Cpma chapter 2 2024 - Study guides, Class notes & Summaries

CPMA Chapter 2 Exam Questions and Verified Answers| Grade A+ | 100% Correct (2024/ 2025 Update)

CPMA Chapter 2 (2024) Questions and Answers Graded A+ HIPAA Enacted on August 21,1996 to provide rights and protections for participants and beneficiaries of group health plans. Under August 21, 1996 HIPAA , what two (2) stipulations were established 1) Exclusions for pre-existing conditions were limited; and 2) Discrimination against employees and dependents based on their health status were prohibited. HIPAA also established what (to combat fraud and abuse in healthcare)? The Heal...

CPMA Chapter 2 (2024) Questions and Answers Graded A+ HIPAA Enacted on August 21,1996 to provide rights and protections for participants and beneficiaries of group health plans. Under August 21, 1996 HIPAA , what two (2) stipulations were established 1) Exclusions for pre-existing conditions were limited; and 2) Discrimination against employees and dependents based on their health status were prohibited. HIPAA also established what (to combat fraud and abuse in healthcare)? The Heal...

Chapter 1 CPMA Exam Prep Questions and Answers | 100% Pass 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 overp...

CPMA Chapter 5 - Analysis and Report of Audit Findings Exam Questions and Answers | 100% Pass Understanding how to develop and draft a well-structured and detailed audit report is - Answer-a critical skill for any competent auditor. The audit report should identify the key findings and present the analysis, rationale and recommendations in a format that is - Answer-easy for the auditee to read, understand and apply Components of the Audit Report - Answer-Background Summary of Audit Find...

CPMA Exam Chapter 3 Study Guide with Complete Solutions Accurate reimbursement begins with - Answer-accurate coding and rules that vary by payer The CPT codebook contains - Answer-instructions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. - Answer-An auditor must be able to apply payer variations to the CPT guidelines during an audit, and must communicate the differences in a way that will make sen...

CPMA chapter 2 Exam with complete solutions 2024_2025

CPMA Chapter 6 Review Questions and Answers | 100% Pass What is the reason audit findings should be discussed with the provider audited? - Answer-To provide a risk analysis, identify problem areas, and recommend corrective action with supporting documentation What type of information can be found In The providers contract with the insurance carrier? - Answer-The providers obligation to follow the insurance company's medical policies What type of insurance plans may require an auditor ...

CPMA Exam Chapter 5: Self-Disclosure Audits Study Guide The OIG Self-Disclosure Protocol (SDP) provides the - Answer-ability to self-disclose potential instances of fraud involving federal healthcare programs for which liability arises under the OIG's civil money penalty authorities The SDP (Self-Disclosure Protocol) is not for reporting of - Answer-potential or actual Stark (self-referral) violations; It is not a means to obtain an advisory opinion to determine if the suspect conduct ...

CPMA Exam - Chapter 5: Corrective action Plans Questions and Answers Except in the case of routine or annual compliance audits conducted on behalf of providers that do not have formal compliance programs or staff, - Answer-it is not usually the auditor's responsibility to develop a corrective action plan. In the case of audits associated with voluntary repayments or disclosures under the SDP (Self Disclosure Protocol) for potentially fraudulent conduct, - Answer-it usually falls to the ...