CPCO STUDY GUIDE 2025
QUESTIONS AND ANSWERS
One of the most important elements of an effective compliance program is to have
a compliance officer or committee who is__________. - ....ANSWER ...-
empowered
If an employee, provider or anyone that deals with Federal or State healthcare
dollars has intent to receive payment for services not legitimately rendered this is
considered ______________? - ....ANSWER ...-fraud
Joan, as an employee of a healthcare organization, has _________to report
erroneous conduct, without repercussions, so that it may be corrected immediately
- ....ANSWER ...-duty
person who exposes misconduct, alleged dishonest or illegal activity occurring in
an organization is called a______________? - ....ANSWER ...-relator
The compliance program will flounder if employees of the organization are not
aware of _________? - ....ANSWER ...-laws and regulations that pertain to
their specific job descriptions
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,When physicians (or their staff) make billing mistakes and errors the most
important thing to do is _________? - ....ANSWER ...-Send a refund
Judy is the Compliance Officer for Apple Medical Group. The practice is a small
group of providers. Judy wants to have an open door policy as suggested by the
OIG, thus she will? - ....ANSWER ...-Post notices of up-to-date compliance
information on the employee bulletin board
Participants in the Federal healthcare programs have an obligation to take
measures, such as instituting a compliance program, to _________________? -
....ANSWER ...-detects and prevent fraudulent, abusive and wasteful
activities
Tim, the Compliance Officer for XYZ Community Hospital, should report to
whom? - ....ANSWER ...-CEO or Board
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? -
....ANSWER ...-double billing
The OIG has described seven basic components of an effective compliance
program for a small physician practice that are based from the _______________?
- ....ANSWER ...-Federal Sentencing Guidelines
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,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 ____________? - ....ANSWER ...-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
A high-level statement or plan that embraces an organization's general beliefs,
goals, objectives and acceptable procedure for a specified subject area is a
_______________? - ....ANSWER ...-policy
Kim is the Compliance Officer for ABC Provider Group. Kim has read the OIG
Compliance Program Guidance that acknowledges patient care as the first priority
of a physician practice. As the Compliance Officer (CO), Kim should implement
what type of compliance model? - ....ANSWER ...-A "patients first"
It is important to educate employees of the methods they may utilize to directly
notify and communicate issues of suspected areas of non-compliance. What is
considered a best practice method of anonymous reporting? -
....ANSWER ...-intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine? -
....ANSWER ...-areas of the billing department that might be in compliance
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, When the term Open Door Policy is used in reference to the Effective
Communication, what is this referring to? - ....ANSWER ...-The Compliance
Officer is accessible to all employees via many methods of communication
When Kim from ABC Provider Group is conducting a risk assessment, one of the
most important and key sources of information that Kim as the Compliance
Officer should utilize is_____________. - ....ANSWER ...-the Office of
Inspector General's Annual Work Plan
The mission statement of the healthcare organization and a statement of why they
are in business are also known as _________? - ....ANSWER ...-The Code
of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital
update the compliance program and plan? - ....ANSWER ...-As laws and
regulations change; and at least annually
After an employee receives their initial training regarding the practice/organization
Compliance Program what is the next step the compliance officer should take to
protect the practice against potential noncompliance activity? -
....ANSWER ...-Perform a baseline assessment of the employee's
competency scores to determine if additional training is required
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
QUESTIONS AND ANSWERS
One of the most important elements of an effective compliance program is to have
a compliance officer or committee who is__________. - ....ANSWER ...-
empowered
If an employee, provider or anyone that deals with Federal or State healthcare
dollars has intent to receive payment for services not legitimately rendered this is
considered ______________? - ....ANSWER ...-fraud
Joan, as an employee of a healthcare organization, has _________to report
erroneous conduct, without repercussions, so that it may be corrected immediately
- ....ANSWER ...-duty
person who exposes misconduct, alleged dishonest or illegal activity occurring in
an organization is called a______________? - ....ANSWER ...-relator
The compliance program will flounder if employees of the organization are not
aware of _________? - ....ANSWER ...-laws and regulations that pertain to
their specific job descriptions
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,When physicians (or their staff) make billing mistakes and errors the most
important thing to do is _________? - ....ANSWER ...-Send a refund
Judy is the Compliance Officer for Apple Medical Group. The practice is a small
group of providers. Judy wants to have an open door policy as suggested by the
OIG, thus she will? - ....ANSWER ...-Post notices of up-to-date compliance
information on the employee bulletin board
Participants in the Federal healthcare programs have an obligation to take
measures, such as instituting a compliance program, to _________________? -
....ANSWER ...-detects and prevent fraudulent, abusive and wasteful
activities
Tim, the Compliance Officer for XYZ Community Hospital, should report to
whom? - ....ANSWER ...-CEO or Board
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? -
....ANSWER ...-double billing
The OIG has described seven basic components of an effective compliance
program for a small physician practice that are based from the _______________?
- ....ANSWER ...-Federal Sentencing Guidelines
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,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 ____________? - ....ANSWER ...-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
A high-level statement or plan that embraces an organization's general beliefs,
goals, objectives and acceptable procedure for a specified subject area is a
_______________? - ....ANSWER ...-policy
Kim is the Compliance Officer for ABC Provider Group. Kim has read the OIG
Compliance Program Guidance that acknowledges patient care as the first priority
of a physician practice. As the Compliance Officer (CO), Kim should implement
what type of compliance model? - ....ANSWER ...-A "patients first"
It is important to educate employees of the methods they may utilize to directly
notify and communicate issues of suspected areas of non-compliance. What is
considered a best practice method of anonymous reporting? -
....ANSWER ...-intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine? -
....ANSWER ...-areas of the billing department that might be in compliance
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, When the term Open Door Policy is used in reference to the Effective
Communication, what is this referring to? - ....ANSWER ...-The Compliance
Officer is accessible to all employees via many methods of communication
When Kim from ABC Provider Group is conducting a risk assessment, one of the
most important and key sources of information that Kim as the Compliance
Officer should utilize is_____________. - ....ANSWER ...-the Office of
Inspector General's Annual Work Plan
The mission statement of the healthcare organization and a statement of why they
are in business are also known as _________? - ....ANSWER ...-The Code
of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital
update the compliance program and plan? - ....ANSWER ...-As laws and
regulations change; and at least annually
After an employee receives their initial training regarding the practice/organization
Compliance Program what is the next step the compliance officer should take to
protect the practice against potential noncompliance activity? -
....ANSWER ...-Perform a baseline assessment of the employee's
competency scores to determine if additional training is required
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
