CPCO EXAM Questions and Answers
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Question:
A. Promote an organizational culture that encourages ethical conduct and a
commitment to compliance with the law.
Answer:
According to the Federal Sentencing Guidelines, "To have an effective compliance and
ethics program..., an organization shall exercise due diligence to prevent and detect
criminal conduct." The FSGs also state organizations shall: A. Promote an
organizational culture that encourages ethical conduct and a commitment to
compliance with the law. B. Implement mandatory compliance programs. C. Perform
annual audits to detect criminal conduct. D. Immediately report evidence of
misconduct to the authorities.
Question:
B. Tailor those materials to the physician practice where they will be applied..
Answer:
If a physician practice uses another entity's standards of conduct, the practice must: A.
Implement the standards of conduct as received because they have already been
approved. B. Tailor those materials to the physician practice where they will be applied.
C. Only select those standards that represent high risk issues for the practice. D. None
of the above. Physician practices must create their own standards of conduct. It would
be a compliance violation to copy another entity's standards of conduct.
Question:
B. For any services billed, documentation must be present in the patient's medical
record to support the services..
Answer:
As the compliance contact for your physician practice, you are charged with developing
the policies and procedures related to coding and billing. When developing these
policies and procedures, which of the following statements should be included? A. If a
new physician joins the practice and the new physician's NPI has not been received,
services performed should be reported using the practice medical director's NPI. B. For
any services billed, documentation must be present in the patient's medical record to
support the services. C. To avoid compliance risk, coding for E/M services should be
,based solely on medical record documentation, even if it appears the level of service is
not warranted. D. For denied services, billing staff should notify the physician to
change the reported diagnosis to allow for resubmission and payment of the claim.
Question:
D. Document the conversation and retain the records..
Answer:
City Orthopedics, a large physician group practice employs several physician assistants
and nurse practitioners. There have been several questions by the physicians on how
incident to services should be billed. The compliance officer has called the Medicare
Administrative Contractor for the practice and was given some information on how
incident to services should be billed. Because the practice will be relying on the
information received from the Medicare Administrative Contractor, what steps should
the compliance officer take at the conclusion of the call according to the OIG
Compliance Guidance for Individual and Small Group Physician Practices? A. Call
someone else at the Medicare Administrative Contractor to confirm the information
received. B. Send a letter to CMS to confirm the information provided by the Medicare
Administrative Contractor is correct. C. Both A and B D. Document the conversation
and retain the records.
Question:
B. Be sure any timeframes or requirements listed can be accomplished given the
practice's resources..
Answer:
Developing effective compliance policies and procedures is an important part of any
compliance program. To help your practice mitigate compliance risk, policies and
procedures should: A. Only be one page long to promote understanding by all staff. B.
Be sure any timeframes or requirements listed can be accomplished given the
practice's resources. C. Be written by consultants because they are more familiar with
the variety of healthcare regulations that apply to the practice. D. Both B and C
, Question:
C. Verify accuracy of coding and reimbursement for the services performed..
Answer:
Select the best phrase from the list below to complete the following policy statement:
Centennial Medical Associates is committed to following Federal, State, and Local laws,
rules, guidelines, and regulations. To promote this effort, Centennial Medical Associates
will perform claims audits at least on an annual basis to ____________________. A.
Maximize reimbursement for the services performed. B. Optimize reimbursement for
the services performed. C. Verify accuracy of coding and reimbursement for the
services performed. D. Ensure all services are submitted for reimbursement.
Question:
A. Reviewing reports to see that new employees and vendors have been checked
against the OIG's list of excluded individuals and entities..
Answer:
You have just been identified as the compliance officer at your practice. The OIG
Compliance Guidance for Individual and Small Group Physician Practices suggests six
specific duties that may be assigned to you. What is one of those duties? A. Reviewing
reports to see that new employees and vendors have been checked against the OIG's
list of excluded individuals and entities. B. Making sure no one changes the compliance
program so you are able to show how the program was implemented. C. Reviewing all
claims being submitted to be sure they do not violate fraud and abuse laws. D.
Submitting annual reports to the Office of Inspector General on all compliance activities
undertaken during the year.
Question:
D. Regularly.
Answer:
For larger physician practices, how frequently does the OIG recommend reporting
compliance activities to the Board of Directors and CEO? A. Monthly B. Quarterly C.
Annually D. Regularly
Question:
C. All employees will receive training on how to perform their jobs in compliance with
the standards of the practice and any applicable regulations..
