CPPM Practice UPDATED ACTUAL Exam
Questions and CORRECT Answers
Which of the following scenarios is appropriate incident-to billing? - CORRECT
ANSWER D. A physician's assistant at an OB/GYN practice sees patients for their follow up
OB appointments while the physician sees new OB patients in the office.
In the practice you manage, the medical assistants are responsible for preparing the patients for
the physician. The medical assistants place a green folder in the door so the physician knows
which patient is next to be seen. The physician refuses to follow the system and determines who
he will see next, which is angering the patients because they are waiting too long in the exam
room. The medical assistant is extremely upset and close to tears. Which of the following
responses is an example of effective communication in this situation? - CORRECT
ANSWER B. "I understand your frustration. Since this system does not appear to be working,
what do you suggest?"
During the typical patient flow for an encounter, when should the copayment be collected? -
CORRECT ANSWER A. When the patient checks in with the front desk prior to the
appointment.
Which of the following is NOT a typical duty of a practice manager?
A. Developing a strategy to increase patient referrals.
B. Inventory control for vaccines needed for school physicals.
C. Processing prior authorizations for minor surgeries performed in the office.
D. Implement strategies to reduce the days in A/R. - CORRECT ANSWER C. Processing
prior authorizations for minor surgeries performed in the office.
Which statement regarding insurance reform is TRUE?
A. A requirement to permit adult children to stay on family policies until age 26.B. Require pre-
authorizations for only emergency department services.C. Limit the lifetime limits on the dollar
amount of the coverage for which insurers will pay.D. Insurers must limit any waiting periods
for coverage to 30 days. - CORRECT ANSWER A. A requirement to permit adult children to
stay on family policies until age 26.
, A patient is very upset because her insurance denied her claim. She was seen for a routine
physical which is not covered by her insurance. The patient asks you to change the diagnosis
code in order for the insurance company to pay the claim. Which of the following should be
done?
A. Explain to the patient the codes are correct and you cannot change the diagnosis unless you
have her consent in writing.
B. Have the provider or coder review the encounter to see if another diagnosis is appropriate
before making any changes to the codes.
C. Change the diagnosis so that the insurance company will pay the claim because a service was
rendered and should be paid.
D. Submit an appeal for the insurance company to reconsider the claim and include a copy of the
medical record for the date of service in question. - CORRECT ANSWER B. Have the
provider or coder review the encounter to see if another diagnosis is appropriate before making
any changes to the codes.
Which of the following sites of service must adhere to EMTALA?
I. Physician office
II. Ambulatory surgical center
III. Emergency department
IV. Intensive care unit - CORRECT ANSWER III is correct
Under OSHA, an emergency action plan should include:
I. Evacuation procedures
II. Fire extinguisher locations
III. Emergency contacts and contact information
IV. Designated meeting location
V. Staff assignments and responsibilities - CORRECT ANSWER The emergency action plan
should include:
• Procedures for reporting a fire or emergency
Questions and CORRECT Answers
Which of the following scenarios is appropriate incident-to billing? - CORRECT
ANSWER D. A physician's assistant at an OB/GYN practice sees patients for their follow up
OB appointments while the physician sees new OB patients in the office.
In the practice you manage, the medical assistants are responsible for preparing the patients for
the physician. The medical assistants place a green folder in the door so the physician knows
which patient is next to be seen. The physician refuses to follow the system and determines who
he will see next, which is angering the patients because they are waiting too long in the exam
room. The medical assistant is extremely upset and close to tears. Which of the following
responses is an example of effective communication in this situation? - CORRECT
ANSWER B. "I understand your frustration. Since this system does not appear to be working,
what do you suggest?"
During the typical patient flow for an encounter, when should the copayment be collected? -
CORRECT ANSWER A. When the patient checks in with the front desk prior to the
appointment.
Which of the following is NOT a typical duty of a practice manager?
A. Developing a strategy to increase patient referrals.
B. Inventory control for vaccines needed for school physicals.
C. Processing prior authorizations for minor surgeries performed in the office.
D. Implement strategies to reduce the days in A/R. - CORRECT ANSWER C. Processing
prior authorizations for minor surgeries performed in the office.
Which statement regarding insurance reform is TRUE?
A. A requirement to permit adult children to stay on family policies until age 26.B. Require pre-
authorizations for only emergency department services.C. Limit the lifetime limits on the dollar
amount of the coverage for which insurers will pay.D. Insurers must limit any waiting periods
for coverage to 30 days. - CORRECT ANSWER A. A requirement to permit adult children to
stay on family policies until age 26.
, A patient is very upset because her insurance denied her claim. She was seen for a routine
physical which is not covered by her insurance. The patient asks you to change the diagnosis
code in order for the insurance company to pay the claim. Which of the following should be
done?
A. Explain to the patient the codes are correct and you cannot change the diagnosis unless you
have her consent in writing.
B. Have the provider or coder review the encounter to see if another diagnosis is appropriate
before making any changes to the codes.
C. Change the diagnosis so that the insurance company will pay the claim because a service was
rendered and should be paid.
D. Submit an appeal for the insurance company to reconsider the claim and include a copy of the
medical record for the date of service in question. - CORRECT ANSWER B. Have the
provider or coder review the encounter to see if another diagnosis is appropriate before making
any changes to the codes.
Which of the following sites of service must adhere to EMTALA?
I. Physician office
II. Ambulatory surgical center
III. Emergency department
IV. Intensive care unit - CORRECT ANSWER III is correct
Under OSHA, an emergency action plan should include:
I. Evacuation procedures
II. Fire extinguisher locations
III. Emergency contacts and contact information
IV. Designated meeting location
V. Staff assignments and responsibilities - CORRECT ANSWER The emergency action plan
should include:
• Procedures for reporting a fire or emergency
