10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
These 10 free CSAF questions are organized by exam domain, so you can see how each part of the Certified Specialist Accounting and Finance blueprint is tested. Reveal the answer and explanation under each question.
Domain 1: Cost Analysis and Management
Question 1
An employer offers a hospital laboratory a one-time contract for 400 tests at $110 each. Supplies and other costs that vary with testing total $42 per test. The work also requires a $12,000 temporary technologist contract. Current full cost is $125 per test, including fixed overhead that will not change. Existing work will not be displaced, and quality requirements can be met. Which recommendation is supported by incremental analysis?
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Correct answer: B - Accept; the contract would increase operating income by $15,200.
Domain 2: Reimbursement and Managed Care
Question 2
A physician organization receives a fixed per-member-per-month payment for covered services. Its main concern is an enrollment-wide increase in utilization: many members could incur moderate costs, while none reaches the existing individual stop-loss threshold. Membership and the documented clinical risk profile are stable. Which additional contract provision most directly limits the resulting total-cost exposure?
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Correct answer: B - Aggregate stop-loss covering eligible annual costs above a total-cost threshold.
Domain 3: Financial Planning and Budgeting
Question 3
An endoscopy department budgeted 1,000 procedures, $140,000 in fixed expense, and $85 in variable expense per procedure. It performed 1,200 procedures and incurred $249,000 in total expense. Procedure mix was unchanged, and volume remained within the range over which fixed costs stay constant. After accounting for the higher volume, which spending variance should be reported?
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Correct answer: C - $7,000 unfavorable, after allowing for the actual number of procedures.
Domain 4: Capital Planning and Financing
Question 4
A finance committee must select one of two mutually exclusive imaging projects. Both have seven-year lives, comparable risk, and acceptable clinical outcomes; funding is sufficient for either. At the hospital's required return, Project North has a $240,000 net present value, a 19% internal rate of return, and a 3.2-year payback. Project South has a $410,000 net present value, a 16% internal rate of return, and a 4.1-year payback. To maximize financial value, the committee should:
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Correct answer: A - Select South because it has the higher net present value.
Domain 5: Investments and Cash Management
Question 5
A hospital's loan agreement requires at least 75 days cash on hand. It defines the measure as cash and short-term investments available for general operations divided by average daily cash operating expense, using 365 days. Reported cash and short-term investments total $15 million, including $3 million restricted by donors solely to future construction. Annual operating expense is $80.3 million, including $7.3 million of depreciation; no other noncash adjustments apply. Which result belongs on the covenant certificate?
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Correct answer: B - 60.0 days; the 75-day requirement is not met.
Domain 6: Accounting Oversight and Internal Control
Question 6
An accounts-payable specialist can create vendors, change their bank details, and release electronic payments. A manager reviews paid invoices at month-end but does not review vendor-master changes. The controller wants to prevent the specialist from diverting an otherwise valid payment to an employee-controlled account. Which change most directly prevents this type of diversion?
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Correct answer: C - Require independent approval of new or changed vendor bank details before payment release.
Domain 9: Medicare and Medicaid Reimbursement Systems
Question 7
Two quarterly summaries show a hospital's Medicare acute inpatient case-mix index increasing from 1.31 to 1.49. Both figures use the same MS-DRG relative weights and the same number of discharges. Audits confirm that documentation supports the assigned DRGs. What does this change establish?
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Correct answer: A - Average expected resource intensity rose; the index does not establish better outcomes.
Domain 10: Fraudulent Acts and Other Compliance Risks
Question 8
At a Medicare-participating hospital's emergency department, an uninsured patient reports severe chest pain. A triage nurse records vital signs and requests a medical screening examination. Registration staff have not released the patient to the clinical queue because a deposit field remains incomplete. The revenue-cycle manager is called. What must the manager change immediately?
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Correct answer: D - Bypass the deposit requirement so the medical screening examination proceeds without delay.
Domain 11: Malpractice Insurance and Risk Management
Question 9
A physician group changes malpractice insurers on January 1, 2026. Both policies are claims-made-and-reported. The old policy expires December 31, 2025, and the new policy has a January 1, 2026 retroactive date. No extended-reporting or prior-acts endorsements apply. A patient first makes a claim in September 2026 for an alleged injury in June 2025; the group reports it immediately. Considering these timing provisions, which insurer responds?
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Correct answer: A - Neither insurer; neither policy satisfies both the event-date and claim-reporting requirements.
Domain 12: Financial Reporting: Revenue and Assets
Question 10
A nongovernmental hospital correctly recognized August patient-service revenue at the contracted amount, after assessing collectibility and any price concessions. In September, the insurer unexpectedly becomes insolvent, and new evidence indicates that part of the receivable will not be recovered. The hospital has not granted a price reduction, and the original accounting was not erroneous. Under U.S. GAAP, the resulting expected loss is:
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Correct answer: D - A credit-loss expense on the recognized receivable.