Answer:
When conducting compliance training within a physician practice, what is one of the
goals that the practice should strive for in this training? A. Only new employees will
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Question:
A. Promote an organizational culture that encourages ethical conduct and a
commitment to compliance with the law.
Answer:
According to the Federal Sentencing Guidelines, "To have an effective compliance and
ethics program..., an organization shall exercise due diligence to prevent and detect
criminal conduct." The FSGs also state organizations shall: A. Promote an
organizational culture that encourages ethical conduct and a commitment to
compliance with the law. B. Implement mandatory compliance programs. C. Perform
annual audits to detect criminal conduct. D. Immediately report evidence of
misconduct to the authorities.
Question:
B. Tailor those materials to the physician practice where they will be applied..
Answer:
If a physician practice uses another entity's standards of conduct, the practice must: A.
Implement the standards of conduct as received because they have already been
approved. B. Tailor those materials to the physician practice where they will be applied.
C. Only select those standards that represent high risk issues for the practice. D. None
of the above. Physician practices must create their own standards of conduct. It would
be a compliance violation to copy another entity's standards of conduct.
Question:
B. For any services billed, documentation must be present in the patient's medical
record to support the services..
Answer:
As the compliance contact for your physician practice, you are charged with developing
the policies and procedures related to coding and billing. When developing these
policies and procedures, which of the following statements should be included? A. If a
new physician joins the practice and the new physician's NPI has not been received,
services performed should be reported using the practice medical director's NPI. B. For
any services billed, documentation must be present in the patient's medical record to
support the services. C. To avoid compliance risk, coding for E/M services should be
,based solely on medical record documentation, even if it appears the level of service is
not warranted. D. For denied services, billing staff should notify the physician to
change the reported diagnosis to allow for resubmission and payment of the claim.
Question:
D. Document the conversation and retain the records..
Answer:
City Orthopedics, a large physician group practice employs several physician assistants
and nurse practitioners. There have been several questions by the physicians on how
incident to services should be billed. The compliance officer has called the Medicare
Administrative Contractor for the practice and was given some information on how
incident to services should be billed. Because the practice will be relying on the
information received from the Medicare Administrative Contractor, what steps should
the compliance officer take at the conclusion of the call according to the OIG
Compliance Guidance for Individual and Small Group Physician Practices? A. Call
someone else at the Medicare Administrative Contractor to confirm the information
received. B. Send a letter to CMS to confirm the information provided by the Medicare
Administrative Contractor is correct. C. Both A and B D. Document the conversation
and retain the records.
Question:
B. Be sure any timeframes or requirements listed can be accomplished given the
practice's resources..
Answer:
Developing effective compliance policies and procedures is an important part of any
compliance program. To help your practice mitigate compliance risk, policies and
procedures should: A. Only be one page long to promote understanding by all staff. B.
Be sure any timeframes or requirements listed can be accomplished given the
practice's resources. C. Be written by consultants because they are more familiar with
the variety of healthcare regulations that apply to the practice. D. Both B and C
, Question:
C. Verify accuracy of coding and reimbursement for the services performed..
Answer:
Select the best phrase from the list below to complete the following policy statement:
Centennial Medical Associates is committed to following Federal, State, and Local laws,
rules, guidelines, and regulations. To promote this effort, Centennial Medical Associates
will perform claims audits at least on an annual basis to ____________________. A.
Maximize reimbursement for the services performed. B. Optimize reimbursement for
the services performed. C. Verify accuracy of coding and reimbursement for the
services performed. D. Ensure all services are submitted for reimbursement.
Question:
A. Reviewing reports to see that new employees and vendors have been checked
against the OIG's list of excluded individuals and entities..
Answer:
You have just been identified as the compliance officer at your practice. The OIG
Compliance Guidance for Individual and Small Group Physician Practices suggests six
specific duties that may be assigned to you. What is one of those duties? A. Reviewing
reports to see that new employees and vendors have been checked against the OIG's
list of excluded individuals and entities. B. Making sure no one changes the compliance
program so you are able to show how the program was implemented. C. Reviewing all
claims being submitted to be sure they do not violate fraud and abuse laws. D.
Submitting annual reports to the Office of Inspector General on all compliance activities
undertaken during the year.
Question:
D. Regularly.
Answer:
For larger physician practices, how frequently does the OIG recommend reporting
compliance activities to the Board of Directors and CEO? A. Monthly B. Quarterly C.
Annually D. Regularly
Question:
C. All employees will receive training on how to perform their jobs in compliance with
the standards of the practice and any applicable regulations..
Answer:
When conducting compliance training within a physician practice, what is one of the
goals that the practice should strive for in this training? A. Only new employees will
