1|Page
CSPR CERTIFIED SPECIALIST PAYMENT REP HFMA ACTUAL EXAM LATEST
2025 ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (100% VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
Which of the following is a trend in payment for healthcare
services?
A) Bundled payment
B) Cost-based payments
C) Care coordination
D) Capitation - ANSWER-A) Bundled payment
Integrated healthcare delivery systems are most capable of
successfully managing which type of payer agreement?
A) Monthly management fee
B) Specialist fee for service
C) Hospital fee for service
D) Global capitation - ANSWER-D) Global capitation
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A clean claim is:
A) A properly completed billing form, ICD-10 or CPT-4
B) A properly completed billing form, UB-04 or CMS 1500
C) A properly completed billing form, CMS 1500
D) A properly completed billing form, ICD-10 or CMS 1500 -
ANSWER-B) A properly completed billing form, UB-04 or CMS
1500
To ensure that patients have the education, tools, and support
they need to make decisions and participate in their own care is
the goal of:
A) The Patient Protection and Affordable Care Act (PPACA)
B) A patient-centered medical home (PCMH)
C) Accountable care organizations (ACO's)
D) Managed care organizations (MCO's) - ANSWER-B) A patient-
centered medical home (PCMH)
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Accountable Care Organizations are designed with the following
criteria:
A) To make providers independent of each other
B) To provide no financial incentives for provider cooperation
C) To save money by avoiding unnecessary tests
D) To increase the use of emergency room services - ANSWER-
C) To save money by avoiding unnecessary tests
Prospective performance and Retrospective performances are
considered:
A) Private health plans
B) Contract performance models
C) Rating tiers
D) Consumer Directed Health Plans (CDHP) - ANSWER-B)
Contract performance models
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Reporting initiative including: Required Nation Performance
Measurement, Voluntary National Performance Measurement,
and Employer Coalition Performance Measure, are all:
A) Group advocacy goals intended to reduced consumer
spending
B) Consumer advocacy and healthcare value efforts
C) Healthcare report cards available to the public
D) Reports that contain public information regarding all healthcare
issues - ANSWER-C) Healthcare report cards available to the
public
Identify which option is NOT a payment type that comprises a
large percentage of Medicare expenditures.
A) Inpatient prospective Payment Systems
B) Outpatient Prospective Payment System
C) Medicare payments to physicians
D) MS-DRG payment - ANSWER-C) Medicare payments to
physicians
CSPR CERTIFIED SPECIALIST PAYMENT REP HFMA ACTUAL EXAM LATEST
2025 ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (100% VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
Which of the following is a trend in payment for healthcare
services?
A) Bundled payment
B) Cost-based payments
C) Care coordination
D) Capitation - ANSWER-A) Bundled payment
Integrated healthcare delivery systems are most capable of
successfully managing which type of payer agreement?
A) Monthly management fee
B) Specialist fee for service
C) Hospital fee for service
D) Global capitation - ANSWER-D) Global capitation
,2|Page
A clean claim is:
A) A properly completed billing form, ICD-10 or CPT-4
B) A properly completed billing form, UB-04 or CMS 1500
C) A properly completed billing form, CMS 1500
D) A properly completed billing form, ICD-10 or CMS 1500 -
ANSWER-B) A properly completed billing form, UB-04 or CMS
1500
To ensure that patients have the education, tools, and support
they need to make decisions and participate in their own care is
the goal of:
A) The Patient Protection and Affordable Care Act (PPACA)
B) A patient-centered medical home (PCMH)
C) Accountable care organizations (ACO's)
D) Managed care organizations (MCO's) - ANSWER-B) A patient-
centered medical home (PCMH)
,3|Page
Accountable Care Organizations are designed with the following
criteria:
A) To make providers independent of each other
B) To provide no financial incentives for provider cooperation
C) To save money by avoiding unnecessary tests
D) To increase the use of emergency room services - ANSWER-
C) To save money by avoiding unnecessary tests
Prospective performance and Retrospective performances are
considered:
A) Private health plans
B) Contract performance models
C) Rating tiers
D) Consumer Directed Health Plans (CDHP) - ANSWER-B)
Contract performance models
, 4|Page
Reporting initiative including: Required Nation Performance
Measurement, Voluntary National Performance Measurement,
and Employer Coalition Performance Measure, are all:
A) Group advocacy goals intended to reduced consumer
spending
B) Consumer advocacy and healthcare value efforts
C) Healthcare report cards available to the public
D) Reports that contain public information regarding all healthcare
issues - ANSWER-C) Healthcare report cards available to the
public
Identify which option is NOT a payment type that comprises a
large percentage of Medicare expenditures.
A) Inpatient prospective Payment Systems
B) Outpatient Prospective Payment System
C) Medicare payments to physicians
D) MS-DRG payment - ANSWER-C) Medicare payments to
physicians
