
C) The Treaty of Algeron
D) The Affordable Care Act - Ans D) The Affordable Care Act
Which of the following is an advantage of direct contrac ng?
A) Providers do not have to adjudicate claims for payment
B) Employers can save the cost of working with an insurance company
C) It allows the pa ents to have a choice of providers and physicians
D) Providers can work directly with employers to reduce the cost of providing insurance - Ans
D) Providers can work directly with employers to reduce the cost of providing insurance
Accountable Care Organiza ons (ACOs) have all of the following characteris cs EXCEPT:
A) Pa ent centric care model
B) Financial incen ve for quan ty of care
C) Integrated care coordina on
D) Electronic Medical Record System - Ans B) Financial incen ve for quan ty of care
, The Emergency Treatment and Ac ve Labor Act (EMTALA) governs when a pa ent may be
transferred from one hospital to another when in a(n) condi on:
A) Life threatening
B) Non-emergency
C) Stable
D) Chronic - Ans A) Life threatening
STAR ra ngs are used to indicate the quality of:
A) Accountable Care Organiza ons performance
B) Medicare Advantage health plan performance
C) Services provided by hospitals
D) Services provided by physicians - Ans B) Medicare Advantage health plan performance
To evaluate an organiza on's compliance with the CMS COP standards and other accredita on
requirements, is the purpose of:
A) A comprehensive accredita on process
B) Recovery Audits
C) The American Osteopathic Associa on
D) A clean claim - Ans A) A comprehensive accredita on process
What is ering?
A) Typically fixed dollar amounts paid by the insured directly to the prac oner per episode of
care
, B) Healthcare coverage products 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 - Ans D) The ranking or classifying of one or more of the provider delivery
system components to influence choice
Which piece of informa on is NOT necessary for claims processing?
A) Provider or referring provider iden fica on
B) Family medical history
C) Type of service
D) Procedure code - Ans B) Family medical history
Which op on is NOT true concerning the Consolidated Omnibus Budget Reconcilia on ACT
(COBRA)?
A) COBRA beneficiaries generally 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
RATED A+ 2025/2026 NEW!! 100% VERIFIED CORRECT
The No Surprise Act was a product of:
A) The Health Insurance Portability Act
B) The Consolida on Appropria ons Act
C) The Treaty of Algeron
D) The Affordable Care Act - Ans D) The Affordable Care Act
Which of the following is an advantage of direct contrac ng?
A) Providers do not have to adjudicate claims for payment
B) Employers can save the cost of working with an insurance company
C) It allows the pa ents to have a choice of providers and physicians
D) Providers can work directly with employers to reduce the cost of providing insurance - Ans
D) Providers can work directly with employers to reduce the cost of providing insurance
Accountable Care Organiza ons (ACOs) have all of the following characteris cs EXCEPT:
A) Pa ent centric care model
B) Financial incen ve for quan ty of care
C) Integrated care coordina on
D) Electronic Medical Record System - Ans B) Financial incen ve for quan ty of care
, The Emergency Treatment and Ac ve Labor Act (EMTALA) governs when a pa ent may be
transferred from one hospital to another when in a(n) condi on:
A) Life threatening
B) Non-emergency
C) Stable
D) Chronic - Ans A) Life threatening
STAR ra ngs are used to indicate the quality of:
A) Accountable Care Organiza ons performance
B) Medicare Advantage health plan performance
C) Services provided by hospitals
D) Services provided by physicians - Ans B) Medicare Advantage health plan performance
To evaluate an organiza on's compliance with the CMS COP standards and other accredita on
requirements, is the purpose of:
A) A comprehensive accredita on process
B) Recovery Audits
C) The American Osteopathic Associa on
D) A clean claim - Ans A) A comprehensive accredita on process
What is ering?
A) Typically fixed dollar amounts paid by the insured directly to the prac oner per episode of
care
, B) Healthcare coverage products 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 - Ans D) The ranking or classifying of one or more of the provider delivery
system components to influence choice
Which piece of informa on is NOT necessary for claims processing?
A) Provider or referring provider iden fica on
B) Family medical history
C) Type of service
D) Procedure code - Ans B) Family medical history
Which op on is NOT true concerning the Consolidated Omnibus Budget Reconcilia on ACT
(COBRA)?
A) COBRA beneficiaries generally 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
