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

Chapter 1 CPMA Exam Prep questions and answers 100% guaranteed success. 12.1% - correct answers.# of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - correct answers.Fee-For-Service Prepayment Review - correct answers.Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review - correct answers.Review of claims after payment. May result in either no change to the initial d...

CPMA 2023 (All of chapter 4) Questions and Answers Graded A+ 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 ...

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...

Which statement is true regarding an audit performed on charts for Medicare beneficiaries? - ANSWER 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? - ANSWER Annually (more often if problem is seen) What is a utilization review...

CPMA Exam Chapter 5: Communication Under Corporate integrity Agreement Study Guide In some circumstances, as part of a settlement agreement involving repayment of money to the government, the government will impose - Answer-a Corporate Integrity Agreement (CIA) A CIA (Corporate Integrity Agreement) is - Answer-an imposed compliance program, usually in force for five (5) years. During the time (usually 5 years) of an imposed Corporate Integrity Agreement, the entity must demonstrate - Ans...

Chapter 1 CPMA Exam Prep, Questions and answers, 1005% accurate, Verified. 12.1% - -# of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - -Fee-For-Service Prepayment Review - -Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review - -Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or overpaym...

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...

Chapter 1 CPMA Exam Prep Questions with accurate answers, 100% Accurate, rated A+ 12.1% - -# of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - -Fee-For-Service Prepayment Review - -Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review - -Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or o...

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 5: Corrective action Plans, Questions and answers, 100% accurate. Except in the case of routine or annual compliance audits conducted on behalf of providers that do not have formal compliance programs or staff, - -it is not usually the auditor's responsibility to develop a corrective action plan. In the case of audits associated with voluntary repayments or disclosures under the SDP (Self Disclosure Protocol) for potentially fraudulent conduct, - -it usually falls to...