CPCO CERTIFICATION EXAM WITH ALL CORRECT &
100% VERIFIED ANSWERS|ACTUAL COMPLETE EXAM|
ALREADY GRADED A+
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191,
what is the name of the national program designed to coordinate Federal, State and local law
enforcement activities with respect to health care fraud and abuse?
A. Health Care Fraud Prevention and Enforcement Action Team (HEAT)
B. Health Care Recovery and Affordable Care Act (HCRAC)
C. Health Care Fraud and Abuse Control Program (HCFAC)
D. Health Care Civil Penalties Law ✔Correct Answer-C. Health Care Fraud and Abuse Control
Program (HCFAC)
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. ✔Correct Answer-A. Promote an
organizational culture that encourages ethical conduct and a commitment to compliance with the
law.
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. ✔Correct Answer-B. Tailor
those materials to the physician practice where they will be applied.
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. ✔Correct Answer-B. For any services billed,
documentation must be present in the patient's medical record to support the services.
, 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 th ✔Correct Answer-D. Document the conversation and
retain the records.
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 ✔Correct Answer-B. Be sure any timeframes or requirements listed can be
accomplished given the practice's resources.
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. ✔Correct Answer-C. Verify accuracy of
coding and reimbursement for the services performed.
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. ✔Correct Answer-A. Reviewing reports to see that new employees
and vendors have been checked against the OIG's list of excluded individuals and entities.
100% VERIFIED ANSWERS|ACTUAL COMPLETE EXAM|
ALREADY GRADED A+
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191,
what is the name of the national program designed to coordinate Federal, State and local law
enforcement activities with respect to health care fraud and abuse?
A. Health Care Fraud Prevention and Enforcement Action Team (HEAT)
B. Health Care Recovery and Affordable Care Act (HCRAC)
C. Health Care Fraud and Abuse Control Program (HCFAC)
D. Health Care Civil Penalties Law ✔Correct Answer-C. Health Care Fraud and Abuse Control
Program (HCFAC)
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. ✔Correct Answer-A. Promote an
organizational culture that encourages ethical conduct and a commitment to compliance with the
law.
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. ✔Correct Answer-B. Tailor
those materials to the physician practice where they will be applied.
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. ✔Correct Answer-B. For any services billed,
documentation must be present in the patient's medical record to support the services.
, 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 th ✔Correct Answer-D. Document the conversation and
retain the records.
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 ✔Correct Answer-B. Be sure any timeframes or requirements listed can be
accomplished given the practice's resources.
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. ✔Correct Answer-C. Verify accuracy of
coding and reimbursement for the services performed.
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. ✔Correct Answer-A. Reviewing reports to see that new employees
and vendors have been checked against the OIG's list of excluded individuals and entities.
