Cpma chapter 2 - Study guides, Class notes & Summaries

CPMA Exam Chapter 3 Questions and Answers 100% correct 2023 Accurate reimbursement begins with accurate coding and rules that vary by payer The CPT codebook contains instructions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. An auditor must be able to apply payer variations to the CPT guidelines during an audit, and must communicate the differences in a way that will make sense to the pro...

Chapter 1 CPMA Exam Prep Questions and Answers | 100% Pass 12.1% - Answer-# of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - Answer-Fee-For-Service Prepayment Review - Answer-Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review - Answer-Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or overp...

CPMA Exam Chapter 3 Study Guide with Complete Solutions Accurate reimbursement begins with - Answer-accurate coding and rules that vary by payer The CPT codebook contains - Answer-instructions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. - Answer-An auditor must be able to apply payer variations to the CPT guidelines during an audit, and must communicate the differences in a way that will make sen...

CPMA Chapter 5 - Analysis and Report of Audit Findings Exam Questions and Answers | 100% Pass Understanding how to develop and draft a well-structured and detailed audit report is - Answer-a critical skill for any competent auditor. The audit report should identify the key findings and present the analysis, rationale and recommendations in a format that is - Answer-easy for the auditee to read, understand and apply Components of the Audit Report - Answer-Background Summary of Audit Find...

CPMA Chapter 6 Review Questions and Answers | 100% Pass What is the reason audit findings should be discussed with the provider audited? - Answer-To provide a risk analysis, identify problem areas, and recommend corrective action with supporting documentation What type of information can be found In The providers contract with the insurance carrier? - Answer-The providers obligation to follow the insurance company's medical policies What type of insurance plans may require an auditor ...

CPMA Exam Prep 2018 Chapter 1 Part 2, Questions and answers, 100% Accurate, rated A+ OIG - -Office of Inspector General CIA - -Corporate Integrity Agreement CMS - -Centers for Medicare and Medicaid Services FCA - -False Claims Act CMPL - -Civil Monetary Penalties Law Billing for services and /or supplies that you know were not furnished or provided - -CMS example of fraud Altering claim forms and/or receipts to receive a higher payment amount - -CMS example of fraud Bil...

CPMA Chapter 1, Top Questions and answers, 100% Accurate. Rated A+ Stark Law - -Physician Self Referral Law Prohibits a physician from making a referral to an entity with which they or their immediate family has a financial relationship if the referral is for the furnishing of designated health services RAT-STATS - -A statistical software that is a valuable analytical tool used by auditors Components of RAT-STATS that should be used to perform CIA Claims Review - -"Random Numbers" ...

CPMA Exam Chapter 3. Top Exam Questions and answers, Verified. Rated A Accurate reimbursement begins with - -accurate coding and rules that vary by payer The CPT codebook contains - -instructions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. - -An auditor must be able to apply payer variations to the CPT guidelines during an audit, and must communicate the differences in a way that will make sen...

CPMA Chapter 1, Questions and answers, 100% Accurate, rated A Stark Law - -Physician Self Referral Law Prohibits a physician from making a referral to an entity with which they or their immediate family has a financial relationship if the referral is for the furnishing of designated health services RAT-STATS - -A statistical software that is a valuable analytical tool used by auditors Components of RAT-STATS that should be used to perform CIA Claims Review - -"Random Numbers" to dr...