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CPMA /156 Questions With Verified Answers Download To Pass!!!
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CPMA /156 Questions With Verified AnswersDownload To Pass!!!
Quiz :When non-compliance is identified, what does the OIG recommended?
a .Take disciplinary action and document the date of the incident, name of the
reporting party, name of the person responsible for taking action, and the
follow-up action taken.
b. Take disciplinary action and document the date of the incident, name of the
reporting party, name of the person responsible for taking action,and the
follow-up action taken.
c. Immediately terminate employment for the party found in non-
compliance,regardless of the severity of the offense,document the date of the
termination,file a corrected claim on all claims affected.
d. Continue to watch the employee in non-compliance until the incidents meet
a federal level before taking action. - Answer :b. Take disciplinary action and
document the date of the incident, name of the reporting party, name of the
person responsible for taking action,and the follow-up action taken
Quiz :A provider consistently charges a higher level E/M service than is
documented to help cover the cost of his declining practice. Would this be
fraud or abuse Why?
a. Abuse,charging one level higher on each visits does not show intent.
b. Abuse; the provider's practice is common and therefore would not be
considered fraudulent .
c. Fraud; and over-coding of services would be considered fraudulent.
d. Fraud; the provider intentionally over-coded to gain financially. - Answer :d.
Fraud; the provider intentionally over-coded to gain financially.
Quiz :The OIG lists potential risk areas for individual and small physician
groups in the compliance plan guidance. Which option below is listed as a risk
area?
,a. Unbundling
b. Under Coding
c. Overuse of E/M codes
d. Failure to follow the "same day" rule - Answer :a. Unbundling
Quiz :The FCA allows for reduced penalties if the person in violation self-
discloses if which conditions exist?
a. The person furnishes all information about the violation with in 30 days after
which the defendant first obtained the information.
b. The person fully cooperates with the investigation.
c. There is no additional criminal prosecution, civil action, or administrated
action with the respect to the violation.
d. All of the above - Answer :d. All of the above
Quiz :What is a Qui Tam Relator?
a. a person who is prosecuted under FCA.
b. The defendant in a Stark Law case.
c. a person listed on the OIG exclusions list.
d. a person who brings civil action for violation under the FCA for themselves
and the government. - Answer :d. a person who brings civil action for violation
under the FCA for themselves and the government.
Quiz :What is CoP?
a. Medicare Conditions of Participation.
b. TriCare's Compliance of Physicians Guidance
c. Medicaid's Coordination of Physician Groups
d. Commercial Programs - Answer :a. Medicare Conditions of Participation.
,Quiz :When a provider is excluded under the Exclusions statute, What must he
or she do at the end of the exclusionary period?
a. the provider is automatically reinstated
b. The provider must apply for reinstatement.
c. The provider cannot be reinstated once excluded.
d. The provider must apply for a group provider number. - Answer :b. The
provider must apply for reinstatement
Quiz :Which option is considered a material breach of CIA?
a. Failure to engage and use an IRO in accordance with the CIA.
b. Failure to hire an OIG employee to oversee compliance efforts.
c. Failure to hire a full-time internal auditor to review every claim before it is
submitted.
d. Failure to fire auditors who do not agree with the provider's coding -
Answer :a. Failure to engage and use an IRO in accordance with the CIA.
Quiz :CMS has two sets of Evaluation and Management Documentations
Guidelines , 1995 and 1997. Which set is used by physicians for office visits?
a. 1995 E/M Documentation Guidelines
b. 1997 E/M Documentation Guidelines
c. The practice must choose either the 1995 or 1997 E/M Documentation
Guidelines for the entire practice.
d. The practice may use 1995 or 1997 E/M Documentation Guidelines for each
visit; whichever is most advantageous for that visit. - Answer :d. The practice
may use 1995 or 1997 E/M Documentation Guidelines for each visit; whichever
is most advantageous for that visit.
Quiz :What is a semi-automated review?
, a. a review based on electronic data examined form submitted claims .
b. A review based on electronic data examined from submitted claims but
electively supported by medical records sent by the provider.
c. a review based on complete medical records review due lack of Medical
Policy being in a place
d. a review based on tips sent in from internal informants. - Answer :b. A
review based on electronic data examined from submitted claims but electively
supported by medical records sent by the provider.
Quiz :Which option is NOT part of the seven elements that should be included
in a compliance plan based on the OIG's recommendations?
a. Conducting effective training and education.
b. Responding promptly to detected offenses and developing corrective action.
c. Identifying employees on the exclusions list .
d. Developing effective lines of communication - Answer :c. Identifying
employees on the exclusions list .
Quiz :What can a provider do if he or she disagrees with a demand letter sent
as a result Recovery Audit?
a. Submit a discussion period request within 15 days of the date of the demand
letter.
b. Submit a discussion period request within 120 days of the date of the
demand letter.
c. Submit a request for review to the MAC within 15 days from the date of the
demand letter.
d. Submit a request for review to the MAC within 120 days from the date of
the demand letter. - Answer :a. Submit a discussion period request within 15
days of the date of the demand letter.
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