CPPM CERT EXAM WITH CORRECT
QUESTIONS AND ANSWERS (GRADED
A+)
Current Liabilities - ANSWER-debts of the business that must be paid within a year
Fixed Expenses - ANSWER-will not change base in revenue
Rent
LLC (Limited Liability Company) - ANSWER-All income flow through owners individual
income tax, LLC can sell interest nor stock. Unlimited # of owners, good for growing
pract.
Basic Components of HIE - ANSWER-Governance
An image and data repository
EMPI
Security
Credentialing process for access to data
Post Disaster Checklist - ANSWER-Contact employees
Contact landlord
Contact insurance
Keep accounting log of all damage related costs
Conduct salvage operations
Call meeting of key players
Obtain new office space
Equip needs for new office space
Contact patients
quantitive risk analysis - ANSWER-risk identification
risk likelihood
risk impact
recommendations/actions
cold site - ANSWER-a backup location that provides only rudimentary services and
facilities
False Claims Act - ANSWER-Allows employees to sue employers on behalf of the
federal government
Employee retains share of recovery
,Labor Laws - ANSWER-Laws which regulated how workers could be paid and treated
Discrimination and wrongful termination
ADA
FMLA
Fair Labor Standards Act
OSHA
Income Statement Model Provider Payment - ANSWER-based on assigning all revenue
and expenses to each provider of the pract. Most complex model
Emerg Prepard and Responce - ANSWER-Participation in domestic and Internationale
humanitarian volunteer work greater than 60 days
Goals of Quality Care Improvement - ANSWER-Safety, Effectiveness, Patient Centered,
Timely, Efficient, Equitable
Market Reform Insurance Rules - ANSWER-Cannot deny based on preexisting
conditions, children to age 26, must provider first dollar preventive health for women
care and screenings, infance child, and adolescent services. No prior auth for ED,
cannot cancel insurance when patient becomes ill, may not place lifetime dollar limits,
limit insurance coverage waiting periods to 90 days.
Break -Even Point Analysis - ANSWER-performed to decide in investing in a new kine
of business
X=(fixed cost+annual equip cost)/(RPU-variable cost per unit)
value based reimbursement - ANSWER-Pay for performance only if certain metric
criteria is met
Net Collection Ratio - ANSWER-Measures how well a practice collects allowable
charges
3,6,19, 12 months, should fall between 90-100%
(total receipts-refunds)/(total charges-contract adjustments)= New collection ratio
150,000-25,000/250,000-45,000=X
125,000/205,000=.609=61%
HSA - ANSWER-Health savings account---employer and employee pre-tax dollars to
the account for expected medical expenses for the coming year-often set up through
your employer-submit claims and receipts for reimbursement up to amount deposited.
Medicare Part A - ANSWER-Inpatient care, SNIF, some home health, hospice
POS 20 - ANSWER-Urgent Care
incident-to services - ANSWER-NPP's, Follow up est patients, 85% reimbursement
, POS 11 - ANSWER-Office
POS 12 - ANSWER-Home
POS 19 - ANSWER-Off campus, outpatient hospital
MDM - ANSWER-Medical Decision Making, # of Dx's, Amount and complexity of data to
review, risk of complications
Physical Exam - ANSWER-1995 Guidelines, body areas and 12 organs
1997 Guidelines, expanded for specialty specific areas and bullet shading system
Components of History - ANSWER-CC, HPI, ROS, Past fam med/surg history
Key Complements to E/M Codes - ANSWER-History, Physical Exam, Medical Decision
Making
HCPCS Level II - ANSWER-non-physician services, supply, equipment, ambulance
services, prosthetic devices, drugs
CPT Cat 3 - ANSWER-Temp codes, new and developing tech, procedures, and
services. DATA collection, May not use CAT 1 unlisted code in lieu of Cat 3 code
CPT Cat 2 - ANSWER-F codes, performance measurement, future patient care, data
collection about quality of care
CPT Cat 1 - ANSWER-00100-99499, E/M, Anesthesia, Surg, Rad, Path & Lab,
Medicine
Code Sets - ANSWER-ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II
Body Language - ANSWER-7% verbal, 38% tone, 55% body language
Positive Results= - ANSWER-Accountability+Responsibility+Pro-activity
POS 32 - ANSWER-nursing facility
Time for credentialing provider - ANSWER-90 days
public healthcare systems - ANSWER-Medicare, Medicaid, Veterans Health Admin,
Military Healthcare, Indian Health Service, CHIP, Fed Employees Health Benefits
Promt Pay Law - ANSWER-State determined
RPV - ANSWER-Revenue Per Visit
QUESTIONS AND ANSWERS (GRADED
A+)
Current Liabilities - ANSWER-debts of the business that must be paid within a year
Fixed Expenses - ANSWER-will not change base in revenue
Rent
LLC (Limited Liability Company) - ANSWER-All income flow through owners individual
income tax, LLC can sell interest nor stock. Unlimited # of owners, good for growing
pract.
