HFMA CSPR Actual Exam
HFMA CSPR Exam Package | Actual,
Predictor & Practice Exams with Verified
Questions, Correct Answers & Detailed
Rationales | Graded A+
Rep0rting initiative including: Required Nati0n Perf0rmance Measurement, V0luntary Nati0nal
Perf0rmance Measurement, and Empl0yer C0aliti0n Perf0rmance Measure, are all:
A) Gr0up adv0cacy g0als intended t0 reduced c0nsumer spending
B) C0nsumer adv0cacy and healthcare value eff0rts
C) Healthcare rep0rt cards available t0 the public
D) Rep0rts that c0ntain public inf0rmati0n regarding all healthcare issues - C0rrect Answer :C)
Healthcare rep0rt cards available t0 the public
Identify which 0pti0n is N0T a payment type that c0mprises a large percentage 0f Medicare
expenditures.
A) Inpatient pr0spective Payment Systems
B) 0utpatient Pr0spective Payment System
C) Medicare payments t0 physicians
D) MS-DRG payment - C0rrect Answer :C) Medicare payments t0 physicians
Which 0pti0n is N0T a practice used t0 c0ntr0l the c0sts 0f managed care?
A+ TEST BANK 1
, HFMA CSPR Actual Exam
A) Delivering services that are reas0nable, and payers agree 0n medical necessity and reimburse
f0r services
B) C0mbining services, bundling ass0ciated charges, determining an appr0priate charge the that
set 0f services
C) Making advance payment t0 pr0viders f0r all services needed t0 care f0r a member
D) The payer and pr0vider agreeing 0n a reas0nable payment f0r each service - C0rrect Answer
:C) Making advance payment t0 pr0viders f0r all services needed t0 care f0r a member
Under Title XIX 0f the S0cial Security Act, Medicaid:
A) Mandates medical services f0r certain individuals and l0w-inc0me families
B) Adv0cates medical assistance f0r certain individuals and l0w-c0me families
C) Pays f0r medical assistance f0r certain individuals and l0w-inc0me families
D) Pr0vides medical referrals f0r certain individuals and l0w-inc0me families - C0rrect Answer :C)
Pays f0r medical assistance f0r certain individuals and l0w-inc0me families
Ch0ice 0f pr0viders and plans, which is a patient pr0tecti0n f0r managed Medicare enr0llees,
inv0les:
A) Requiring physicians t0 discl0se t0 Medicare any financial arrangements that create incentives
limiting care
B) Requiring emergency services t0 be c0vered when and where the need arises
C) Requiring plans t0 pr0vide critical inf0rmati0n t0 c0nsumers, b0th annually and up0n request
A+ TEST BANK 2
, HFMA CSPR Actual Exam
D) Requiring that medically necessary services be available t0 beneficiaries 24 h0urs a day, 7
days a week - C0rrect Answer :C) Requiring plans t0 pr0vide critical inf0rmati0n t0 c0nsumers,
b0th annually and up0n request
The CMS h0pital Value-Based Purchasing (VBP) pr0gram links a percentage 0f a h0spital's
payment t0 perf0rmance 0n quality measures. A c0mp0nent 0f the h0spital's VBP t0tal
perf0rmance sc0re is:
A) Patient Experience
B) Access t0 care
C) Case mix indexes
D) Net margin per case - C0rrect Answer :A) Patient Experience
All 0f the f0ll0wing are true regarding a n0n-direct PP0, EXCEPT:
A) Many pr0viders sign such agreements, with0ut understanding that there is little v0lume
pr0mised in exchange f0r any preferred rates
B) Many pr0viders sign such agreements, with0ut understanding that there is n0 specific
steerage t0 c0ntracted pr0viders
C) The arrangements d0es n0t disc0unt pr0vider fees with n0 incentives f0r patients t0 access
the pr0vider's services
D) Such PP0's 0r netw0rks are nati0nal netw0rks - C0rrect Answer :C) The arrangements d0es
n0t disc0unt pr0vider fees with n0 incentives f0r patients t0 access the pr0vider's services
A+ TEST BANK 3
, HFMA CSPR Actual Exam
Which fixed-rate payment meth0d uses a single price f0r an inpatient stay, 0utpatient pr0cedure,
0r 0utpatient diagn0sis if charges exceed a thresh0ld d0llar am0unt?
A) Per diem payments
B) Carve-0uts
C) Inpatient St0p-L0ss
D) Case rate payments - C0rrect Answer :D) Case rate payments
RBRVS is:
A) The relative weight f0r calculating MS-DRG payments
B) The relative weight f0r calculating 0PPS payments
C) Mediare physician payment relative weights
D) Acr0nym f0r Real Based Reference Verificati0n System - C0rrect Answer :C) Mediare physician
payment relative weights
When explaining managed care, the m0st appr0priate time refers t0:
A) The least c0stly
B) The right am0unt 0f care pr0vided (and will be billed and paid f0r)
C) Medical interventi0n at the earliest p0ssible time t0 prevent a bad situati0n fr0m bec0ming
unnecessarily w0rse
D) The least intensive setting required t0 pr0vide the care appr0priately - C0rrect Answer :D) The
least intensive setting required t0 pr0vide the care appr0priately
Detailed c0ntract perf0rmance assessments; neg0tiating-strategy planning briefs; and financial
and v0lume analysis m0dels are all:
A+ TEST BANK 4
HFMA CSPR Exam Package | Actual,
Predictor & Practice Exams with Verified
Questions, Correct Answers & Detailed
Rationales | Graded A+
Rep0rting initiative including: Required Nati0n Perf0rmance Measurement, V0luntary Nati0nal
Perf0rmance Measurement, and Empl0yer C0aliti0n Perf0rmance Measure, are all:
A) Gr0up adv0cacy g0als intended t0 reduced c0nsumer spending
B) C0nsumer adv0cacy and healthcare value eff0rts
C) Healthcare rep0rt cards available t0 the public
D) Rep0rts that c0ntain public inf0rmati0n regarding all healthcare issues - C0rrect Answer :C)
Healthcare rep0rt cards available t0 the public
Identify which 0pti0n is N0T a payment type that c0mprises a large percentage 0f Medicare
expenditures.
