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CPCO EXAM | 50 New Questions with 100% Correct Answers | Latest Update 2024 | Rated A+
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CPCO EXAM | 50 New Questions with 100% Correct Answers | Latest Update 2024 | Rated A+
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CPCO EXAM | 50 New Questions with 100% CorrectAnswers | Latest Update 2024 | Rated A+
Question 1
What is the goal of ongoing auditing and monitoring in a physician's practice? - ✔✔Ongoing
auditing and monitoring will evaluate whether the physician practice's standards and
procedures are current and accurate and whether the compliance program is working.
Question 2
A compliance program's plan for communication should include a provision for non-retaliation
for reporting fraudulent conduct. Which method below helps ensure that an employee would
be free from retribution? - ✔✔Well-publicized disciplinary actions for retaliation
Question 3
What does the HHS OIG suggest as possible warning signs that non-compliance may exist? -
✔✔Significant change in the number or type of claim rejections.
Question 4
Having the ability to respond to issues enables a practice to develop effective action plans to
correct problems and prevent future problems from occurring. What is one step that can be
taken to establish compliance effectiveness for the response/prevention element? -
✔✔Create a response team, consisting of representatives from compliance, audit, and any
other relevant functional department.
Question 5
A physician office laboratory is authorized to perform urinalysis testing, including the
microscopic analysis under their PPMP certification. It has been the physician's experience that
many of his patients that have urinalysis testing done also require the microscopic exam.
Because of this and to be able to provide better treatment, he has established an office policy
that for all urinalysis testing performed in his office, the lab should also perform the
microscopic test. Is this a
, compliance risk? - ✔✔Yes. Performing the microscopic test on all patients when the results
of the urinalysis are negative could be considered medically unnecessary.
Question 6
Billing companies should have written policies and procedures that reflect and reinforce
Federal and State statutes. These policies must create a mechanism for the billing or
reimbursement staff to communicate effectively and accurately with the health care provider.
Which of the following policies and procedures should a billing office have in place to meet
these needs? - ✔✔Establish and maintain a process for pre- and post-submission review of
claims to ensure claims submitted for reimbursement accurately represent services provided,
are supported by sufficient documentation and are in conformity with any applicable
coverage criteria for reimbursement
Question 7
According to the OIG, medically unnecessary services should only be billed to Medicare in
what circumstance? - ✔✔To receive a denial so that the claim can be submitted to a
secondary payer.
Question 8
As part of a practice's compliance program, record retention policies and procedures should
be developed. This policy and procedure should address the timeframes associated with the
retention of various records. When developing a policy, which of the following statements
should be present? - ✔✔Specific records must be retained based upon the most stringent
requirement identified in federal or state law, or internal policies and procedures
Question 9
A patient being seen by a physician has unpaid medical bills in excess of $5,000 after insurance
payments. The patient has now lost his job and has limited financial resources. The office
manager has reviewed the patient's financial situation to assess the patient's ability to pay and
has agreed to reduce the fees owed to $2,500. Would this act violate the OIG gift allowance for
beneficiaries? - ✔✔No, this would be an exception to the OIG gift allowance because it is
based on the patient's ability to pay.
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