CPCO PREP EXAM 2025
QUESTIONS AND ANSWERS
Audit MICs can audit a Medicaid provider throughout his or her__________. -
....ANSWER ...-Country
What type of software process identifies potential claim errors? -
....ANSWER ...-?
Data mining
What does Medicare Part D cover? - ....ANSWER ...-Prescription Drugs
RACs perform what type of review(s) - ....ANSWER ...-Automated and
complex
What description below best describes ZPICs? - ....ANSWER ...-ZPICs are
private companies contracted by CMS, used to conduct audits for Medicare and
Medicaid overpayments
What is the level 3 of the RAC Claims appeals process? - ....ANSWER ...-
Hearing by an Administrative Law Judge (ALJ)
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
, What sets ZPIC audits apart from other Medicare audits? - ....ANSWER ...-
The audits are targeted by potential Medicare fraud
How many regions are part of the Medicaid Fraud Control Unit? -
....ANSWER ...-6
Medicaid Fraud Control Units (MFCUs) operate under the direction of _______. -
....ANSWER ...-Office of Inspector General (OIG)
Comprehensive Error Rate Testing Program (CERT) started in what year? -
....ANSWER ...-2001
John is the Compliance Officer for ABC Medical Group. He is explaining to a
group of providers the many types of acronyms that are associated with healthcare
compliance. A provider asks John what the acronym MIP refers to. The answer
is________? - ....ANSWER ...-Medicaid Integrity Program
What is the jurisdiction limit of Medicaid Fraud Control Units (MFCUs)? -
....ANSWER ...-Limited to investigating Medicaid provider fraud
A provider at Apple Community Hospital asks the Compliance Officer if the
Medicaid Integrity Contractor (MIC) has authority to audit claims in a particular
region or in any state? The Compliance Officer states that _________ -
....ANSWER ...-the MIC's can work in any state.
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
QUESTIONS AND ANSWERS
Audit MICs can audit a Medicaid provider throughout his or her__________. -
....ANSWER ...-Country
What type of software process identifies potential claim errors? -
....ANSWER ...-?
Data mining
What does Medicare Part D cover? - ....ANSWER ...-Prescription Drugs
RACs perform what type of review(s) - ....ANSWER ...-Automated and
complex
What description below best describes ZPICs? - ....ANSWER ...-ZPICs are
private companies contracted by CMS, used to conduct audits for Medicare and
Medicaid overpayments
What is the level 3 of the RAC Claims appeals process? - ....ANSWER ...-
Hearing by an Administrative Law Judge (ALJ)
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
, What sets ZPIC audits apart from other Medicare audits? - ....ANSWER ...-
The audits are targeted by potential Medicare fraud
How many regions are part of the Medicaid Fraud Control Unit? -
....ANSWER ...-6
Medicaid Fraud Control Units (MFCUs) operate under the direction of _______. -
....ANSWER ...-Office of Inspector General (OIG)
Comprehensive Error Rate Testing Program (CERT) started in what year? -
....ANSWER ...-2001
John is the Compliance Officer for ABC Medical Group. He is explaining to a
group of providers the many types of acronyms that are associated with healthcare
compliance. A provider asks John what the acronym MIP refers to. The answer
is________? - ....ANSWER ...-Medicaid Integrity Program
What is the jurisdiction limit of Medicaid Fraud Control Units (MFCUs)? -
....ANSWER ...-Limited to investigating Medicaid provider fraud
A provider at Apple Community Hospital asks the Compliance Officer if the
Medicaid Integrity Contractor (MIC) has authority to audit claims in a particular
region or in any state? The Compliance Officer states that _________ -
....ANSWER ...-the MIC's can work in any state.
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
