Exam (elaborations)
CPCO Final Exam prep 40 Questions and Answers 100% Solved
- Course
- Institution
CPCO Final Exam prep 40 Questions and Answers 100% Solved
[Show more]
Content preview
CPCO Final Exam prep 40 Questions andAnswers 100% Solved
Many times a Compliance Committee will review provider documentation on a regular basis.
When a practice identifies that a provider is an outlier, it becomes most important to verify that
the billed services are what? - ✔✔documented and coded correctly
A patient is considered new if they meet which of the following criteria? - ✔✔A patient who has
not received any professional services from the physician or another physician of the same
specialty who belongs to the same group practice within the past three (3) years
Larry is a Non Physician Provider (PA) and he is explaining that the services he delivers to
patients must be delivered under the provider's direct supervision and the provider must be
____________ if he is going to bill Incident To. - ✔✔same office suite
If a physician or mid-level (non-physician provider) in the group supervises the services, the bill
goes out under who's name? - ✔✔his/her name
As specified in the Code of Conduct, no employee or agent of the practice/organization may
have a relationship if they have a criminal conviction related to health care or _________? -
✔✔have been excluded from participating in federally funded healthcare plans.
Hannah is the Compliance Officer for Orange Hospital. She is explaining to her mother that
Medicare Part B pays for what type of services? - ✔✔Physician
Which services—in particular, require physicians to complete a Certificate of Medical Necessity
(CMN)? - ✔✔Medicare covered durable medical equipment (DME)
, The Medicare program has program manual instructions on overpayments. Generally,
overpayments are returned to the____________? - ✔✔MAC
During the monthly new hire training, Sarah , the Compliance Officer for Apple Hospital,
explains that as an element of a billing and reimbursement compliance program is essential.
Employees must be aware of the compliance issues and the applicable laws and regulations
especially those that pertain to what? - ✔✔their specific job descriptions
Modifiers provide the means by which a physician practice can indicate a service or procedure
that has been performed has been altered by some specific circumstance, but not changed in its
definition or code. Assuming the modifier is used correctly and appropriately, this specificity
provides the justification for payment for those services. The OIG recently published
information that modifier ____ was being misused. This modifier is only suppose to be used for
a procedure on a different site or location. - ✔✔59
In addition to keeping a training log, materials, and records, to make sure employees
understand the training content compliance officers should also obtain what from employees? -
✔✔an attestation
John, Compliance Officer for ABC Medical Group told the Board that when conducting a risk
assessment, that coding and billing are considered to be what level of risk to an organization? -
✔✔high
Medical practices should be aware of risks identified in the past and then establish policies and
procedures for what? - ✔✔continual monitoring
Modifier 25 is used to allow additional payment for E/M services performed by a provider on
the same day as a procedure, as long as ____________. - ✔✔The E/M services are significant,
separately identifiable, and above and beyond the usual preoperative and postoperative care
associated with the procedure.
To ensure that Medicare does not incorrectly reimburse the physician for the overhead portion
of the payment if the service was performed in a facility setting it is important to have what on
the claim? - ✔✔The correct place of service
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller TheeGrades. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79373 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now