CPPM EXAM QUESTIONS WITH
CORRECT SOLUTIONS
What percentage of communication occurs through body language ? - ANSWER-55
The physician who owns the practice approaches you to discuss an increased
frequency of denials . Which of the following would give the physician the impression
that you have low interest in what he is saying ? - ANSWER-Fidgeting or little eye
contact
Which of the following is NOT a typical duty of a practice manager ? - ANSWER-
Preparation of the patient for the physician .
Which of the following support staff is typically not found in an outpatient physician
practice ? - ANSWER-CNA
The difference between efficiency and effectiveness is : - ANSWER-Efficiency is doing
things right while effectiveness is doing the right things .
In a typical patient flow , verification of benefits will typically occur : - ANSWER-After the
patient calls to schedule an appointment .
You work for a primary care practice . A patient has recently suffered a transient
ischemic attack ( TIA ) and your physician wants to send the patient to a specialist for a
consultation . Which specialty would handle this type of diagnosis ? - ANSWER-
Neurologist
Which of the following is an effective response when a provider is complaining about
how hard it is to use the new EMR system the owner's of the practice selected ? -
ANSWER-This is a major change . I'll do my best to show you how it works . "
The following are blocks of effective communication EXCEPT : - ANSWER-Speaking
and expressing your thoughts
Which of the following statements is true ? - ANSWER-A consolation comment is
considered a block to effective communication .
A PA ( physician's assistant ) has been hired by a cardiology practice to help see
patients who are in the hospital . The PA performs all the rounds and notifies the
physician on call if there are any patients that need to be seen by a physician . Is it
appropriate to bill for the PA's services incident - to ? - ANSWER-No , incident to
services are not covered in a hospital setting .
,Which of the following will motivate employees ? - ANSWER-Hold employees
accountable for reaching established goals .
When should the staff obtain a photocopy of the patient's insurance card ? - ANSWER-
When the patient arrives for their appointment
Which of the following services is covered by Medicare Part B ? - ANSWER-covered
Physician surgical fees
What is the best way to prevent denials for invalid codes ? - ANSWER-Update the
practice management system when new , deleted and revised codes are released
When should credentialing of a provider be performed ? - ANSWER-When it is
determined the physician will be hired
In order to effectively collect money from a patient you should : - ANSWER-Inform your
patients that payment of copays is due when the patient is seen
Which of the following best describes when accounts should be sent to a collections
agency ? - ANSWER-Any patient account over 90 days old and with a balance over $
10
Which of these methods is NOT recommended for collecting payment from insurance
payers ? - ANSWER-Provide a discount if payment is reived by a certain date
What are three components that are necessary to have a claim paid correctly by the
payer ? - ANSWER-Procedure code ( s ) , diagnosis code ( s ) , and insurance policy
number
Which of the following scenarios would violate the policy provided ? - ANSWER-patient
calls to get a refill on his prescription . The receptionist takes down the patient's name ,
birth date , phone number , date and time of the call , and the phone number for the
pharmacy The receptionist attaches the message to the patient's chart and puts it in the
physician's inbox .
Which of the following is a statement that includes the payment amount and denial
explanations for claims submitted ? - ANSWER-Remittance advice
What is the most important criteria to meet for the selection of Evaluation and
Management codes ? - ANSWER-Medical necessity
Which volume of the ICD - 9 is used to identify diagnoses ? Select all that apply .
a. Volume 1
b. Volume 2
c. Volume 3 - ANSWER-a . Volume 1 . b . Volume 2
, When reviewing denials , your biller notices that one of the private payers is not paying
for venipuncture when performed during an office visit . What should be done ? -
ANSWER-The biller should check the payer contract to see if the denial is appropriate .
Payment for physician services is based on the _____ code . Select all that apply .
a. CPT
b. APC
c. MS-DRG
d. SCHIP
e. HCPCS Level II - ANSWER-a . CPTⓇ e . HCPCS Level II
Hospitals bill for inpatient services ( charges for the room , time in the OR , meals ,
supplies and nursing services ) based on a ____ - ANSWER-MS - DRG
a . Customer service
b . Optimizing physician time
c . Denials resolution
d . Claim quality assurance
e . Clinical assessment of patients - ANSWER-a . Customer service b . Optimizing
physician time d . Claim quality assurance
Which of the following is NOT required to process the online application on the CMS
website for a NPI ( National Provider Identification ) ? - ANSWER-DEA number
An ABN form is used to : - ANSWER-Notification to patients that Medicare may not
cover a certain procedure or service .
When reviewing payer contracts , how is the RPV ( Revenue Per Visit ) calculated ? -
ANSWER-Total amount collected divided by the total number of patient visits .
Which of the following is a chronological description of the development of the patient's
complaints ? - ANSWER-History of present illness
In which of the following scenarios is Medicare the secondary payer ? - ANSWER-A
patient who requires surgery for a fractured hip as a result of a car accident .
You work for a pediatric office and one of your patient's parents informs you that they
cannot afford health insurance for their child . She does not qualify for Medicaid
because she makes too much money . What would you recommend ? - ANSWER-
Apply for CHIP coverage
The clinic's income statement can effectively be used to - ANSWER-Create and
manage the budget for the clinic .
