CPCO Chapter 11 Review
UPDATED ACTUAL Exam
Questions and CORRECT Answers
Save
Terms in this set (25)
Can providers Yes, by calling the requestor and
request an explaining the reason for delay
extension for
providing Response Feedback:
records Rationale: If there is a problem
requested by meeting the deadline, call the
an auditor if requestor to explain the reason for
there is a the delay and ask for an extension.
problem
meeting the
deadline?
, Section 1936 of the Social Security
Act
Response Feedback:
What Section 1936 of the Social Security
established the Act created the Medicaid Integrity
Medicaid Program (MIP) and directed the
Integrity CMS to enter into contracts to
Program? review Medicaid provider actions,
audit claims, identify
overpayments, and educate
providers and others on Medicaid
program integrity issues.
, 75 days
The
Compliance Response Feedback:
Officer asked 75 days. The CERT documentation
the Billing contractor may request medical
Manager at records from the provider or
Orange supplier who submitted the claim:
Hospital how For some claim types (e.g.,
many days they DMEPOS, clinical diagnostic
had to send laboratory services), additional
CERT documentation requests are also
contractor made to the referring provider
documentation. who ordered the item or service.
The Billing If no documentation is received
Manager said within 75 days of the initial request,
that the claim is classified as a "no
documentation documentation" claim and counted
had to be sent as an error.
to the CERT If documentation is received after
contractor 75 days of the initial request (late
within: documentation), CERT will still
review the claim.
UPDATED ACTUAL Exam
Questions and CORRECT Answers
Save
Terms in this set (25)
Can providers Yes, by calling the requestor and
request an explaining the reason for delay
extension for
providing Response Feedback:
records Rationale: If there is a problem
requested by meeting the deadline, call the
an auditor if requestor to explain the reason for
there is a the delay and ask for an extension.
problem
meeting the
deadline?
, Section 1936 of the Social Security
Act
Response Feedback:
What Section 1936 of the Social Security
established the Act created the Medicaid Integrity
Medicaid Program (MIP) and directed the
Integrity CMS to enter into contracts to
Program? review Medicaid provider actions,
audit claims, identify
overpayments, and educate
providers and others on Medicaid
program integrity issues.
, 75 days
The
Compliance Response Feedback:
Officer asked 75 days. The CERT documentation
the Billing contractor may request medical
Manager at records from the provider or
Orange supplier who submitted the claim:
Hospital how For some claim types (e.g.,
many days they DMEPOS, clinical diagnostic
had to send laboratory services), additional
CERT documentation requests are also
contractor made to the referring provider
documentation. who ordered the item or service.
The Billing If no documentation is received
Manager said within 75 days of the initial request,
that the claim is classified as a "no
documentation documentation" claim and counted
had to be sent as an error.
to the CERT If documentation is received after
contractor 75 days of the initial request (late
within: documentation), CERT will still
review the claim.
