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Exam (elaborations)

CPMA STUDY Questions and Answers (100% Pass)

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CPMA STUDY Questions and Answers (100% Pass)

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  • October 29, 2024
  • 14
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • CPMA
  • CPMA
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1|Page | © copyright 2024/2025 | Grade A+




CPMA STUDY Questions and
Answers (100% Pass)
WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE?


✓ 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 health plan request and denial.




Exclusion Statute


✓ 1.Physician is banned from participating in any federal or state

healthcare program by OIG 2. They can't bill federal or state for any

services provided .3 length: host less than five years .4 When

exclusionary period has ended dr must apply for reinstatement and

receive authorize notice from OIG that reinstate has been granted




Abuse


✓ In action resulting in unnecessary cost to a federal healthcare program

either directly or indirectly




What is the civil penalty




Master01 | October, 2024/2025 | Latest update

, 1|Page | © copyright 2024/2025 | Grade A+

✓ Not less than 5000 and not more than 10,000 per claim x3 times the

amount of government damages




Federal False Claims Act


✓ Having knowledge that claims is fake.

✓ .1 knowing and knowingly that a person must act in deliberate

ignorance of the truth or falsely of the relevant information or act in a

reckless manner of the truth or falsity of the Information




Qui Tam


✓ whistleblower




what percentage is offered for a whistleblower/qui tam as an award from

what is recovered by the government?


✓ between 15% and 25%




fraud


✓ Knowingly making false statements or misrepresenting facts to obtain

an undeserved benefit or payment from federal healthcare program




Discovery sample


Master01 | October, 2024/2025 | Latest update

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