CPCO STUDY GUIDE (Certified Professional
Compliance Officer)- AAPC Exam 2025–2026
Accurate Real Exam Questions and Verified
Correct Answers JUST RELEASED
Medicare requires physicians and mid-level providers to certify the need for physical,
occupational, and speech therapy. The first certification is needed within how many days
of starting therapy - answer>>>30
After initial education and training have been implemented, what does the OIG
recommends a benchmark audit be performed? - answer>>>3 months
If a state or federal agent arrives at your office and presents a search warrant, it is best
practice to what? - answer>>>Contact your attorney immediately
The __________ usually requires that police officers have probable cause before they
search a person's home, their clothing, car, or other property. This also relates to
businesses and the search of their premises. - answer>>>Fourth Amendment
Work the attorney does in creating reports, interview memos, or research is called what?
- answer>>>Attorney-client work-product
The ________ is one of the primary investigation agencies that assist the federal
prosecutors. - answer>>>FBI
MACs can initiate an investigation if there is a complaint, or if something about the billing
profile is triggering flags. If quality concerns are an issue, what type of organization may
be involved? - answer>>>QIO (Quality Improvement Organization)
,The OIG defines the term "reportable event" in its CIA by noting that it could be: -
answer>>>All of the above
What usually happens next when settlement negotiations are unsuccessful? -
answer>>>Litigation
What is it called when the OIG waives its exclusion authority concurrent with resolution
of monetary liability under the False Claims Act and the CMP Law? - answer>>>Corporate
Integrity Agreement
OIG negotiates CIAs with healthcare providers and other entities as part of the
settlement of federal healthcare program investigations arising under a variety of Civil
False Claims statutes. Providers or entities agree to the obligations and, in exchange, the
OIG agrees not to seek
_______________________________________________________. - answer>>>their
exclusion from participation in Medicare, Medicaid, or other federal healthcare
programs.
If an internal audit reveals issues, it's time to do some interviews and document reviews.
How many people should be involved in the interview process of an employee? -
answer>>>2
Private or government investigations usually start with a request for __________. -
answer>>>records
The Signatory page includes the signatures of the provider representatives (counsel and
the Compliance Officer and/or president), as well as the _______. -
answer>>>representative from the OIG
You cannot protect certain facts from disclosure simply by communicating them to your
lawyer. If information may be gathered from another source besides the privileged
,communication, then the underlying information itself is ______________________. -
answer>>>not privileged
When drafting audit protocol in an internal investigation it should be carefully worded
and tied back to the regulatory scope and applicability research. If an attorney does not
draft the protocol, one should review it for language. Why? - answer>>>The government
or opposing party may obtain a copy
Joan is just learning about compliance and all of the various agencies that are involved in
allegations and investigations. For a state fraud investigation, which agency is likely to get
involved? - answer>>>MFCU (Medicaid Fraud Control Units)
The OIG takes into consideration severity and extent of the underlying misconduct, the
nature and resources of the provider, the provider's existing compliance capabilities, and
whether the case resulted from a self-disclosure are all relevant factors considered in
crafting what? - answer>>>A corporate integrity agreement
A standard boiler plate clause in a CIA includes language on the rights of the OIG to
inspect any aspect of the provider's business under what circumstances? - answer>>>At
any time
States may also offer CIAs to providers with a history of________ as an alternative to
exclusion from the Medicaid program. - answer>>>program integrity issues
n an internal investigation it is important to communicate to employees that it is against
policy to destroy or remove any documentation from a patient's medical record.
Document reviews can be extensive and may involve: - answer>>>Emails, mobile phone
calendars, and notes
, During an internal investigation, creating an audit report for negotiation is important.
Overpayments (as well as underpayments) should be included as_________. -
answer>>>offsets
A search warrant, State or federal (or both) allows the agents the right to what? -
answer>>>To enter and seize documents
The HITECH Act revisions significantly increased the penalty amounts the Secretary may
impose for violations of the HIPAA rules and encourage prompt _____________? -
answer>>>corrective action
Whose responsibility is it to focus on the key risk areas through education and
documented audit improvement? - answer>>>The Compliance Officer
Health Information Technology for Economic and Clinical Health Act (HITECH), which was
enacted as part of the _________. - answer>>>American Recovery and Reinvestment Act
Typically, document reviews are done ________, and the government will ask for ______.
