HFMA CSPR EXAM QUESTIONS WITH
100% COMPLETE ANSWERS
Terms in this set (76) QUIZZES Verified Answers
1. The No Surprise Act was a product of: D) The Affordable Care Act
A) The Health Insurance Portability Act
B) The Consolidation Appropriations Act
C) The Treaty of Algeron
D) The Affordable Care Act
2. Which of the following is an advantage of direct D) Providers can work
contracting? directly with employers to
reduce the cost of providing
A) Providers do not have to adjudicate claims for insurance
payment
B) Employers can save the cost of working with an
insurance company
C) It allows the patients to have a choice of
, providers and physicians
D) Providers can work directly with employers to
reduce the cost of providing insurance
3. Accountable Care Organizations (ACOs) have all B) Financial incentive for
of the following characteristics EXCEPT: quantity of care
A) Patient centric care model
B) Financial incentive for quantity of care
C) Integrated care coordination
D) Electronic Medical Record System
4. The Emergency Treatment and Active Labor Act A) Life threatening
(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
5. STAR ratings are used to indicate the quality of: B) Medicare Advantage
health plan performance
A) Accountable Care Organizations performance
B) Medicare Advantage health plan performance
, C) Services provided by hospitals
D) Services provided by physicians
6. To evaluate an organization's compliance with the A) A comprehensive
CMS COP standards and other accreditation accreditation process
requirements, is the purpose of:
A) A comprehensive accreditation process
B) Recovery Audits
C) The American Osteopathic Association
D) A clean claim
7. What is tiering? D) The ranking or
classifying of one or more
A) Typically fixed dollar amounts paid by the of the provider delivery
insured directly to the practitioner per episode of system components to
care influence choice
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
8. Which piece of information is NOT necessary for B) Family medical history
claims processing?
A) Provider or referring provider identification
B) Family medical history
C) Type of service
D) Procedure code
9. Which option is NOT true concerning the A) COBRA beneficiaries
Consolidated Omnibus Budget Reconciliation ACT generally are eligible for
(COBRA)? group coverage during a
maximum of 48 months for
A) COBRA beneficiaries generally are eligible for qualifying events
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,
100% COMPLETE ANSWERS
Terms in this set (76) QUIZZES Verified Answers
1. The No Surprise Act was a product of: D) The Affordable Care Act
A) The Health Insurance Portability Act
B) The Consolidation Appropriations Act
C) The Treaty of Algeron
D) The Affordable Care Act
2. Which of the following is an advantage of direct D) Providers can work
contracting? directly with employers to
reduce the cost of providing
A) Providers do not have to adjudicate claims for insurance
payment
B) Employers can save the cost of working with an
insurance company
C) It allows the patients to have a choice of
, providers and physicians
D) Providers can work directly with employers to
reduce the cost of providing insurance
3. Accountable Care Organizations (ACOs) have all B) Financial incentive for
of the following characteristics EXCEPT: quantity of care
A) Patient centric care model
B) Financial incentive for quantity of care
C) Integrated care coordination
D) Electronic Medical Record System
4. The Emergency Treatment and Active Labor Act A) Life threatening
(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
5. STAR ratings are used to indicate the quality of: B) Medicare Advantage
health plan performance
A) Accountable Care Organizations performance
B) Medicare Advantage health plan performance
, C) Services provided by hospitals
D) Services provided by physicians
6. To evaluate an organization's compliance with the A) A comprehensive
CMS COP standards and other accreditation accreditation process
requirements, is the purpose of:
A) A comprehensive accreditation process
B) Recovery Audits
C) The American Osteopathic Association
D) A clean claim
7. What is tiering? D) The ranking or
classifying of one or more
A) Typically fixed dollar amounts paid by the of the provider delivery
insured directly to the practitioner per episode of system components to
care influence choice
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
8. Which piece of information is NOT necessary for B) Family medical history
claims processing?
A) Provider or referring provider identification
B) Family medical history
C) Type of service
D) Procedure code
9. Which option is NOT true concerning the A) COBRA beneficiaries
Consolidated Omnibus Budget Reconciliation ACT generally are eligible for
(COBRA)? group coverage during a
maximum of 48 months for
A) COBRA beneficiaries generally are eligible for qualifying events
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,
