Cpma chapter 2 - Study guides, Class notes & Summaries

CPMA Exam Chapter 3, Questions and answers, 100% Accurate, rated A+ Accurate reimbursement begins with - -accurate coding and rules that vary by payer The CPT codebook contains - -instructions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. - -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 sense ...

CPMA EXAM chapter 5 What guidelines should be followed when performing an audit on charts for Medicare beneficiaries? A) Only CMS policies should be utilized B) Only local MAC policies should be utilized C) National CMS policies and local MAC policies should be utilized D) Neither CMS nor local MAC policies should be utilized Correct answer: C) National CMS policies and local MAC policies should be utilized when performing Medicare audits. Additionally, it is necessary to know the ...

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 ...

CPMA Exam Chapter 3 questions and answers well illustrated. Accurate reimbursement begins with - correct ate coding and rules that vary by payer The CPT codebook contains - correct uctions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. - correct answers.An auditor must be able to apply payer variations to the CPT guidelines during an audit, and must communicate the dif...

CPMA Chapter 2.3 & 2.4 - Medical Record Documentation 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 Exam Chapter 3 Study Guide with Verified 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 sens...

Chapter 5 CPMA Exam: Contract-based Commercial Insurance Plans Questions and Answers Most common commercial insurance plans are - Answer-contract based That is, benefits arise primarily under a contract between the insurance company and the subscriber/patient Where the healthcare provider is in network, - Answer-the provider agrees to abide by certain rules in a separate contract.. The auditor must review the contract to determine the rules the provider is bound to follow For commercial...

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...