Basic Components of HIE - ANSWER-Governance
An image and data repository
EMPI
Security
Credentialing process for access to data
Post Disaster Checklist - ANSWER-Contact employees
Contact landlord
Contact insurance
Keep accounting log of all damage related costs
Conduct salvage operations
Call meeting of key players
Obtain new office space
Equip needs for new office space
Contact patients
quantitive risk analysis - ANSWER-risk identification
risk likelihood
risk impact
recommendations/actions
cold site - ANSWER-a backup location that provides only rudimentary services and
facilities
False Claims Act - ANSWER-Allows employees to sue employers on behalf of the
federal government
Employee retains share of recovery
,Labor Laws - ANSWER-Laws which regulated how workers could be paid and treated
Discrimination and wrongful termination
ADA
FMLA
Fair Labor Standards Act
OSHA
Income Statement Model Provider Payment - ANSWER-based on assigning all revenue
and expenses to each provider of the pract. Most complex model
Emerg Prepard and Responce - ANSWER-Participation in domestic and Internationale
humanitarian volunteer work greater than 60 days
Goals of Quality Care Improvement - ANSWER-Safety, Effectiveness, Patient Centered,
Timely, Efficient, Equitable
Market Reform Insurance Rules - ANSWER-Cannot deny based on preexisting
conditions, children to age 26, must provider first dollar preventive health for women
care and screenings, infance child, and adolescent services. No prior auth for ED,
cannot cancel insurance when patient becomes ill, may not place lifetime dollar limits,
limit insurance coverage waiting periods to 90 days.
Break -Even Point Analysis - ANSWER-performed to decide in investing in a new kine
of business
X=(fixed cost+annual equip cost)/(RPU-variable cost per unit)
value based reimbursement - ANSWER-Pay for performance only if certain metric
criteria is met
Net Collection Ratio - ANSWER-Measures how well a practice collects allowable
charges
3,6,19, 12 months, should fall between 90-100%
(total receipts-refunds)/(total charges-contract adjustments)= New collection ratio
150,000-25,000/250,000-45,000=X
125,000/205,000=.609=61%
HSA - ANSWER-Health savings account---employer and employee pre-tax dollars to
the account for expected medical expenses for the coming year-often set up through
your employer-submit claims and receipts for reimbursement up to amount deposited.
Medicare Part A - ANSWER-Inpatient care, SNIF, some home health, hospice
POS 20 - ANSWER-Urgent Care
incident-to services - ANSWER-NPP's, Follow up est patients, 85% reimbursement
, POS 11 - ANSWER-Office
POS 12 - ANSWER-Home
POS 19 - ANSWER-Off campus, outpatient hospital
MDM - ANSWER-Medical Decision Making, # of Dx's, Amount and complexity of data to
review, risk of complications
Physical Exam - ANSWER-1995 Guidelines, body areas and 12 organs
1997 Guidelines, expanded for specialty specific areas and bullet shading system
Components of History - ANSWER-CC, HPI, ROS, Past fam med/surg history
Key Complements to E/M Codes - ANSWER-History, Physical Exam, Medical Decision
Making
HCPCS Level II - ANSWER-non-physician services, supply, equipment, ambulance
services, prosthetic devices, drugs
CPT Cat 3 - ANSWER-Temp codes, new and developing tech, procedures, and
services. DATA collection, May not use CAT 1 unlisted code in lieu of Cat 3 code
CPT Cat 2 - ANSWER-F codes, performance measurement, future patient care, data
collection about quality of care
CPT Cat 1 - ANSWER-00100-99499, E/M, Anesthesia, Surg, Rad, Path & Lab,
Medicine
Code Sets - ANSWER-ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II
Body Language - ANSWER-7% verbal, 38% tone, 55% body language
Positive Results= - ANSWER-Accountability+Responsibility+Pro-activity
POS 32 - ANSWER-nursing facility
Time for credentialing provider - ANSWER-90 days
public healthcare systems - ANSWER-Medicare, Medicaid, Veterans Health Admin,
Military Healthcare, Indian Health Service, CHIP, Fed Employees Health Benefits
Promt Pay Law - ANSWER-State determined
RPV - ANSWER-Revenue Per Visit
