Certified Specialist Physician Practice
Management (CSPPM) Study Guide Exam
Questions with verified correct detailed
answers latest update 2025
43. CDHP--- correct answer --- Consumer Directed Health Plan
| | | | | | |
44. Components to a CDHP?--- correct answer --- *Underlying health
| | | | | | | |
plan
|
*Healthcare savings account | |
45. Healthcare savings account--- correct answer --- allowing for the
| | | | | | | |
management of spending for smaller healthcare expenses such as
| | | | | | | | |
office visits, routine care and prescriptions.
| | | | | |
46. Underlying health plan--- correct answer --- these are typically a
| | | | | | | | |
high deductible health plan (HDHP) that will cover bigger health
| | | | | | | | | |
expenses such as surgery or hospitalization
| | | | | |
47. HDHP--- correct answer --- High Deductible Health Plan
| | | | | | |
48. Performance Standards--- correct answer --- Average days of
| | | | | | |
revenue in receivables
| | |
49. Outsourcing Disadvantages--- correct answer --- *Decrease in
| | | | | |
direct control of accounts receiv- able
| | | | | |
*Potential negative impact on patient relations
| | | | |
,*Increased cost if the vendor is unable to provide the service less
| | | | | | | | | | |
expensively than an in-house A/R
| | | | |
*Legal considerations if the vendor staff represent themselves as
| | | | | | | |
employees of the medical group
| | | | |
50. Outsourcing Advantages--- correct answer --- *A vendor may
| | | | | | |
have access to staffing and/or com- puter systems not available to the
| | | | | | | | | | | |
medical group.
| |
*The vendor assumes responsibility for hiring, training, and
| | | | | | |
supervision of staff.
| | |
*The vendor may accept a contract that includes some financial risk if
| | | | | | | | | | |
the cost of handling A/R increases or that includes an "efficiency"
| | | | | | | | | | |
factor.
|
*A vendor may receive economies of scale, not available to smaller
| | | | | | | | | |
medical groups, by handling A/R in a central location for a variety of
| | | | | | | | | | | | |
groups
|
*If A/R billing and collections are outsourced, it is critical to manage
| | | | | | | | | | |
the vendor closely and hold them accountable for pre-determined and
| | | | | | | | | |
agreed-to deliverables.
| |
51. Bad Debts--- correct answer --- results when a patient who has
| | | | | | | | | |
been determined to have the financial capacity to pay for healthcare
| | | | | | | | | | |
services is unwilling to settle the claim (for example, a patient who
| | | | | | | | | | | |
has a bank account or other assets but chooses not to pay a legitimate
| | | | | | | | | | | | | |
bill).
|
,52. Charity Accounts--- correct answer --- is defined as a legitimate
| | | | | | | | |
debt that the patient does not have the ability to pay, and
| | | | | | | | | | | |
reimbursement for services is not expected (for example, a patient
| | | | | | | | | |
who has no insurance and incurs a bill far in excess of any assets or
| | | | | | | | | | | | | | |
income).
|
53. Accounts will be written off to the bad debt account and, in most
| | | | | | | | | | | |
cases, should be transferred to a collection agency for follow-up
| | | | | | | | | |
against the patient's assets.--- correct answer --- Bad debt
| | | | | | | | |
54. Where the patient has no assets, would not be transferred to a
| | | | | | | | | | |
collection agency, as the patient has no assets.--- correct answer ---
| | | | | | | | | | |
| Charity Account |
55. Two major deductions from accounts receivables?--- correct
| | | | | |
| answer --- Bad debt and Charity Account
| | | | | |
56. Purpose of financial counseling?--- correct answer --- To
| | | | | | |
minimize accounts receivables out- standing , particularly long-term
| | | | | | | |
payments
|
57. Chapter 7--- correct answer --- Chapter Seven bankruptcy is
| | | | | | | |
used when the patient has too few assets and little or no income to
| | | | | | | | | | | | | |
satisfy the debts.
| | |
58. Chapter 11--- correct answer --- is generally restricted to those
| | | | | | | | |
who operate a business.
| | | |
59. Chapter 12--- correct answer --- is available only to family
| | | | | | | | |
farmers.
|
, 60. Chapter 13--- correct answer --- the patient uses existing assets
| | | | | | | | |
and current and future income to pay the debts
| | | | | | | | |
61. Fee-for-service--- correct answer --- Authorization and referrals | | | | | |
62. Insurance receivables fall into the following three specific
| | | | | | |
categories--- correct answer ------ correct answer --- -
| | | | | | | |
*Fee-for-service Collection |
*Capitation Payment Collection
| |
*Collection of Balances Arising from Patient Co-pays, Co-insurance,
| | | | | | |
and De- ductibles
| | |
63. Charge posting--- correct answer --- Collection of funds. It
| | | | | | | |
should occur as rapidly as possible, normally within 24 hours of
| | | | | | | | | | |
service.
|
64. Encounter report--- correct answer --- to advise the health plans
| | | | | | | | |
that patients have been treated, list the types of treatment rendered,
| | | | | | | | | | |
and track specific diagnoses and procedures as required for other
| | | | | | | | | |
reporting mechanisms.
