CPMA

CPMA Exam - Chapter 5: Corrective action Plans, Questions and answers, 100% Accurate. Approved. Except in the case of routine or annual compliance audits conducted on behalf of providers that do not have formal compliance programs or staff, - -it is not usually the auditor's responsibility to develop a corrective action plan. In the case of audits associated with voluntary repayments or disclosures under the SDP (Self Disclosure Protocol) for potentially fraudulent conduct, - -it usuall...

Cpma Top test bank Questions and answers, 100% Accurate. Approved. When non-compliance is identified, what does the OIG recommended? a .Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action, and the follow-up action taken. b. Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action,and the follow-up action taken. ...

CPMA Chapter 1, Top Questions and answers, 100% Accurate. Rated A+ Stark Law - -Physician Self Referral Law Prohibits a physician from making a referral to an entity with which they or their immediate family has a financial relationship if the referral is for the furnishing of designated health services RAT-STATS - -A statistical software that is a valuable analytical tool used by auditors Components of RAT-STATS that should be used to perform CIA Claims Review - -"Random Numbers" ...

CPMA Top Exam Questions and answers, 100% Accurate, rated A+ B. If documentation supports the service, have the staff contact the carrier to reprocess the claims. Code 33010 was valid for the date of service billed. Rationale: The effective dates of codes are date of service driven. New CPT® codes become effective January 1st of every year. When auditing, verify codes based on the codes that were valid during the date of service. - -In February 2020, an auditor is asked to review 10 recor...

AAPC CASES CPMA Review Questions and answers, (Answered). Verified. You are performing an audit of evaluation and management services for a family practice office. In the encounter, you read the physician ordered and reviewed a differential WBC. Which of the following best describes what you would expect to see in the medical record? - -Patient identification, assignment of benefits, patient's medical history, immunizations, physical examination, lab report, clinical impression, and physic...

CPMA EXAM chapter 5, Top Questions and answers, 100% Accurate, Verified. Which statement is true regarding an audit performed on charts for Medicare beneficiaries? - -National CMS policies and local MAC policies should be utilized when performing Medicare audits. In addition to CMS it is necessary to know your Medicare Administrative Contractor that supports the location where services are rendered for example 4x4 rule. How often should an internal audit be conducted minimally? - -Annual...

CPMA STUDY QUESTIONS & Answers, (accurate). Rated A+ WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? - -1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and health plan request and denial. Exclusion Statute - -1.Physician is banned from participating in any federal or state healthcare program by OIG 2. They ca...

CPMA Study Guide Questions and answers, 100% Accurate. Verified. The Joint Commission requires that Factors that Affect Learning must be ascertained for a hospital or hospital owned physician practice when assessing this element what does this include? - -*The patients ability to read, method learning, & understanding. *Any language or physical disabilities *Cultural beliefs. According to Federal regulations how long must report copies and printouts of films, scans, & other radiologica...

CPMA Practice Exam A, Questions and answers, 100% Accurate, rated A+ You are performing an audit of evaluation and management services for a family practice office. In the encounter, you read the physician order and reviewed a differential WBC. Which of the following best describes what you would expect to see in the medical record? - -Patient identification, assignment of benefits, patient's medical history, immunizations, physical examination, lab report, clinical impression, and physici...

CPMA Exam Chapter 3. Top Exam Questions and answers, Verified. Rated A Accurate reimbursement begins with - -accurate coding and rules that vary by payer The CPT codebook contains - -instructions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. - -An auditor must be able to apply payer variations to the CPT guidelines during an audit, and must communicate the differences in a way that will make sen...

CPMA Top Exam Questions and answers, 100% Accurate, Approved. The Joint Commission (JC) requires the Factors that Affect Learning must be assessed for a hospital or hospital owned physician practice as well as other health care facilities. When assessing this element what does this include? A. The patient's ability to read, method of learning and understanding. B. Any language or physical disabilities. C. Cultural beliefs. D. All the above - -D. All the above Report copies ...

CPMA practice exam A, Questions and answers, 100% Accurate, rated A+ SOAP - -Subjective, Objective, Assessment, Plan CHEDDAR - -Chief complaint, Hx, Exam, Details of problem/complaint, Drugs & dosages, Assessment, Return visit Subjective - -Pt complaint Objective - -Provider observation Assessment - -Medical Dx Plan - -Treatment You are performing an audit of e/m services for a FP office. In the encounter you read the physician ordered and reviewed a differential WBC. What...

CPMA Exam Test Bank.Top exam Questions and answers, 100% Accurate, Verified. CMS Fraud Definition - -Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition - -An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud - -Billing for services and/or supplies that you know were not furnished or provided, altering claim forms an...

CPMA Top Exam Questions and answers. Approved Rated A+ Which option is NOT part of the seven elements that should be included in a compliance plan based on the OIG's recommendations? a. Responding promptly to detected offenses and developing corrective action. b. Conducting effective training and education. c. Identifying employees on the exclusions list. d. Developing effective lines of communication. - -c. Identifying employees on the exclusions list. The OIG's Compliance Program ...

CPMA Chapter 1, Questions and answers, 100% Accurate, rated A Stark Law - -Physician Self Referral Law Prohibits a physician from making a referral to an entity with which they or their immediate family has a financial relationship if the referral is for the furnishing of designated health services RAT-STATS - -A statistical software that is a valuable analytical tool used by auditors Components of RAT-STATS that should be used to perform CIA Claims Review - -"Random Numbers" to dr...

CPMA EXAM chapter 5. Questions and answers, 100% Accurate. Approved. Which statement is true regarding an audit performed on charts for Medicare beneficiaries? - -National CMS policies and local MAC policies should be utilized when performing Medicare audits. In addition to CMS it is necessary to know your Medicare Administrative Contractor that supports the location where services are rendered for example 4x4 rule. How often should an internal audit be conducted minimally? - -Annually (...

CPMA Exam Questions and answers, 100% Accurate, graded A+ Fraud or Abuse: Billing for a service at a higher level than provided - -Fraud What is a Qua Tam relator? - -A person who brings a civil action for a violation for him/herself & for US Govt What is the difference between Stark Law & Antikickback law? - -No INTENT must be provien for Stark, Antikickpack requires proof of intent When banned for Fed/State healthcare program, what is the term of exclusion (in Years)? - -5 years ...

CPMA Practice Exam A, Questions and answers, 100% Accurate, rated A+ You are performing an audit of evaluation and management services for a family practice office. In the encounter, you read the physician order and reviewed a differential WBC. Which of the following best describes what you would expect to see in the medical record? - -Patient identification, assignment of benefits, patient's medical history, immunizations, physical examination, lab report, clinical impression, and physici...

CPMA STUDY QUESTIONS & Answers, 100% Accurate. Graded A+ WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? - -1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and health plan request and denial. Exclusion Statute - -1.Physician is banned from participating in any federal or state healthcare program by OIG 2. The...

AAPC CPMA Practice Exam Study Questions and answers, 100% Accurate, rated A+ What elements must be in a medical record - -Patient ID, Assignment of Benefits, medical history, immunizations, physical exam, lab report, clinical impression, physician orders What is the minimum signature assignment of the author of entry in the medical record? - -First initial, Last Name and credentials Based on the JC accreditation guidelines for personal data, what 2 elements must be evident in the medi...