Exam (elaborations) CPPM

CPPM
Questions
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Answers
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Correct
Answers A
part
of
the
initiate
cost
control.
There
is
a
focus
on
fraud
and
abuse
reform
by
HHS,
OIG,
FBI,
Medicare
and
Medicaid
and
DOJ.
Which
of
the
following
is
included
in
the
fraud
and
abuse
provision?
-
ANSProviders
are
required
to
supply
upon
request
documentation
of
DME
and
home
health
referrals
According
to
the
national
alliance
for
health
information
technology,
the
difference
in
an
EMR
and
EHR
is
what?
-
ANSElectronic
data
stored
in
one
practice
versus
cumulatively
across
more
than
one
healthcare
organization
Accounts
Payable
-
ANSAmounts
to
be
paid
in
the
future
for
goods
or
services
already
acquired
Activity
Based
Costing
-
ANSA
method
of
allocating
overhead
based
on
each
product's
use
of
activities
in
making
the
product.
Advance
Benefit
Notification
(ABN)
-
ANSNotification
given
to
patients
advising
Medicare
may
not
cover
a
certain
procedure
or
service
Capitation
payment
-
ANSA
prospective
method
of
payment.
Payments
are
based
on
a
physician
fee
schedules
negotiated
with
the
payer.
Cash
Flow
Statement
-
ANSA
financial
statement
that
shows
the
flow
of
money
in
and
out
of
the
business. Cash-based
Accounting
System
-
ANSWhen
purchases
and
expenses
are
reported
the
same
month
even
if
not
being
used
until
future
dates.
Clean
Claim
Form
-
ANSA
form
that
is
complete
and
accurate
and
includes
all
provider
information
and
other
additional
information
to
process
for
payment
Clinical
data
repository
-
ANSA
database
that
compiles
a
patient's
data
from
a
variety
of
clinical
sources
to
present
a
unified
view
of
a
single
patient
Common
performance
indicators
for
charge
entry
includes
-
ANSDays
to
enter
charges,
missing
charges,
coding
accuracy
CPT
codes
-
ANScurrent
procedural
terminology
represent
procedures
performed
&
bilked
by
physicians
and
non-physicians
practitioners
(APP's)
Customer
service,
optimizing
physician
time
and
claim
quality
assurance
are
key
components
to
which
role?
-
ANSFront
Desk
DEA
number
-
ANSIs
not
needed
for
the
online
application
to
CMS
for
an
NPI
During
which
phase
of
plan,
and
do,
check
and
act
would
be
necessary
for
staff
to
discuss
the
success
of
a
new
process
and
potential
issues?
-
ANSCheck
Expansion
of
Medicaid
and
insurance
mandate
will
have
the
following
affect
-
ANSExpand
the
roles
and
scope
of
services
for
nonphysician
providers
Fixed
costs
+
annual
equipment
cost/
revenue
per
unit
-
total
fixed
cost
-
ANS
HCPCS
Level
II
-
ANSfor
products
and
supplies
and
services
not
included
in
level
I.
the
code
is
alphanumeric
HEI
is
the
exchange
of
data,
PHI,
between
organizations
what
types
of
organizations
are
receiving
PHI?
-
ANSHospitals,
patient
portals,
public
health
HIE
-
ANSHealth
information
exchange
History
of
present
illness
-
ANSChronological
description
of
the
development
of
patients
complaint
How
often
should
you
run
a
productivity
report?
-
ANSTwice
a
year,
minimally
ICD-10-CM
-
ANSInternational
Classification
of
Diseases,
Tenth
Revision,
Clinical
Modification
CM
codes
represent
the
diagnosis/reason
a
service
is
performed.