CPCO Exam Review| Questions and Verified Answers| 2023/ 2024 Newly Updated

CPCO Exam Review| Questions and Verified Answers| 2023/ 2024 Newly Updated Q: The HITECH Act revisions significantly increased the penalty amounts the Secretary may impose for violations of the HIPAA rules and encourage prompt _________? Answer: Corrective action Q: A search warrant, State or federal (or both) allows the agents the right to what? Answer: to enter and seize documents Q: Which office is mainly responsible to investigate health care fraud waste and abuse? Answer: Office of Inspector General (OIG) Q: When drafting audit protocol in an internal investigation it should be carefully worded and tied to the regulatory scope and applicability research. If an attorney doe snot draft the protocol, one should review it for language, Why? Answer: For attorney client privilege. Q: CMS relies on a number of program contractors to identify and respond to fraud, abuse, and improper payments in the Medicare and Medicaid programs. these contractors are charged with protecting the programs ____________. Answer: Integrity Q: If an internal audit reveals issues, it's time to do some interviews and document reviews. How many people should be involved in the interview process of an employee? Answer: 2+ the attorney Q: Free statistical software that can be used to select a random sample for audits is called what? Answer: RAT-STATS Q: When is it acceptable to bill an office visit based on time? Answer: If over half of the visit is spent counseling the patient. Q: Incident to rules can be complicated and present additional risks to a practice/organization. If a provider is available only via paper or telephone, incident-to billing _________________ Answer: Requirements are not met. Q: Because it is considered the overarching criteria for determining a level of service, the provider must ensure that the documentation supports what? Answer: Medical Necessity. Q: Which screening exam does not require an order, in any setting? Answer: Mammogram Q: In general, the OIG recommends auditing how many medical records per federal payer? Answer: 5 or more Q: Accountable care organizations (ACO's) involve different providers, including hospitals and physicians. Members of the ACO share both the gains and losses for certain Medicare fee-for-service beneficiaries with high-risk conditions such as heart failure, COPD, and diabetes. What is this arrangement called? Answer: Gain sharing Q: Medical practices should be aware of risks identified in the past and then establish policies and procedures for what? Answer: Continual monitoring Q: Which law governs relationships between competitors? Answer: Antitrust Q: Which of the following is not true regarding how improper payments are categorized? Answer: Billed based on time Q: Can CMS take back monies without reviewing a patient's record? Answer: Yes, through the use of data mining. Q: What department monitors and recertifies MFCU's? Answer: OIG Q: Can providers request an extension for providing records requested by an auditor? Answer: Yes, by sending a valid explanation. Q: Which of the following best describes ZPIC's? Answer: ZPIC's are private companies contracted by CMS Q: Can a provider disregard an auditor's request for records?