HFMA CSPR LATEST
CERTIFICATION EXAM
ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
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 - ANSWERS-B) A
properly completed billing form, UB-04 or CMS 1500
QUESTION 2
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)
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PAGE
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, HFMA CSPR LATEST
CERTIFICATION EXAM
D) Managed care organizations (MCO's) - ANSWERS-B) A patient-centered
medical home (PCMH)
QUESTION 3
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 - ANSWERS-C) To save
money by avoiding unnecessary tests
QUESTION 4
Prospective performance and Retrospective performances are considered:
A) Private health plans
B) Contract performance models
C) Rating tiers
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, HFMA CSPR LATEST
CERTIFICATION EXAM
D) Consumer Directed Health Plans (CDHP) - ANSWERS-B) Contract
performance models
QUESTION 5
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 -
ANSWERS-C) Healthcare report cards available to the public
QUESTION 6
Identify which option is NOT a payment type that comprises a large percentage of
Medicare expenditures.
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PAGE
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, HFMA CSPR LATEST
CERTIFICATION EXAM
A) Inpatient prospective Payment Systems
B) Outpatient Prospective Payment System
C) Medicare payments to physicians
D) MS-DRG payment - ANSWERS-C) Medicare payments to physicians
QUESTION 7
Which option is NOT a practice used to control the costs of managed care?
A) Delivering services that are reasonable, and payers agree on medical necessity
and reimburse for services
B) Combining services, bundling associated charges, determining an appropriate
charge the that set of services
C) Making advance payment to providers for all services needed to care for a
member
END OF
PAGE
4
CERTIFICATION EXAM
ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
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 - ANSWERS-B) A
properly completed billing form, UB-04 or CMS 1500
QUESTION 2
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)
END OF
PAGE
1
, HFMA CSPR LATEST
CERTIFICATION EXAM
D) Managed care organizations (MCO's) - ANSWERS-B) A patient-centered
medical home (PCMH)
QUESTION 3
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 - ANSWERS-C) To save
money by avoiding unnecessary tests
QUESTION 4
Prospective performance and Retrospective performances are considered:
A) Private health plans
B) Contract performance models
C) Rating tiers
END OF
PAGE
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, HFMA CSPR LATEST
CERTIFICATION EXAM
D) Consumer Directed Health Plans (CDHP) - ANSWERS-B) Contract
performance models
QUESTION 5
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 -
ANSWERS-C) Healthcare report cards available to the public
QUESTION 6
Identify which option is NOT a payment type that comprises a large percentage of
Medicare expenditures.
END OF
PAGE
3
, HFMA CSPR LATEST
CERTIFICATION EXAM
A) Inpatient prospective Payment Systems
B) Outpatient Prospective Payment System
C) Medicare payments to physicians
D) MS-DRG payment - ANSWERS-C) Medicare payments to physicians
QUESTION 7
Which option is NOT a practice used to control the costs of managed care?
A) Delivering services that are reasonable, and payers agree on medical necessity
and reimburse for services
B) Combining services, bundling associated charges, determining an appropriate
charge the that set of services
C) Making advance payment to providers for all services needed to care for a
member
END OF
PAGE
4