- answer>>>Electronically, electronic files
If the main entrance cannot be made handicap accessible, then ___________________. -
answer>>>People should be detoured to an alternative entrance
What can employers do to increase employee engagement? - answer>>>Employers
should hold management accountable for engagement
Sofie works at Apple Rural Health Center. Here husband just returned from active duty
and was injured- she needs to take of time to get the house hold stabilized. How much
time can Sofie take off? - answer>>>26 weeks
Compliance Officer)- AAPC Exam 2025–2026
Accurate Real Exam Questions and Verified
Correct Answers JUST RELEASED
Medicare requires physicians and mid-level providers to certify the need for physical,
occupational, and speech therapy. The first certification is needed within how many days
of starting therapy - answer>>>30
After initial education and training have been implemented, what does the OIG
recommends a benchmark audit be performed? - answer>>>3 months
If a state or federal agent arrives at your office and presents a search warrant, it is best
practice to what? - answer>>>Contact your attorney immediately
The __________ usually requires that police officers have probable cause before they
search a person's home, their clothing, car, or other property. This also relates to
businesses and the search of their premises. - answer>>>Fourth Amendment
Work the attorney does in creating reports, interview memos, or research is called what?
- answer>>>Attorney-client work-product
The ________ is one of the primary investigation agencies that assist the federal
prosecutors. - answer>>>FBI
MACs can initiate an investigation if there is a complaint, or if something about the billing
profile is triggering flags. If quality concerns are an issue, what type of organization may
be involved? - answer>>>QIO (Quality Improvement Organization)
,The OIG defines the term "reportable event" in its CIA by noting that it could be: -
answer>>>All of the above
What usually happens next when settlement negotiations are unsuccessful? -
answer>>>Litigation
What is it called when the OIG waives its exclusion authority concurrent with resolution
of monetary liability under the False Claims Act and the CMP Law? - answer>>>Corporate
Integrity Agreement
OIG negotiates CIAs with healthcare providers and other entities as part of the
settlement of federal healthcare program investigations arising under a variety of Civil
False Claims statutes. Providers or entities agree to the obligations and, in exchange, the
OIG agrees not to seek
_______________________________________________________. - answer>>>their
exclusion from participation in Medicare, Medicaid, or other federal healthcare
programs.
If an internal audit reveals issues, it's time to do some interviews and document reviews.
How many people should be involved in the interview process of an employee? -
answer>>>2
Private or government investigations usually start with a request for __________. -
answer>>>records
The Signatory page includes the signatures of the provider representatives (counsel and
the Compliance Officer and/or president), as well as the _______. -
answer>>>representative from the OIG
You cannot protect certain facts from disclosure simply by communicating them to your
lawyer. If information may be gathered from another source besides the privileged
,communication, then the underlying information itself is ______________________. -
answer>>>not privileged
When drafting audit protocol in an internal investigation it should be carefully worded
and tied back to the regulatory scope and applicability research. If an attorney does not
draft the protocol, one should review it for language. Why? - answer>>>The government
or opposing party may obtain a copy
Joan is just learning about compliance and all of the various agencies that are involved in
allegations and investigations. For a state fraud investigation, which agency is likely to get
involved? - answer>>>MFCU (Medicaid Fraud Control Units)
The OIG takes into consideration severity and extent of the underlying misconduct, the
nature and resources of the provider, the provider's existing compliance capabilities, and
whether the case resulted from a self-disclosure are all relevant factors considered in
crafting what? - answer>>>A corporate integrity agreement
A standard boiler plate clause in a CIA includes language on the rights of the OIG to
inspect any aspect of the provider's business under what circumstances? - answer>>>At
any time
States may also offer CIAs to providers with a history of________ as an alternative to
exclusion from the Medicaid program. - answer>>>program integrity issues
n an internal investigation it is important to communicate to employees that it is against
policy to destroy or remove any documentation from a patient's medical record.
Document reviews can be extensive and may involve: - answer>>>Emails, mobile phone
calendars, and notes
, During an internal investigation, creating an audit report for negotiation is important.
Overpayments (as well as underpayments) should be included as_________. -
answer>>>offsets
A search warrant, State or federal (or both) allows the agents the right to what? -
answer>>>To enter and seize documents
The HITECH Act revisions significantly increased the penalty amounts the Secretary may
impose for violations of the HIPAA rules and encourage prompt _____________? -
answer>>>corrective action
Whose responsibility is it to focus on the key risk areas through education and
documented audit improvement? - answer>>>The Compliance Officer
Health Information Technology for Economic and Clinical Health Act (HITECH), which was
enacted as part of the _________. - answer>>>American Recovery and Reinvestment Act
Typically, document reviews are done ________, and the government will ask for ______.
- answer>>>Electronically, electronic files
If the main entrance cannot be made handicap accessible, then ___________________. -
answer>>>People should be detoured to an alternative entrance
What can employers do to increase employee engagement? - answer>>>Employers
should hold management accountable for engagement
Sofie works at Apple Rural Health Center. Here husband just returned from active duty
and was injured- she needs to take of time to get the house hold stabilized. How much
time can Sofie take off? - answer>>>26 weeks