| |
65. RFI--- correct answer --- Request for information
| | | | | |
66. RFP--- correct answer --- Request for Proposal
| | | | | |
67. Criteria for Choosing a Collection Agency--- correct answer ------
| | | | | | | |
| correct answer --- *Reputation
| | |
*Patient relations |
*Agency fees |
Management (CSPPM) Study Guide Exam
Questions with verified correct detailed
answers latest update 2025
43. CDHP--- correct answer --- Consumer Directed Health Plan
| | | | | | |
44. Components to a CDHP?--- correct answer --- *Underlying health
| | | | | | | |
plan
|
*Healthcare savings account | |
45. Healthcare savings account--- correct answer --- allowing for the
| | | | | | | |
management of spending for smaller healthcare expenses such as
| | | | | | | | |
office visits, routine care and prescriptions.
| | | | | |
46. Underlying health plan--- correct answer --- these are typically a
| | | | | | | | |
high deductible health plan (HDHP) that will cover bigger health
| | | | | | | | | |
expenses such as surgery or hospitalization
| | | | | |
47. HDHP--- correct answer --- High Deductible Health Plan
| | | | | | |
48. Performance Standards--- correct answer --- Average days of
| | | | | | |
revenue in receivables
| | |
49. Outsourcing Disadvantages--- correct answer --- *Decrease in
| | | | | |
direct control of accounts receiv- able
| | | | | |
*Potential negative impact on patient relations
| | | | |
,*Increased cost if the vendor is unable to provide the service less
| | | | | | | | | | |
expensively than an in-house A/R
| | | | |
*Legal considerations if the vendor staff represent themselves as
| | | | | | | |
employees of the medical group
| | | | |
50. Outsourcing Advantages--- correct answer --- *A vendor may
| | | | | | |
have access to staffing and/or com- puter systems not available to the
| | | | | | | | | | | |
medical group.
| |
*The vendor assumes responsibility for hiring, training, and
| | | | | | |
supervision of staff.
| | |
*The vendor may accept a contract that includes some financial risk if
| | | | | | | | | | |
the cost of handling A/R increases or that includes an "efficiency"
| | | | | | | | | | |
factor.
|
*A vendor may receive economies of scale, not available to smaller
| | | | | | | | | |
medical groups, by handling A/R in a central location for a variety of
| | | | | | | | | | | | |
groups
|
*If A/R billing and collections are outsourced, it is critical to manage
| | | | | | | | | | |
the vendor closely and hold them accountable for pre-determined and
| | | | | | | | | |
agreed-to deliverables.
| |
51. Bad Debts--- correct answer --- results when a patient who has
| | | | | | | | | |
been determined to have the financial capacity to pay for healthcare
| | | | | | | | | | |
services is unwilling to settle the claim (for example, a patient who
| | | | | | | | | | | |
has a bank account or other assets but chooses not to pay a legitimate
| | | | | | | | | | | | | |
bill).
|
,52. Charity Accounts--- correct answer --- is defined as a legitimate
| | | | | | | | |
debt that the patient does not have the ability to pay, and
| | | | | | | | | | | |
reimbursement for services is not expected (for example, a patient
| | | | | | | | | |
who has no insurance and incurs a bill far in excess of any assets or
| | | | | | | | | | | | | | |
income).
|
53. Accounts will be written off to the bad debt account and, in most
| | | | | | | | | | | |
cases, should be transferred to a collection agency for follow-up
| | | | | | | | | |
against the patient's assets.--- correct answer --- Bad debt
| | | | | | | | |
54. Where the patient has no assets, would not be transferred to a
| | | | | | | | | | |
collection agency, as the patient has no assets.--- correct answer ---
| | | | | | | | | | |
| Charity Account |
55. Two major deductions from accounts receivables?--- correct
| | | | | |
| answer --- Bad debt and Charity Account
| | | | | |
56. Purpose of financial counseling?--- correct answer --- To
| | | | | | |
minimize accounts receivables out- standing , particularly long-term
| | | | | | | |
payments
|
57. Chapter 7--- correct answer --- Chapter Seven bankruptcy is
| | | | | | | |
used when the patient has too few assets and little or no income to
| | | | | | | | | | | | | |
satisfy the debts.
| | |
58. Chapter 11--- correct answer --- is generally restricted to those
| | | | | | | | |
who operate a business.
| | | |
59. Chapter 12--- correct answer --- is available only to family
| | | | | | | | |
farmers.
|
, 60. Chapter 13--- correct answer --- the patient uses existing assets
| | | | | | | | |
and current and future income to pay the debts
| | | | | | | | |
61. Fee-for-service--- correct answer --- Authorization and referrals | | | | | |
62. Insurance receivables fall into the following three specific
| | | | | | |
categories--- correct answer ------ correct answer --- -
| | | | | | | |
*Fee-for-service Collection |
*Capitation Payment Collection
| |
*Collection of Balances Arising from Patient Co-pays, Co-insurance,
| | | | | | |
and De- ductibles
| | |
63. Charge posting--- correct answer --- Collection of funds. It
| | | | | | | |
should occur as rapidly as possible, normally within 24 hours of
| | | | | | | | | | |
service.
|
64. Encounter report--- correct answer --- to advise the health plans
| | | | | | | | |
that patients have been treated, list the types of treatment rendered,
| | | | | | | | | | |
and track specific diagnoses and procedures as required for other
| | | | | | | | | |
reporting mechanisms.
| |
65. RFI--- correct answer --- Request for information
| | | | | |
66. RFP--- correct answer --- Request for Proposal
| | | | | |
67. Criteria for Choosing a Collection Agency--- correct answer ------
| | | | | | | |
| correct answer --- *Reputation
| | |
*Patient relations |
*Agency fees |
