CPCO STUDY GUIDE EXAM QUESTIONS
WITH COMPLETE ANSWERS
A high-level statement or plan that embraces an organization's general beliefs, goals,
objectives and acceptable procedure for a specified subject area is a
_______________? - ANSWER-policy
Kim is the Compliance Officer for ABC Provider Group. Kim has read the OIG
Compliance Program Guidance that acknowledges patient care as the first priority of a
physician practice. As the Compliance Officer (CO), Kim should implement what type of
compliance model? - ANSWER-A "patients first"
It is important to educate employees of the methods they may utilize to directly notify
and communicate issues of suspected areas of non-compliance. What is considered a
best practice method of anonymous reporting? - ANSWER-intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine? - ANSWER-areas of
the billing department that might be in compliance
When the term Open Door Policy is used in reference to the Effective Communication,
what is this referring to? - ANSWER-The Compliance Officer is accessible to all
employees via many methods of communication
When Kim from ABC Provider Group is conducting a risk assessment, one of the most
important and key sources of information that a Kim as the Compliance Officer should
utilize is_____________. - ANSWER-the Office of Inspector General's Annual Work
Plan
The mission statement of the healthcare organization and a statement of why they are
in business are also known as _________? - ANSWER-The Code of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital update the
compliance program and plan? - ANSWER-As laws and regulations change; and at
least annually
After an employee receives their initial training regarding the practice/organization
Compliance Program what is the next step the compliance officer should take to protect
the practice against potential noncompliance activity? - ANSWER-Perform a baseline
assessment of the employee's competency scores to determine if additional training is
required
ABC Provider Group and Apple Medical Group agree to pool their resources for the
purpose of accomplishing a specific task. This is called _____________. - ANSWER-
Joint ventures
, The following is not a level of non-compliance: - ANSWER-Mistake in billing
For potential criminal violations, a practice should have immediate discussions with a
criminal attorney who - ANSWER-Is well versed in Healthcare Fraud and Abuse law
The Compliance Officer's main two responsibilities are to ____________the
practice/organization's compliance program. - ANSWER-develops and then implement
Judy is the Compliance Officer for Apple Medical Group. The providers of the group ask
Judy to design a new Compliance Plan. Should Judy ask some other practices in town
for a copy of their Compliance Plan? Do all Compliance Programs have to be the same
regardless of the practice size or specialty? Why? - ANSWER-No, compliance
programs need to be tailored to fit the unique needs of every organization or physician
practice
USSC is important as it related to the Federal Sentencing Guidelines and thus related to
the core elements of compliance. What does the USSC acronym stand for? - ANSWER-
United States Sentencing Commission
Kathy, the Compliance Officer at a small provider office, is notified that a non-English
speaking patient will be arriving today. A LEP person/patient who needs an interpreter
to translate to and from the person's primary language must be provided. - ANSWER-at
no cost to the patient or insurance carrier
In addition to hospitals, what other type of facility did the OIG provide supplemental
compliance program guidance for? - ANSWER-Nursing Facilities
What is (are) considered a significant element(s) in fraud? - ANSWER-Knowingly and
Intent
Department of Labor requires compliance with employee and employer laws including: -
ANSWER-FLSA, OSHA, CRA, ERISA
Which government branch was created to fight waste, fraud and abuse in all federal
health care programs especially Medicare, Medicaid? - ANSWER-Office of Inspector
General (OIG)
Dr. X is a very through provider. He always runs a full blood panel on each patient every
year for their physical. This is an example of: - ANSWER-Waste
The current strategy for the DOJ includes all of the following except: - ANSWER-Ensure
the privacy of patient records with the use of HIPAA
Which options are key elements for an effective Compliance Program?
I. Conducting external auditing and monitoring.
WITH COMPLETE ANSWERS
A high-level statement or plan that embraces an organization's general beliefs, goals,
objectives and acceptable procedure for a specified subject area is a
_______________? - ANSWER-policy
Kim is the Compliance Officer for ABC Provider Group. Kim has read the OIG
Compliance Program Guidance that acknowledges patient care as the first priority of a
physician practice. As the Compliance Officer (CO), Kim should implement what type of
compliance model? - ANSWER-A "patients first"
It is important to educate employees of the methods they may utilize to directly notify
and communicate issues of suspected areas of non-compliance. What is considered a
best practice method of anonymous reporting? - ANSWER-intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine? - ANSWER-areas of
the billing department that might be in compliance
When the term Open Door Policy is used in reference to the Effective Communication,
what is this referring to? - ANSWER-The Compliance Officer is accessible to all
employees via many methods of communication
When Kim from ABC Provider Group is conducting a risk assessment, one of the most
important and key sources of information that a Kim as the Compliance Officer should
utilize is_____________. - ANSWER-the Office of Inspector General's Annual Work
Plan
The mission statement of the healthcare organization and a statement of why they are
in business are also known as _________? - ANSWER-The Code of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital update the
compliance program and plan? - ANSWER-As laws and regulations change; and at
least annually
After an employee receives their initial training regarding the practice/organization
Compliance Program what is the next step the compliance officer should take to protect
the practice against potential noncompliance activity? - ANSWER-Perform a baseline
assessment of the employee's competency scores to determine if additional training is
required
ABC Provider Group and Apple Medical Group agree to pool their resources for the
purpose of accomplishing a specific task. This is called _____________. - ANSWER-
Joint ventures
, The following is not a level of non-compliance: - ANSWER-Mistake in billing
For potential criminal violations, a practice should have immediate discussions with a
criminal attorney who - ANSWER-Is well versed in Healthcare Fraud and Abuse law
The Compliance Officer's main two responsibilities are to ____________the
practice/organization's compliance program. - ANSWER-develops and then implement
Judy is the Compliance Officer for Apple Medical Group. The providers of the group ask
Judy to design a new Compliance Plan. Should Judy ask some other practices in town
for a copy of their Compliance Plan? Do all Compliance Programs have to be the same
regardless of the practice size or specialty? Why? - ANSWER-No, compliance
programs need to be tailored to fit the unique needs of every organization or physician
practice
USSC is important as it related to the Federal Sentencing Guidelines and thus related to
the core elements of compliance. What does the USSC acronym stand for? - ANSWER-
United States Sentencing Commission
Kathy, the Compliance Officer at a small provider office, is notified that a non-English
speaking patient will be arriving today. A LEP person/patient who needs an interpreter
to translate to and from the person's primary language must be provided. - ANSWER-at
no cost to the patient or insurance carrier
In addition to hospitals, what other type of facility did the OIG provide supplemental
compliance program guidance for? - ANSWER-Nursing Facilities
What is (are) considered a significant element(s) in fraud? - ANSWER-Knowingly and
Intent
Department of Labor requires compliance with employee and employer laws including: -
ANSWER-FLSA, OSHA, CRA, ERISA
Which government branch was created to fight waste, fraud and abuse in all federal
health care programs especially Medicare, Medicaid? - ANSWER-Office of Inspector
General (OIG)
Dr. X is a very through provider. He always runs a full blood panel on each patient every
year for their physical. This is an example of: - ANSWER-Waste
The current strategy for the DOJ includes all of the following except: - ANSWER-Ensure
the privacy of patient records with the use of HIPAA
Which options are key elements for an effective Compliance Program?
I. Conducting external auditing and monitoring.
