CPMA BUNDLED EXAMS WITH COMPLETE SOLUTIONS

CPMA QUESTIONS AND ANSWERS 100% SOLVED What regulation is the penalty for violating the False Claims Act (FCA) increased by? The Federal Civil Penalties Inflation Adjustment Act; The statute originally provided for a civil penalty of not less than $5,000, and not more than $10,000, per claim,...

CPMA QUESTIONS WITH COMPLETE SOLUTIONS 2024 What is a qui tam relator?A person who brings a civil action for a violation for him-/herself and for the U.S. Government. What is one of the differences between the stark law and the anti-kickback law? When a physician is banned from participating ...

CPMA Questions with Correct Answers Graded A+ Under CIA, 50 sampling units are reviewed. What is the sample referred as? A. Discovery Sample B. Initial Sample C. Complete Sample D. Selective Sample A. Discovery Sample (used to determine the net financial error rate) Which may result in fals...

CPMA Study Guide Question and Answers 100% Solved The Joint Commission requires that Factors that Affect Learning must be ascertained for a hospital or hospital owned physician practice when assessing this element what does this include? *The patients ability to read, method learning, & under...

CPMA STUDY QUESTIONS AND ANSWERS 100% SOLVED WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE?1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external ...

CPMA TEST QUESTIONS AND ANSWERS 1OO% SOLVED Cms examples of abuse Misusing codes on a claim Cms examples of abuse charging excessively for services and supplies Cms examples of abuse Billing for no necessary /failure to maintain good records Cms examples of abuse Improper bill practices /billi...

CPMA practice exam A Questions And Answers You are performing an audit of e/m services for a FP office. In the encounter you read the physician ordered and reviewed a differential WBC. What elements would you expect to see in the medical records? Patient ID, assignment of benefits, pt's me...

CPMA Exam Questions And Answers CMS Examples of Abuse Misusing codes on a claim, charging excessively for services or supplies, billing for services that were not medically necessary, failure to maintain adequate medical or financial records, improper billing practices, billing Medicare patient...

CPMA Questions And Answers Far enough in advance that the beneficiary or representative has time to consider the options and make an informed decision When must ABNs be signed? For a six (6) year period of time Patients can request copies of disclosure of PHI under HIPAA Fraud A provider know...

CPMA Questions And Answers What action would be considered fraud rather than abuse? A provider requiring the coding staff to intentionally code E/M services one level higher than documented. The OIG Work Plan is divided into seven elements. Which option is a part of the OIG Work Plan most appl...

Cpma Study Questions And Answers What is the civil penalty Not less than 5000 and not more than 10,000 per claim x3 times the amount of government damages Federal False Claims Act Having knowledge that claims is fake. .1 knowing and knowingly that a person must act in deliberate ignorance of t...

CPMA Study Guide Questions And Answers What is considered essential elements to allow for proper coding of an operative report? *the approach *type of anesthesia *location & severity of the wounds repaired. Who is NOT considered a covered entity under HIPAA? Health care consultant What entai...

CPMA Practice test Questions And Answers What is the minimum signature assignment(s) of the author of an entry in the medical record? . The first initial, last name and credentials Based on Joint Commission accreditation guidance for personal data, what two elements must be evident in the med...

CPMA Practice Test C Questions And Answers When auditing an ENT practice, you discover the practice uses an EMR. Which of the following options would you look for when reviewing documents created in the electronic medical record or notes created using templates that may be indicators of misus...

CPMA Practice Exam Questions And Answers What are Category II HCPCS codes? a. These are also known as CPT codes b. E & M Codes c. Category I codes are supplemental tracking codes that can be used for performance measurement. d. CMS Tracking codes. c. Category I codes are supplemental track...

CPMA Exam Questions And Answers False Claims Act Any person is liable if they knowingly present or cause to be presented a false or fraudulent claim for payment or approval; knowingly makes, uses, or causes to be made or used, a false record or material to a false or fraudulent claims Current ...

CPMA EXAM 2022 Med Records and Documentation guidelines Questions And Answers Covered entities under HIPAAs Privacy rule include? a. an employer based and maintained health plan with 50 or less employees b. health care clearinghouses c. Government-funded community health centers d. all ...

CPMA EXAM chapter 5 Questions And Answers What is numerical sampling? Sampling based on all possible services within a chosen time frame. In this methodology, the sample size is based on all possible services within a certain timeframe. This type of sample lends itself well to a random final ...

