Cpma chapter 1 - Study guides, Class notes & Summaries

CPMA- Chapter one exam | Questions and Correct Answers | Latest Update 2024/2025 | 100% PASS In the NCCI edits, what does modifier indicator nine (9) represent? A modifier may be used to bypass the edits if the documentation supports the modifier. B. A modifier is not allowed to bypass the NCCI edits. C. Only modifier 59 can be used to bypass the edit. D. Modifiers are not applicable to the edits, the NCCI edit is not in effect. - Answer -D. Modifiers are not applicable to the edits, t...

CPMA Certification Study Guide 2018 Chapter 1. Questions and answers, rated A+ How does CMS define fraud? - -Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program. How does CMS define abuse? - -An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Example of Fraud - -Billing for services and/or supplies that you know were not furnished or provided Altering ...

12.1% - Answer # of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - Answer Fee-For-Service Prepayment Review - Answer Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review - Answer Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or overpayment. Underpayment - Answer A payment a prov...

CPMA Certification Study Guide 2018 Chapter 1, Questions and answers, 100% Accurate, Verified. How does CMS define fraud? - -Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program. How does CMS define abuse? - -An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Example of Fraud - -Billing for services and/or supplies that you know were not furnished or pro...

CPMA chapter 1

CPMA Chapter 1, Top Questions and answers, 100% Accurate. Rated A+ Stark Law - -Physician Self Referral Law Prohibits a physician from making a referral to an entity with which they or their immediate family has a financial relationship if the referral is for the furnishing of designated health services RAT-STATS - -A statistical software that is a valuable analytical tool used by auditors Components of RAT-STATS that should be used to perform CIA Claims Review - -"Random Numbers" ...

CPMA Chapter 1, Questions and answers, 100% Accurate, rated A Stark Law - -Physician Self Referral Law Prohibits a physician from making a referral to an entity with which they or their immediate family has a financial relationship if the referral is for the furnishing of designated health services RAT-STATS - -A statistical software that is a valuable analytical tool used by auditors Components of RAT-STATS that should be used to perform CIA Claims Review - -"Random Numbers" to dr...

Chapter 1 CPMA Exam Prep Question and answers already passed 2023 12.1% - correct answer # of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - correct answer Fee-For-Service Prepayment Review - correct answer Review of claims prior to payment. Prepayment reviews result in an initial determination.