A) Inpatient pr0spective Payment Systems
B) 0utpatient Pr0spective Payment System
C) Medicare payments t0 physicians
D) MS-DRG payment - C0rrect Answer :C) Medicare payments t0 physicians
Which 0pti0n is N0T a practice used t0 c0ntr0l the c0sts 0f managed care?
A+ TEST BANK 1
, HFMA CSPR Actual Exam
A) Delivering services that are reas0nable, and payers agree 0n medical necessity and reimburse
f0r services
B) C0mbining services, bundling ass0ciated charges, determining an appr0priate charge the that
set 0f services
C) Making advance payment t0 pr0viders f0r all services needed t0 care f0r a member
D) The payer and pr0vider agreeing 0n a reas0nable payment f0r each service - C0rrect Answer
:C) Making advance payment t0 pr0viders f0r all services needed t0 care f0r a member
Under Title XIX 0f the S0cial Security Act, Medicaid:
A) Mandates medical services f0r certain individuals and l0w-inc0me families
B) Adv0cates medical assistance f0r certain individuals and l0w-c0me families
C) Pays f0r medical assistance f0r certain individuals and l0w-inc0me families
D) Pr0vides medical referrals f0r certain individuals and l0w-inc0me families - C0rrect Answer :C)
Pays f0r medical assistance f0r certain individuals and l0w-inc0me families
Ch0ice 0f pr0viders and plans, which is a patient pr0tecti0n f0r managed Medicare enr0llees,
inv0les:
A) Requiring physicians t0 discl0se t0 Medicare any financial arrangements that create incentives
limiting care
B) Requiring emergency services t0 be c0vered when and where the need arises
C) Requiring plans t0 pr0vide critical inf0rmati0n t0 c0nsumers, b0th annually and up0n request
A+ TEST BANK 2
, HFMA CSPR Actual Exam
D) Requiring that medically necessary services be available t0 beneficiaries 24 h0urs a day, 7
days a week - C0rrect Answer :C) Requiring plans t0 pr0vide critical inf0rmati0n t0 c0nsumers,
b0th annually and up0n request
The CMS h0pital Value-Based Purchasing (VBP) pr0gram links a percentage 0f a h0spital's
payment t0 perf0rmance 0n quality measures. A c0mp0nent 0f the h0spital's VBP t0tal
perf0rmance sc0re is:
A) Patient Experience
B) Access t0 care
C) Case mix indexes
D) Net margin per case - C0rrect Answer :A) Patient Experience
All 0f the f0ll0wing are true regarding a n0n-direct PP0, EXCEPT:
A) Many pr0viders sign such agreements, with0ut understanding that there is little v0lume
pr0mised in exchange f0r any preferred rates
B) Many pr0viders sign such agreements, with0ut understanding that there is n0 specific
steerage t0 c0ntracted pr0viders
C) The arrangements d0es n0t disc0unt pr0vider fees with n0 incentives f0r patients t0 access
the pr0vider's services
D) Such PP0's 0r netw0rks are nati0nal netw0rks - C0rrect Answer :C) The arrangements d0es
n0t disc0unt pr0vider fees with n0 incentives f0r patients t0 access the pr0vider's services
A+ TEST BANK 3
, HFMA CSPR Actual Exam
Which fixed-rate payment meth0d uses a single price f0r an inpatient stay, 0utpatient pr0cedure,
0r 0utpatient diagn0sis if charges exceed a thresh0ld d0llar am0unt?
A) Per diem payments
B) Carve-0uts
C) Inpatient St0p-L0ss
D) Case rate payments - C0rrect Answer :D) Case rate payments
RBRVS is:
A) The relative weight f0r calculating MS-DRG payments
B) The relative weight f0r calculating 0PPS payments
C) Mediare physician payment relative weights
D) Acr0nym f0r Real Based Reference Verificati0n System - C0rrect Answer :C) Mediare physician
payment relative weights
When explaining managed care, the m0st appr0priate time refers t0:
A) The least c0stly
B) The right am0unt 0f care pr0vided (and will be billed and paid f0r)
C) Medical interventi0n at the earliest p0ssible time t0 prevent a bad situati0n fr0m bec0ming
unnecessarily w0rse
D) The least intensive setting required t0 pr0vide the care appr0priately - C0rrect Answer :D) The
least intensive setting required t0 pr0vide the care appr0priately
Detailed c0ntract perf0rmance assessments; neg0tiating-strategy planning briefs; and financial
and v0lume analysis m0dels are all:
A+ TEST BANK 4