CPMA Exam Chapter 3 Questions And Answers When the list of associated add-on codes is too extensive, there will not be a list of applicable primary codes in a parenthetical note following the add-on code All add-on codes are exempt from the multiple procedure concepts (modifier 51) See Appen...

CPMA Exam Questions And Answers The HIPAA Privacy Rule defines "minimum necessary" as typically requiring healthcare employees to: Follow policies and procedures developed by the covered entity which limit use and disclosure of PHI to that which is needed to accomplish the intended purpos...

CPMA Study Guide Exam Questions And Answers What is considered essential elements to allow for proper coding of an operative report? *the approach *type of anesthesia *location & severity of the wounds repaired. Who is NOT considered a covered entity under HIPAA? Health care consultant Wha...

Cpma Exam Questions And Answers A provider consistently charges a higher level E/M service than is documented to help cover the cost of his declining practice. Would this be fraud or abuse Why? a. Abuse,charging one level higher on each visits does not show intent. b. Abuse; the provider's p...

CPMA Exam Questions And Answers Fraud or Abuse? Misrepresenting a DX to justify payment? Fraud Fraud or Abus? Improper billing practices Abuse Fraud or Abuse? Altering claim forms and/or receipts to receive a higher payment amount. Fraud Fraud or Abuse? Billing Medicare patients a higher fee ...

CPMA EXAM chapter 5 Exam Questions And Answers What is considered good parameters for a baseline audit? Random audit of 10-15 records per practitioner along with office and surgical procedures selected procedures selected randomly. Which resource is valuable when performing a surgical audit? N...

CPMA Exam Questions And Answers CMS Examples of Fraud Billing for services and/or supplies that you know were not furnished or provided, altering claim forms and/or receipts to receive a higher payment amount, billing a Medicare patient above the allowed amount for services, billing for servi...

Chapter 1 CPMA Exam Prep Questions And Answers 5 Common reasons for overpayment are: *Billing for excessive and subsequent payment of the same service or claim. *Duplicate submission and payment for same service or claim *Payment for excluded or Medically unnecessary services. *Payment for...

AAPC CPMA Practice Exam Study Questions And Answers When must ABNs be signed? Far enough in advance that the beneficiary or representative has time to consider the options and make an informed decision. SOAP and CHEDDAR are two formats of medical record documentation. Which section of each fo...

AAPC CASES CPMA Review Questions And Answers When must ABNs be signed? Far enough in advance that the beneficiary or representative has time to consider the options and make an informed choice What is the appropriate way to dispose of PHI that is no longer needed? Discard it in a locked shre...

CPMA Questions And Answers Who can use PCM Current certified practitioners , must pass test Next least restrictive transport after Sunday stroll Wrist tricep 4 guiding principals Respect for human dignity and freedom from pain Freedom of choice Least restrictive alternative Continuous feedback...

CPMA Questions And Answers Which may result in false claims act violation? A. A provider routinely waives the copay for MCR beneficiaries B. A provider accepts insurance only payments from MCR beneficiaries C. A provider submits claims to MCR for DME supplies not provided to MCR beneficiaries D...

CPMA 2018 (All of chapter 4) Questions And Answers Which of the following scenarios qualifies for a consultation code? A patient followed by her primary care physician for diabetes is referred to an endocrinologist in the same group practice to review the patient's current regimen and offe...

CPMA Compliance and Regulatory Guidelines (Ch 1) Questions And Answers Abuse * CMS defines as an action resulting in unnecessary costs to a federal healthcare program, either directly or indirectly. * Unnecessary costs * Examples include: 1) Misusing codes on a claim. 2) Charging excessivel...

CPMA- Chapter one exam Questions And Answers A provider consistently charges a higher level of E/M service than is documented to help cover the cost of his declining practice. Would this be fraud or abuse, and why? a. Abuse; the provider's practice is common and therefore would not be consi...

CPMA chapter 2 Questions And Answers Why is tCPMA chapter 2 Questions And Answers Why is the CERT program beneficial to auditors? The Cert program identifies errors causing improper payments by the Medicare program. The errors found can identify areas for providers to improve documentation SO...

Chapter 5 CPMA Exam: Contract-based Commercial Insurance Plans Questions And Answers Is the provider offered a chance at implementing corrective action? How these questions are answered will significantly affect the audit result, in terms of whether an auditor can declare error or can simply...