Cpma chapter 4 review - Study guides, Class notes & Summaries

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 chapter 4, Exam Questions and answers, 100% Accurate, rated A+ An auditor is asked to perform a baseline audit of a multi-provider practice. How many records should be selected for the baseline audit? - -10-15 records per provider An external auditor has been asked to review the E/M visits for a practice. For this focused audit, how should the auditor determine which E/m levels to audit? - -Run a utilization report comparing the providers E/M levels to other providers of the same sp...

CPMA Chapter 4 Review Already Graded A+ What modifier is used to indicate a service provided under the primary care exception without the presence of a teaching physician? A) Modifier 22 B) Modifier GE C) Modifier -58 D) Modifier -59 Correct answer: B) Modifier GE Which scenario is likely to result in an audit finding? A) The lab results were reviewed by the provider after the tests were performed. B) The lab results were not reviewed by the provider after the tests were perf...

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 ...

CPMA 2018 (All of chapter 4) questions and answers well illustrated. Which procedure is exempt from Modifier 5? - correct answers.93456 Which of the following code combination are NOT subject to a multiple procedure payment reduction? - correct answers.32666, 32764 In febuary 2018, an auditor is asked to review 10 records for date of service 12/1/2017 to make sure the claims were paid correctly. The claims included code 55450, which was denied on all the cl...

CPMA Chapter 4 Review Exam Questions And Answers.

Chapter 1 CPMA Exam Prep Questions and Answers 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. Und...

CPMA- Chapter one exam Questions and Answers 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, the NCCI edit is not in effect. Rationale: The Correc...