Exam (elaborations)
CPCO CHAPTER #12 EXAM QUESTIONS WITH CORRECT ANSWERS
- Course
- Institution
CPCO CHAPTER #12 EXAM QUESTIONS WITH CORRECT ANSWERS
[Show more]
Content preview
CPCO CHAPTER #12 EXAM QUESTIONSWITH CORRECT ANSWERS
Which Code of Federal Regulation section is important to Compliance Officers and
why?
42; it covers the Medicare and Medicaid programs
42; it covers practice management rules
40; it covers military insurance issues
40; it covers HIPAA privacy rules - ANSWER-42; it covers the Medicare and Medicaid
programs
The bulk of the federal regulations in 42 CFR Part 4 covers the Medicare and Medicaid
programs.
The guidance provided by the OIG can be incorporated in policies to prevent
_______________________________ errors from occurring.
documentation and coding
coding and auditing
coding and billing
billing and fee schedule - ANSWER-coding and billing
The guidance provided by the OIG can be incorporated in policies to prevent coding and
billing errors form occurring and help with false claims.
Incident-to services are defined as those services that are furnished incident to
physician professional services in the physician's office (whether located in a separate
office suite or within an institution) or in a patient's home. Who may provide incident-to
services?
fellow
non-physician provider (NP or PA)
resident
All of the above - ANSWER-non-physician provider (NP or PA)
Incident-to services are defined as those services that are furnished incident to
physician professional services in the physician's office (whether located in a separate
office suite or within an institution) or in a patient's home. The overseeing provider does
not have to be physically present in the same room while the services are provided but
must provide direct supervision. If it is physician's group, any physician member of the
group may be present in the office to supervise. There have been some questions
recently about whether a Non-Physician Provider (NP or PA) could see patients in the
hospital or a Skilled Nursing Facility (SNF) and bill incident-to.
Workers Compensation is part of the _________.
DOL
OIG
CMS
DOJ - ANSWER-DOL
, Workers Compensation is part of the Department of Labor.
Which entity enforces the HIPAA Privacy Rule?
OIG
DOJ
HHS
OCR - ANSWER-OCR
The Office for Civil Rights enforces the HIPAA Privacy Rule, which protects the privacy
of individually identifiable health information; the HIPAA Security Rule, which sets
national standards for the security of ePHI; the HIPAA Breach Notification Rule, which
requires covered entities and business associates to provide notification following a
breach of unsecured PHI; and the confidentiality provisions of the Patient Safety Rule,
which protect identifiable information being used to analyze patient safety events and
improve patient safety. OCR also provides oversight of the HIPAA Enforcement Rule.
CMS publishes the physician fee schedule each year in the _____.
Federal Register
Work Plan
Semi Annual Report
Advisory Letters - ANSWER-Federal Register
CMS publishes the physician fee schedule each year in the Federal Register.
Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131. This section
provides instructions regarding the notice issued by providers to beneficiaries in
advance of providing what they believe to be ________ services.
covered
deductible
non-covered
medically necessary - ANSWER-non-covered
Section 50 of the Medicare Claims Processing Manual establishes the standards for use
by providers and suppliers (including laboratories) in implementing the Advance
Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131. This section provides
instructions regarding the notice issued by providers to beneficiaries in advance of
providing what they believe to be non-covered items or services.
Which statement is TRUE regarding marketing providers who are credentialed with
Medicare?
A provider can market as approved by Medicare within a 100 mile radius of his practice.
A provider can market himself as credentialed or approved as the terms are used
interchangeable.
Marketing a provider as credentialed is only allowed once the provider has been
contracted with Medicare for more than one year.
Marketing a provider as approved by Medicare is a violation of the Social Security Act. -
ANSWER-Marketing a provider as approved by Medicare is a violation of the Social
Security Act.
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 biggdreamer. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
71241 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 15 years now
