CSPPM PRACTICE EXAM
COMPLETE 75 QUESTIONS
Question 1: During preregistration, which action most directly reduces eligibility- related claim denials?
Choices:
1) Con�rm the patient's mailing address 2) Verify active coverage and bene�ts for the date of service 3) Collect a copy of the patient's photo ID only 4) Assign a diagnosis code before the visit Correct Answer: Verify active coverage and bene�ts for the date of service Explanation: Eligibility and bene�t veri�cation con�rms that coverage is active for the planned date of service and identi�es payer requirements before the encounter occurs.Page 1
Question 2: Which item is most important to con�rm when a patient reports a new insurance plan before an appointment?
Choices:
1) The patient's preferred pharmacy 2) The payer name, member ID, group number, and e�ective date 3) The patient's employer dress code 4) The physician's vacation schedule Correct Answer: The payer name, member ID, group number, and e�ective date Explanation: Accurate payer identi�ers and the policy e�ective date are core registration data used to establish coverage and submit a clean claim.
Question 3: A patient arrives for a scheduled service that requires prior
authorization, but no authorization is on �le. What is the best �rst response by the practice?
Choices:
1) Perform the service and bill later without review 2) Verify whether authorization is required and obtain it or explain the �nancial implications before proceeding 3) Change the diagnosis code to avoid authorization 4) Bill the patient as uninsured without checking bene�ts Correct Answer: Verify whether authorization is required and obtain it or explain the �nancial implications before proceeding Explanation: The practice should verify the payer requirement and resolve authorization before service when possible, while communicating potential patient �nancial responsibility.Page 2
Question 4: Which registration control best helps prevent duplicate patient records in an electronic practice management system?
Choices:
1) Creating a new record at every visit 2) Searching existing records using multiple identi�ers before creating a new record 3) Using only the patient's �rst name for matching 4) Deleting inactive patients each month Correct Answer: Searching existing records using multiple identi�ers before creating a new record Explanation: Searching by multiple identi�ers such as name, date of birth, address, or medical record number reduces duplicate records and downstream billing and clinical errors.Question 5: What is the main purpose of collecting a patient's signed assignment- of-bene�ts authorization when applicable?
Choices:
1) To transfer ownership of the medical record to the payer 2) To permit insurance bene�ts to be paid directly to the provider when allowed 3) To waive all patient �nancial responsibility 4) To authorize the practice to change the insurance contract Correct Answer: To permit insurance bene�ts to be paid directly to the provider when allowed Explanation: Assignment of bene�ts generally authorizes the payer to send covered bene�t payments directly to the provider, subject to plan and legal requirements.Page 3