CPPM/AAPC EXAM QUESTIONS AND ANSWERS
LATEST UPDATE (GRADED A+)
One of the goals of the ACA was to change employer requirements as they pertain to employee health
insurance benefits. Employers with less than______ employees AND average wages of less than
_______________ receive a tax credit for providing health insurance.
25; $50,000
MACRA, introduced in 2015, stands for:
Medicare Access and CHIP Reauthorization Act
CMS's quality payment program includes two tracks:
1. Merit-Based Incentive Program
Advanced (MIPS)
2. Alternative Payment Models (APM)
MACRA's primary goals are: (3)
1. Repeal sustainable Growth Rate (SGR) formula
2. Reauthorize CHIP
3. Simplify federal regulation of payment and the health IT
The goal of MIPS is to provide a single _____________________ with a single
_________________________ based on performance in Medicare Part B
quality reporting system; payment adjustment factor
MIPS is a budget-neutral program, meaning...
successful reporters earn positive payment adjustments funded by unsuccessful reporters' negative
payment adjustments
Under the ACA, Medicare overpayments must be returned within ____ days.
60
What is an ACO?
group of doctors and hospitals who, as a team, agree to be responsible for a patient's overall care
MIPS eligible clinicians/groups' Medicare Part B performance threshold and payment adjustment
statutorily increase each year until the maximums are reached in performance year
____________________.
2021
, The MIPS low-volume threshold is based on what measures? (3)
1. The number of covered professional services under the MPFS.
2.. Part B allowed charges for covered professional services.
3. Any one of the above criteria.
Value-based purchasing is a reimbursement model that pays hospitals based on performance around
the following: (3)
1. Patient satisfaction scores
2. Quality of care
3. Efficiency
The state-based insurance exchange for small businesses (SHOP) stands for:
Small Business Health Options Program
The state-based insurance exchange for individuals is called the...
American Health Benefit Exchanges
Under MIPS, payment is based on performance in what year?
2 years prior (e.g. payment in 2023 is based on performance in 2021)
QA is also a management function that deals with _____________________ and running a(n)
_____________________________________________ to ensure the usability of the product.
setting policy; administrative system of controls
___________________ is a technical function that includes activities such as calibrations and analyses
of a sample of items (claims, lab results, data, etc.) to assess the accuracy associated with sample
selection as it relates to the entire population of items.
Quality Control
Converting to _______________ of medications has the potential to greatly reduce medication errors.
computerized provider order entry (CPOE)
CPOE stands for
computerized physician order entry
PDCA stands for:
Plan
Do
Check
Act
The "PLAN" phase of PDCA requires a ____________________ so the team understands the goal for
improvement.
LATEST UPDATE (GRADED A+)
One of the goals of the ACA was to change employer requirements as they pertain to employee health
insurance benefits. Employers with less than______ employees AND average wages of less than
_______________ receive a tax credit for providing health insurance.
25; $50,000
MACRA, introduced in 2015, stands for:
Medicare Access and CHIP Reauthorization Act
CMS's quality payment program includes two tracks:
1. Merit-Based Incentive Program
Advanced (MIPS)
2. Alternative Payment Models (APM)
MACRA's primary goals are: (3)
1. Repeal sustainable Growth Rate (SGR) formula
2. Reauthorize CHIP
3. Simplify federal regulation of payment and the health IT
The goal of MIPS is to provide a single _____________________ with a single
_________________________ based on performance in Medicare Part B
quality reporting system; payment adjustment factor
MIPS is a budget-neutral program, meaning...
successful reporters earn positive payment adjustments funded by unsuccessful reporters' negative
payment adjustments
Under the ACA, Medicare overpayments must be returned within ____ days.
60
What is an ACO?
group of doctors and hospitals who, as a team, agree to be responsible for a patient's overall care
MIPS eligible clinicians/groups' