CPCO Exam Prep Questions and Verified Answers (2023/ 2024)

CPCO Exam Prep Questions and Verified Answers (2023/ 2024) Q: The Compliance Officer's main two responsibilities are to ____________the practice/organization's compliance program. Selected Answer: a. develop and then implement b. write and oversee c. report to the board and CFO d. provide training and policies for Answer: a. develop and then implement The Compliance Officer's main two responsibilities are to develop and then implement the practice/organization's compliance program. Q: Judy at Apple Medical Group wants to know why Hot Line allegations should be tracked? a. Look for groups of employees who complain b. Establish patterns or trends that need to be followed c. In order to find out who is making the call d. As a way to catch 100% of false claims Answer:b. Establish patterns or trends that need to be followed All hotline concerns should be investigated and the outcome recorded in order to look for patters or trends of non-compliance that would help to establish the types of correction action steps will be required. Q: The OIG recommends that each Compliance Program should be______________? a. Developed by an attorney b. Unique c. Comprehensive d. HIPAA and OSHA only Answer:b. Unique Because each organization is unique, each Compliance Program should be developed to enhance and protect the individual entity. Q: Failure to respond quickly to suspected or alleged instances of non-compliance threatens the organization's reputation as trustworthy, law-abiding, and ______________? a. the organization's ability to accept cash patients. b. the organization's ability to scrutinize practices for other providers. c. the organization's ability to participate with federally funded healthcare plans and/or third party payers. d. the organization's ability to hire new employees. Answer:c. the organization's ability to participate with federally funded healthcare plans and/or third party payers. Non-compliance with the Corporate Compliance Program and all applicable laws and regulation threatens the organization's reputation as a trustworthy, law-abiding organization and threatens the organization's ability to participate with federally funded healthcare plans and/or third party payers. It is for these reasons that the Compliance Program has been developed and why responding quickly to suspect or alleged instances of non-compliance is imperative. Q: Everyone should be educated in their role in adhering to the Compliance Program including their duty to report__________________? a. employees who are chronically late b. safety issues c. suspected misconduct d. quality issues Answer:c. suspected misconduct Everyone should be educated in their role in adhering to the Compliance Program including their duty to report misconduct, the procedures and methods to report suspected misconduct, confidentiality and when/where confidentiality ends, as well as the organization's non-retaliation policy for good faith reporting Q: Records associated with an inquiry will include the nature of the inquiry or report, the investigation procedures and outcomes, and all actions taken by the Compliance Officer and/or the organization to rectify any non-compliance uncovered. What is an important component of the compliance officers responsibly when managing incidents and investigations? a. CMS needs to be kept apprised of ongoing investigations and results b. The staff needs to be kept apprised of ongoing investigations and results c. The OIG needs to be kept apprised of ongoing investigations and results d. The Board of Directors need to be kept apprised of ongoing investigations and results Answer:d. The Board of Directors need to be kept apprised of ongoing investigations and results (Organization Name) will maintain a file of all records associated with an inquiry to (the Compliance Officer and/or any reports of suspected noncompliance within the organization. Files will include the nature of the inquiry or report, the investigation procedures and outcomes, and all actions taken by the Compliance Officer and/or the organization to rectify any non-compliance uncovered. The owner(s), managing physician(s) or Board of Directors will be kept apprised of all ongoing investigations and the results of all closed investigations. Q: What is more important to have in place for enforcing and disciplining individuals who violate the practice's compliance or other practice standards? a. meetings b. training c. procedures d. rules Answer:c. procedures There should be procedures for enforcing and disciplining individuals who violate the practice's compliance or other practice standards. All employees, regardless of rank, need to be held accountable for non-compliance of federal regulations. Q: A Compliance Corrective Action Plan might deal with which of the below item? a. Nurse steals injections b. Employee alters their time card c. CEO takes too much time off from work d. Provider does not complete documentation timely Answer:d. Provider does not complete documentation timely If a compliance problem is detected, the practice should analyze the situation to determine whether a flaw in the compliance program failed to anticipate the detected problem, or whether the compliance program's procedure failed to prevent the violation. The above example is just one of the many that might violate your State or CMS guidelines on timely note completion and require a corrective action plan. Q: Kim, Compliance Officer for ABC Provider Group, created a compliance plan and policy a year ago. While reviewing the groups Baseline Audits it comes to her attention that many of the staff have decided NOT to follow the compliance plan. The Non-Compliance has ____________? a. been noted in the new plan and the group will try to be better about compliance next year b. not created any issues so all is well c. created issues that will cause huge fines to be given to the practice d. created a big risk of the group and Kim needs to make sure that everyone knows about the risk of not following the compliance plan Answer:d. created a big risk of the group and Kim needs to make sure that everyone knows about the risk of not following the compliance plan Levels of non-compliance include (1) intentional or reckless disregard for policies and regulations (2) failure to detect violation (3) failure to report a violation. All employees, regardless of rank need to be held accountable for non-compliance. Q: The biller at XYZ Community Hospital wants to win the award every month for posting the most insurance checks. Instead of giving the claims 30-60 days to clear, she bills them again at the end of the month. This is an example of? a. double billing b. waste c. fraud d. incentives