CPCO Questions and Answers with Verified Solutions | Latest 2026
Update
Q: What is the goal of ongoing auditing and monitoring in a physician's practice?
Answer:
Ongoing auditing and monitoring will evaluate whether the physician practice's
standards and procedures are current and accurate and whether the compliance
program is working.
Q: Question 2 A compliance program's plan for communication should include a
provision for non-retaliation for reporting fraudulent conduct. Which method
below helps ensure that an employee would be free from retribution?
Answer:
Well-publicized disciplinary actions for retaliation
Q: Question 3 What does the HHS OIG suggest as possible warning signs that
non-compliance may exist?
Answer:
Significant change in the number or type of claim rejections.
,CPCO Questions and Answers with Verified Solutions | Latest 2026
Update
Q: Question 4 Having the ability to respond to issues enables a practice to develop
effective action plans to correct problems and prevent future problems from
occurring. What is one step that can be taken to establish compliance
effectiveness for the response/prevention element?
Answer:
Create a response team, consisting of representatives from compliance, audit, and
any other relevant functional department.
Q: Question 5 A physician office laboratory is authorized to perform urinalysis
testing, including the microscopic analysis under their PPMP certification. It has
been the physician's experience that many of his patients that have urinalysis
testing done also require the microscopic exam. Because of this and to be able to
provide better treatment, he has established an office policy that for all urinalysis
testing performed in his office, the lab should also perform the microscopic test.
Is this a compliance risk?
Answer:
Yes. Performing the microscopic test on all patients when the results of the urinalysis
are negative could be considered medically unnecessary.
, CPCO Questions and Answers with Verified Solutions | Latest 2026
Update
Q: Question 6 Billing companies should have written policies and procedures that
reflect and reinforce Federal and State statutes. These policies must create a
mechanism for the billing or reimbursement staff to communicate effectively
and accurately with the health care provider. Which of the following policies
and procedures should a billing office have in place to meet these needs?
Answer:
Establish and maintain a process for pre- and post-submission review of claims to
ensure claims submitted for reimbursement accurately represent services provided,
are supported by sufficient documentation and are in conformity with any applicable
coverage criteria for reimbursement
Q: Question 7 According to the OIG, medically unnecessary services should only
be billed to Medicare in what circumstance?
Answer:
To receive a denial so that the claim can be submitted to a secondary payer.
Update
Q: What is the goal of ongoing auditing and monitoring in a physician's practice?
Answer:
Ongoing auditing and monitoring will evaluate whether the physician practice's
standards and procedures are current and accurate and whether the compliance
program is working.
Q: Question 2 A compliance program's plan for communication should include a
provision for non-retaliation for reporting fraudulent conduct. Which method
below helps ensure that an employee would be free from retribution?
Answer:
Well-publicized disciplinary actions for retaliation
Q: Question 3 What does the HHS OIG suggest as possible warning signs that
non-compliance may exist?
Answer:
Significant change in the number or type of claim rejections.
,CPCO Questions and Answers with Verified Solutions | Latest 2026
Update
Q: Question 4 Having the ability to respond to issues enables a practice to develop
effective action plans to correct problems and prevent future problems from
occurring. What is one step that can be taken to establish compliance
effectiveness for the response/prevention element?
Answer:
Create a response team, consisting of representatives from compliance, audit, and
any other relevant functional department.
Q: Question 5 A physician office laboratory is authorized to perform urinalysis
testing, including the microscopic analysis under their PPMP certification. It has
been the physician's experience that many of his patients that have urinalysis
testing done also require the microscopic exam. Because of this and to be able to
provide better treatment, he has established an office policy that for all urinalysis
testing performed in his office, the lab should also perform the microscopic test.
Is this a compliance risk?
Answer:
Yes. Performing the microscopic test on all patients when the results of the urinalysis
are negative could be considered medically unnecessary.
, CPCO Questions and Answers with Verified Solutions | Latest 2026
Update
Q: Question 6 Billing companies should have written policies and procedures that
reflect and reinforce Federal and State statutes. These policies must create a
mechanism for the billing or reimbursement staff to communicate effectively
and accurately with the health care provider. Which of the following policies
and procedures should a billing office have in place to meet these needs?
Answer:
Establish and maintain a process for pre- and post-submission review of claims to
ensure claims submitted for reimbursement accurately represent services provided,
are supported by sufficient documentation and are in conformity with any applicable
coverage criteria for reimbursement
Q: Question 7 According to the OIG, medically unnecessary services should only
be billed to Medicare in what circumstance?
Answer:
To receive a denial so that the claim can be submitted to a secondary payer.
