CPMA Questions And Answers
Far enough in advance that the beneficiary or representative has time to consider the options and
make an informed decision When must ABNs be signed?
For a six (6) year period of time Patients can request copies of disclosure of PHI under
HIPAA
Fraud A provider knows that an evaluation and management service they provide on the
same date as a major procedure will be bundled, so he submits the claim for the E/M with a
different date of service. This is an example of:
Three times the amount improperly claimed For the civil monetary penalties, for false or
fraudulent claims, up to how many times of the amount damages are for each false claim
submitted?
Physician Tax Issues Which type of case is not prosecuted under the federal false claims
act?
, CPMA Questions And Answers
5% A full sample must be reviewed and a systems review must be conducted when the net
financial error rate of the sampling equals or exceeds what percent?
Only physicians who refer Medicare and Medicaid patients to entities for designated health care
services with which the provider or immediate family member has a financial relationship
The Stark Statute applies to...
If a RAC can demonstrate a high level of error, the RAC can then extrapolate the findings and
request a refund. When can a RAC extrapolate the overpayment(s) on claims?
10 records per year, per provider What are the recommended number of charts to audit per
provider and the minimum frequency of the audit according to the OIG Recommended
Compliance Plan?
Software used in performing statistical random samples and evaluating results How is
RAT-STATS used by an auditor?
Selection of a large number of claims are selected for a review that might be focused on specific
procedure and/or diagnosis codes. A comprehensive audit is
Far enough in advance that the beneficiary or representative has time to consider the options and
make an informed decision When must ABNs be signed?
For a six (6) year period of time Patients can request copies of disclosure of PHI under
HIPAA
Fraud A provider knows that an evaluation and management service they provide on the
same date as a major procedure will be bundled, so he submits the claim for the E/M with a
different date of service. This is an example of:
Three times the amount improperly claimed For the civil monetary penalties, for false or
fraudulent claims, up to how many times of the amount damages are for each false claim
submitted?
Physician Tax Issues Which type of case is not prosecuted under the federal false claims
act?
, CPMA Questions And Answers
5% A full sample must be reviewed and a systems review must be conducted when the net
financial error rate of the sampling equals or exceeds what percent?
Only physicians who refer Medicare and Medicaid patients to entities for designated health care
services with which the provider or immediate family member has a financial relationship
The Stark Statute applies to...
If a RAC can demonstrate a high level of error, the RAC can then extrapolate the findings and
request a refund. When can a RAC extrapolate the overpayment(s) on claims?
10 records per year, per provider What are the recommended number of charts to audit per
provider and the minimum frequency of the audit according to the OIG Recommended
Compliance Plan?
Software used in performing statistical random samples and evaluating results How is
RAT-STATS used by an auditor?
Selection of a large number of claims are selected for a review that might be focused on specific
procedure and/or diagnosis codes. A comprehensive audit is
