CPMA (100% Errorless Answers)

What are the 3 key components that generally are the influential factors in determining level of service? correct answers history, exam, and medical decision making (MDM) History correct answers information communication by the patient to the physician Some categories of service only require a...

CMS Fraud Definition correct answers Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition correct answers An action that results in unnecessary costs to a federal healthcare program, either directly or i...

Mrs.Sawyer is a 65 year-old Medicare patient visiting Dr.Levy's office for the first time at the request of Dr.James (her PCP)for cardiology consultation.She presents with complaints of heart palpitations with shortness of breath and nausea. Dr.Levy examines the patient and sends his recommendation...

Medical Reporting and Returning of self-identified overpayments correct answers Have 60-day time line for reporting and returning Medicare overpayment Or, the date any cost report is due If the provider does not report and return within 60 days correct answers Faces liability under the False ...

WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? correct answers 1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and he...

The Joint Commission (JC) requires the Factors that Affect Learning must be assessed for a hospital or hospital owned physician practice as well as other health care facilities. When assessing this element what does this include? A. The patient's ability to read, method of learning and understan...

Which option is NOT part of the seven elements that should be included in a compliance plan based on the OIG's recommendations? a. Responding promptly to detected offenses and developing corrective action. b. Conducting effective training and education. c. Identifying employees on the exclusions...

The first initial, last name and credentials correct answers What is the minimum signature assignment(s) of the author of an entry in the medical record? Personal biographical data and consent for treatment or authorization for treatment form correct answers Based on Joint Commission accreditatio...

B. If documentation supports the service, have the staff contact the carrier to reprocess the claims. Code 33010 was valid for the date of service billed. Rationale: The effective dates of codes are date of service driven. New CPT® codes become effective January 1st of every year. When auditing, v...

When auditing operative notes, the auditor will expect to see documentation from all of the following except: correct answers Surgical assistants. According to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), an outside auditor must sign which of the following agreements p...