Certified Specialist Payment & Reimbursement (CSPR)

Learning Objectives

• Identify key factors that influenced the development of managed care
• Explain coordination of benefits, managed Medicare organizations, and TRICARE
  
• Describe the role of Medicare and Medicaid Managed Care
• Identify the clinical integration components of case management
  
• Describe basic hospital service reimbursement methodologies and cost control incentives
• Describe the impact of the ACA on reimbursement, and list emerging payment trends under healthcare reform
• List key case and utilization (care) management and clinical integration components
• Identify major trends in healthcare policy, including consumerism, outcomes-based reimbursement, and other elements of reform

Program Delivery

• HFMA eLearning courses and certifications are delivered online (virtually). Benefits:
  • Self-directed (at your own pace) and on-demand
  • Available 24/7 via your HFMA eLearning account - anytime and anywhere
  • Convenient and flexible - all resources available in one place
• Program features and study aids:
  • Bookmark option
  • Interactive elements
  • Knowledge checks throughout
  • Notes tab to record ideas
  • Quiz builder offering practice on specific topics
  • Downloadable Key Concepts Guide
• Earning a Certificate or Certification . After successful completion of the program, you will receive:
  • a "Certificate of Completion" that can be downloaded from your eLearning account, and
  • a Digital badge via HFMA's digital badging partner, Credly. The digital badge is a validated, visual representation of your certification achievement. Display your badge in your email signature, electronic resume, and on your LinkedIn profile or anywhere you want to be recognized for attaining a new level of knowledge or a specific skill set..

Program Access

• Members (all-access professional, business partner, student, faculty, and enterprise) will have 12 months access from enrollment date.
  
• Non-members registering/paying for course(s) will have 12 months access from enrollment date.

HFMA Certification Programs Oversight

• Under governance of the HFMA Board of Directors and HFMA Bylaws, the HFMA Board of Examiners serves as reviewers of the certification preparation materials and examinations, and authorizes release of the materials for use by candidates.
  • HFMAs Board of Examiners is responsible for overseeing the development of appropriate study materials that assist candidates in preparing for HFMA certification examinations.
  • HFMAs Board of Examiners is responsible for overseeing the development and administration of all HFMA certification examinations
  • HFMA and the Board of Examiners enlists recognized industry experts to author the examination preparation materials according to psychometric evaluation and role delineation study (or job analysis) findings.
• HFMAs programs are registered with the National Association of State Boards of Accountancy (NASBA), as a Quality Assurance Service sponsor of continuing professional education offering Continuing Professional Education (CPE) for several programs.

CPE Award Amount: 13.0

Program Level: Intermediate

Program Prerequisite: Knowledge of health care payment and reimbursement models, managed care environment, payment rates, benefit coordination and legislative changes.

Recommended Experience: 1-2 years experience in payment, reimbursement or managed care setting.

Advanced Preparation: None

Instructional Method: Self-Study

Delivery Method: QAS Self-Study

Field of Study & Topic in hours: 13.0 Specialized Knowledge

Content last revised: October 2021

CPE Sponsor- HFMA is registered with the National Association of State Boards of Accountancy (NASBA), as a Quality Assurance Service sponsor of continuing professional education. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding QAS program sponsors may be submitted to the NASBA through its website: www.learningmarket.org.

For more information regarding refund policies, as well as any program concerns, please contact our offices at 800.252.4362 or, inquiry@hfma.org.

Maintenance Requirements: Certified Specialist Payment and Reimbursement (CSPR)

• HFMA Certified Specialist Payment and Reimbursement certificants must maintain their certification every two years.
• The recertification process is straightforward: to re-certify as a CSPR, you must take a 50-question online assessment.
• To help you prepare for the CSPR Recertification assessment, you will have access to a CSPR Recertification eLearning course.
• The HFMA Recertification course does NOT offer NASBA CPE. Time taken to complete recertification programs qualifies as an activity for CHFP and FHFMA maintenance.
• Information will be emailed to you in advance of your maintenance due date.
• The maintenance fee for non-members is $100 and free for HFMA members.

A Student member of HFMA? The American Council on Education’s College Credit Recommendation Service (ACE CREDIT®) has evaluated and recommended college credit for the Certified Specialist Payment & Reimbursement (CSPR).

Earn college credit. Take one less class! Student members of HFMA can earn 1 college credit outside the classroom when successfully completing the Certified Specialist Payment & Reimbursement (CSPR) program.

Healthcare Financial Management Association (HFMA) (acenet.edu) - ACE National Guide