CORRECT SOLUTIONS
What percentage of communication occurs through body language ? - ANSWER-55
The physician who owns the practice approaches you to discuss an increased
frequency of denials . Which of the following would give the physician the impression
that you have low interest in what he is saying ? - ANSWER-Fidgeting or little eye
contact
Which of the following is NOT a typical duty of a practice manager ? - ANSWER-
Preparation of the patient for the physician .
Which of the following support staff is typically not found in an outpatient physician
practice ? - ANSWER-CNA
The difference between efficiency and effectiveness is : - ANSWER-Efficiency is doing
things right while effectiveness is doing the right things .
In a typical patient flow , verification of benefits will typically occur : - ANSWER-After the
patient calls to schedule an appointment .
You work for a primary care practice . A patient has recently suffered a transient
ischemic attack ( TIA ) and your physician wants to send the patient to a specialist for a
consultation . Which specialty would handle this type of diagnosis ? - ANSWER-
Neurologist
Which of the following is an effective response when a provider is complaining about
how hard it is to use the new EMR system the owner's of the practice selected ? -
ANSWER-This is a major change . I'll do my best to show you how it works . "
The following are blocks of effective communication EXCEPT : - ANSWER-Speaking
and expressing your thoughts
Which of the following statements is true ? - ANSWER-A consolation comment is
considered a block to effective communication .
A PA ( physician's assistant ) has been hired by a cardiology practice to help see
patients who are in the hospital . The PA performs all the rounds and notifies the
physician on call if there are any patients that need to be seen by a physician . Is it
appropriate to bill for the PA's services incident - to ? - ANSWER-No , incident to
services are not covered in a hospital setting .
,Which of the following will motivate employees ? - ANSWER-Hold employees
accountable for reaching established goals .
When should the staff obtain a photocopy of the patient's insurance card ? - ANSWER-
When the patient arrives for their appointment
Which of the following services is covered by Medicare Part B ? - ANSWER-covered
Physician surgical fees
What is the best way to prevent denials for invalid codes ? - ANSWER-Update the
practice management system when new , deleted and revised codes are released
When should credentialing of a provider be performed ? - ANSWER-When it is
determined the physician will be hired
In order to effectively collect money from a patient you should : - ANSWER-Inform your
patients that payment of copays is due when the patient is seen
Which of the following best describes when accounts should be sent to a collections
agency ? - ANSWER-Any patient account over 90 days old and with a balance over $
10
Which of these methods is NOT recommended for collecting payment from insurance
payers ? - ANSWER-Provide a discount if payment is reived by a certain date
What are three components that are necessary to have a claim paid correctly by the
payer ? - ANSWER-Procedure code ( s ) , diagnosis code ( s ) , and insurance policy
number
Which of the following scenarios would violate the policy provided ? - ANSWER-patient
calls to get a refill on his prescription . The receptionist takes down the patient's name ,
birth date , phone number , date and time of the call , and the phone number for the
pharmacy The receptionist attaches the message to the patient's chart and puts it in the
physician's inbox .
Which of the following is a statement that includes the payment amount and denial
explanations for claims submitted ? - ANSWER-Remittance advice
What is the most important criteria to meet for the selection of Evaluation and
Management codes ? - ANSWER-Medical necessity
Which volume of the ICD - 9 is used to identify diagnoses ? Select all that apply .
a. Volume 1
b. Volume 2
c. Volume 3 - ANSWER-a . Volume 1 . b . Volume 2
, When reviewing denials , your biller notices that one of the private payers is not paying
for venipuncture when performed during an office visit . What should be done ? -
ANSWER-The biller should check the payer contract to see if the denial is appropriate .
Payment for physician services is based on the _____ code . Select all that apply .
a. CPT
b. APC
c. MS-DRG
d. SCHIP
e. HCPCS Level II - ANSWER-a . CPTⓇ e . HCPCS Level II
Hospitals bill for inpatient services ( charges for the room , time in the OR , meals ,
supplies and nursing services ) based on a ____ - ANSWER-MS - DRG
a . Customer service
b . Optimizing physician time
c . Denials resolution
d . Claim quality assurance
e . Clinical assessment of patients - ANSWER-a . Customer service b . Optimizing
physician time d . Claim quality assurance
Which of the following is NOT required to process the online application on the CMS
website for a NPI ( National Provider Identification ) ? - ANSWER-DEA number
An ABN form is used to : - ANSWER-Notification to patients that Medicare may not
cover a certain procedure or service .
When reviewing payer contracts , how is the RPV ( Revenue Per Visit ) calculated ? -
ANSWER-Total amount collected divided by the total number of patient visits .
Which of the following is a chronological description of the development of the patient's
complaints ? - ANSWER-History of present illness
In which of the following scenarios is Medicare the secondary payer ? - ANSWER-A
patient who requires surgery for a fractured hip as a result of a car accident .
You work for a pediatric office and one of your patient's parents informs you that they
cannot afford health insurance for their child . She does not qualify for Medicaid
because she makes too much money . What would you recommend ? - ANSWER-
Apply for CHIP coverage
The clinic's income statement can effectively be used to - ANSWER-Create and
manage the budget for the clinic .
