CSPR - Certified Specialist Payment Rep (HFMA) Exam with Complete Solutions

CSPR - Certified Specialist Payment Rep (HFMA) Exam with Complete Solutions
Question: Which of the following statements regarding
employer-based health insurance in the United States is true?
Correct answer: The real advent of employer-based insurance
came through Blue Cross, which was started by hospital
associations during the Depression.
Question: The Health Maintenance Organization (HMO) Act
of 1973 gave qualified HMOs the right to "mandate" an
employer under certain conditions, meaning employers:
Correct answer: Would have to offer HMO plans along side
traditional fee-for-service medical plans.
Question: Which of the following is an anticipated change in
the relationships between consumers and providers?
Correct answer: Providers will face many new service
demands and consumers will have virtually unfettered access
to those services.
Question: Which statement is false concerning ABNs?
Correct answer: ABN began establishing new requirements
for managed care plans participating in the Medicare
program.

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