Cpma chapter 5 review - Study guides, Class notes & Summaries

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? NCCI Manual assists the auditor in determining bundling issues with CPT code services provided. What is non-statistical sampling? Sample based on unique services that were defined in the objective...

Chapter 5 CPMA Exam Contract-based Commercial Insurance Plans Questions and Answers Most common commercial insurance plans are - Answer ️️ contract based That is, benefits arise primarily under a contract between the insurance company and the subscriber/patient Where the healthcare provider is in network, - Answer ️️ the provider agrees to abide by certain rules in a separate contract.. The auditor must review the contract to determine the rules the provider is bound to follow Fo...

Chapter 5 CPMA Exam: Contract-based Commercial Insurance Plans | Questions and Correct Answers | Latest Update 2024/2025 | 100% PASS Most common commercial insurance plans are - Answer -contract based That is, benefits arise primarily under a contract between the insurance company and the subscriber/patient Where the healthcare provider is in network, - Answer -the provider agrees to abide by certain rules in a separate contract.. The auditor must review the contract to determine the...

CPMA 2024(All of chapter 4) Questions and Answers 100% Solved Which procedure is exempt from Modifier 5? 93456 Which of the following code combination are NOT subject to a multiple procedure payment reduction? 32666, 32764 In febuary 2018, an auditor is asked to review 10 records for date of service 12/1/2017 to make sure the claims were paid correctly. The claims included code 55450, which was denied on all the claims. The denial was for an invalid code. What should the auditor advise...

CPMA EXAM chapter 5 Questions & Answers Which statement is true regarding an audit performed on charts for Medicare beneficiaries? - Correct ️️ National CMS policies and local MAC policies should be utilized when performing Medicare audits. In addition to CMS it is necessary to know your Medicare Administrative Contractor that supports the location where services are rendered for example 4x4 rule. How often should an internal audit be conducted minimally? - Correct ️️ Annually (more...

CPMA EXAM chapter 5 Questions and Answers Which statement is true regarding an audit performed on charts for Medicare beneficiaries? - Correct ️️ National CMS policies and local MAC policies should be utilized when performing Medicare audits. In addition to CMS it is necessary to know your Medicare Administrative Contractor that supports the location where services are rendered for example 4x4 rule. How often should an internal audit be conducted minimally? - Correct ️️ Annually (mo...

CPMA EXAM chapter 5 Questions and Answers 100% Solved Which statement is true regarding an audit performed on charts for Medicare beneficiaries?National CMS policies and local MAC policies should be utilized when performing Medicare audits. In addition to CMS it is necessary to know your Medicare Administrative Contractor that supports the location where services are rendered for example 4x4 rule. How often should an internal audit be conducted minimally?Annually (more often if probl...

CPMA 2024(All of chapter 4) Questions and Answers 100% Solved Which procedure is exempt from Modifier 5? 93456 Which of the following code combination are NOT subject to a multiple procedure payment reduction? 32666, 32764 In febuary 2018, an auditor is asked to review 10 records for date of service 12/1/2017 to make sure the claims were paid correctly. The claims included code 55450, which was denied on all the claims. The denial was for an invalid code. What should the auditor advise...

CPMA Exam (All of chapter 4) Questions and Answers Which procedure is exempt from Modifier 5? - Correct ️️ 93456 Which of the following code combination are NOT subject to a multiple procedure payment reduction? - Correct ️️ 32666, 32764 In febuary 2018, an auditor is asked to review 10 records for date of service 12/1/2017 to make sure the claims were paid correctly. The claims included code 55450, which was denied on all the claims. The denial was for an invalid code. What should...

CPMA EXAM chapter 5 Questions and Answers 100% Solved Which statement is true regarding an audit performed on charts for Medicare beneficiaries?National CMS policies and local MAC policies should be utilized when performing Medicare audits. In addition to CMS it is necessary to know your Medicare Administrative Contractor that supports the location where services are rendered for example 4x4 rule. How often should an internal audit be conducted minimally?Annually (more often if probl...