CPMA Exam Complete Questions And Answers With Latest Quiz 2024

CPMA Exam Complete Questions And Answers With Latest Quiz 2024 SOAP Correct Answer: Subjective, Objective, Assessment, Plan CHEDDAR Correct Answer: Chief complaint, Hx, Exam, Details of problem/complaint, Drugs & dosages, Assessment, Return visit Subjective Correct Answer: Pt complaint Objective Correct Answer: Provider observation Assessment Correct Answer: Medical Dx Plan Correct Answer: 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 elements would you expect to see in the medical records? Correct Answer: Patient ID, assignment of benefits, pt's medical hx, immunizations, physical examination, lab report, clinical impression & physician orders. When labs are ordered, there must be a copy of the order and the lab report that the physician has reviewed. What is the minimum requirement for the signature of the author of an entry in the medical records? Correct Answer: The first initial, last name and credentials Based on JCAHO accreditation guidance for personal data, what two elements must be evident in the medical records? Correct Answer: Personal biographical data and consent for Treatment or authorization for Treatment form. What is a comprehensive/focus review audit? Correct Answer: A large number of claims are selected for review that might be focused on specific procedure and/or dx codes What is RAT-STATS used for by an auditor? Correct Answer: Software used in performing statistical random samples and evaluating results. The Stark Statute applies to who and states what? Correct Answer: Applies to government payers. States the provider cannot refer pts to a health care facility where they or immediate family members has a financial relationship. What are the recommended number of charts to audit per provider and the minimum frequency of the audit? Correct Answer: 10 records per provider each year. When can a RAC extrapolate the overpayment(s) on claim? Correct Answer: If a RAC can demonstrate a high level of error, the RAC can then extrapolate the findings and request a refund. Patients can request copies of disclosure of PHI under HIPAA for how long? Correct Answer: A six year period of time. What are the civil monetary penalties for false or fraudulent claims? Correct Answer: Up to 11,000 per claim and three times the amount improperly claimed. The Claims Review procedure requires a full sample of 50 sampling units be randomly selected for review when the net financial error rate reaches what % Correct Answer: 5% Recovery Audit Contractor (RAC) Audit Correct Answer: Is a kind of audit that aims to migrate overpayments to providers. National Committee for Quality Assurance (NCLA) Correct Answer: Is a private not-for-profit organization in the US which is dedicated to improving health care quality. An analysis that gives the organization an overview of the deficit areas is called what? Correct Answer: Aggregate What information should be reported to the OIG in the Claims Review findings, as part of an entity's Annual Report? Correct Answer: Claims review methodology, statistical sampling documentation, and claim review findings The penalties for violation of the Stark law include program exclusion for knowing violations and: Correct Answer: Potential $15,000CMP for each service An audit performed on one provider would be considered a: Correct Answer: A focused audit is one that looks at one item, one type of service, or one provider. ALJ Correct Answer: Administrative law judge OIG Correct Answer: Office of Inspector General CIA Correct Answer: Corporate Integrity Agreement IRO Correct Answer: Independent Review Organization HHS Correct Answer: Health and Human Services LEIE Correct Answer: List of Excluded Individuals /Entities CMPL Correct Answer: Civil Monetary Penalties Law NIH Correct Answer: National Institute of Health