CPCO CERTIFICATION EXAM AND PRACTICE EXAM
NEWEST 2024 ACTUAL EXAM 400 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |
ALREADY GRADED A+
Question 1
Under Public Law 104-191, the Health Insurance Portability and Accountability Act of
1996 (HIPAA), what is the name of the national program designed to coordinate
Federal, State and local law enforcement activities with respect to health care fraud
and abuse? - ANSWER: Health Care Fraud and Abuse Control Program (HCFAC)
Question 2
According to the Federal Sentencing Guidelines, "To have an effective compliance
and ethics program..., an organization shall exercise due diligence to prevent and
detect criminal conduct." The FSGs also state organizations shall: - ANSWER:
Promote an organizational culture that encourages ethical conduct and a
commitment to compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice must:
- ANSWER: Tailor those materials to the physician practice where they will be
applied.
Question 4
As the compliance contact for your physician practice, you are charged with
developing the policies and procedures related to coding and billing. When
developing these policies and procedures, which of the following statements should
be included? - ANSWER: For any services billed, documentation must be present in
the patient's medical record to support the services.
Question 5
City Orthopedics, a large physician group practice employs several physician
assistants and nurse practitioners. There have been several questions by the
physicians on how incident to services should be billed. The compliance officer has
called the Medicare Administrative Contractor for the practice and was given some
information on how incident to services should be billed. Because the practice will be
relying on the information received from the Medicare Administrative Contractor,
what steps should the compliance officer take at the conclusion of the call according
to the OIG Compliance Guidance for Individual and Small Group Physician Practices?
- ANSWER: Document the conversation and retain the records.
Question 6
Developing effective compliance policies and procedures is an important part of any
compliance program. To help your practice mitigate compliance risk, policies and
, procedures should: - ANSWER: Be sure any time frames or requirements listed can
be accomplished given the practice's resources.
Question 7
Select the best phrase from the list below to complete the following policy
statement: Centennial Medical Associates is committed to following Federal, State,
and Local laws, rules, guidelines, and regulations. To promote this effort, Centennial
Medical Associates will perform claims audits at least on an annual basis to
____________________. - ANSWER: Verify accuracy of coding and reimbursement
for the services performed.
Question 8
You have just been identified as the compliance officer at your practice. The OIG
Compliance Guidance for Individual and Small Group Physician Practices suggests six
specific duties that may be assigned to you. What is one of those duties? - ANSWER:
Reviewing reports to see that new employees and vendors have been checked
against the OIG's list of excluded individuals and entities.
Question 9
For larger physician practices, how frequently does the OIG recommend reporting
compliance activities to the Board of Directors and CEO? - ANSWER: Regularly
Question 10
When conducting compliance training within a physician practice, what is one of the
goals that the practice should strive for in this compliance training? - ANSWER: All
employees will receive training on how to perform their jobs in compliance with the
standards of the practice and any applicable regulations.
Question 11
What is the goal of ongoing auditing and monitoring in a physician's practice? -
ANSWER: Ongoing auditing and monitoring will evaluate whether the physician
practice's standards and procedures are current and accurate and whether the
compliance program is working.
Question 12
A compliance program's plan for communication should include a provision for non-
retaliation for reporting fraudulent conduct. Which method below helps ensure that
an employee would be free from retribution? - ANSWER: Well-publicized disciplinary
actions for retaliation
Question 13
What does the HHS OIG suggest as possible warning signs that non-compliance may
exist? - ANSWER: Significant change in the number or type of claim rejections.
Question 14
Having the ability to respond to issues enables a practice to develop effective action
plans to correct problems and prevent future problems from occurring. What is one
NEWEST 2024 ACTUAL EXAM 400 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |
ALREADY GRADED A+
Question 1
Under Public Law 104-191, the Health Insurance Portability and Accountability Act of
1996 (HIPAA), what is the name of the national program designed to coordinate
Federal, State and local law enforcement activities with respect to health care fraud
and abuse? - ANSWER: Health Care Fraud and Abuse Control Program (HCFAC)
Question 2
According to the Federal Sentencing Guidelines, "To have an effective compliance
and ethics program..., an organization shall exercise due diligence to prevent and
detect criminal conduct." The FSGs also state organizations shall: - ANSWER:
Promote an organizational culture that encourages ethical conduct and a
commitment to compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice must:
- ANSWER: Tailor those materials to the physician practice where they will be
applied.
Question 4
As the compliance contact for your physician practice, you are charged with
developing the policies and procedures related to coding and billing. When
developing these policies and procedures, which of the following statements should
be included? - ANSWER: For any services billed, documentation must be present in
the patient's medical record to support the services.
Question 5
City Orthopedics, a large physician group practice employs several physician
assistants and nurse practitioners. There have been several questions by the
physicians on how incident to services should be billed. The compliance officer has
called the Medicare Administrative Contractor for the practice and was given some
information on how incident to services should be billed. Because the practice will be
relying on the information received from the Medicare Administrative Contractor,
what steps should the compliance officer take at the conclusion of the call according
to the OIG Compliance Guidance for Individual and Small Group Physician Practices?
- ANSWER: Document the conversation and retain the records.
Question 6
Developing effective compliance policies and procedures is an important part of any
compliance program. To help your practice mitigate compliance risk, policies and
, procedures should: - ANSWER: Be sure any time frames or requirements listed can
be accomplished given the practice's resources.
Question 7
Select the best phrase from the list below to complete the following policy
statement: Centennial Medical Associates is committed to following Federal, State,
and Local laws, rules, guidelines, and regulations. To promote this effort, Centennial
Medical Associates will perform claims audits at least on an annual basis to
____________________. - ANSWER: Verify accuracy of coding and reimbursement
for the services performed.
Question 8
You have just been identified as the compliance officer at your practice. The OIG
Compliance Guidance for Individual and Small Group Physician Practices suggests six
specific duties that may be assigned to you. What is one of those duties? - ANSWER:
Reviewing reports to see that new employees and vendors have been checked
against the OIG's list of excluded individuals and entities.
Question 9
For larger physician practices, how frequently does the OIG recommend reporting
compliance activities to the Board of Directors and CEO? - ANSWER: Regularly
Question 10
When conducting compliance training within a physician practice, what is one of the
goals that the practice should strive for in this compliance training? - ANSWER: All
employees will receive training on how to perform their jobs in compliance with the
standards of the practice and any applicable regulations.
Question 11
What is the goal of ongoing auditing and monitoring in a physician's practice? -
ANSWER: Ongoing auditing and monitoring will evaluate whether the physician
practice's standards and procedures are current and accurate and whether the
compliance program is working.
Question 12
A compliance program's plan for communication should include a provision for non-
retaliation for reporting fraudulent conduct. Which method below helps ensure that
an employee would be free from retribution? - ANSWER: Well-publicized disciplinary
actions for retaliation
Question 13
What does the HHS OIG suggest as possible warning signs that non-compliance may
exist? - ANSWER: Significant change in the number or type of claim rejections.
Question 14
Having the ability to respond to issues enables a practice to develop effective action
plans to correct problems and prevent future problems from occurring. What is one
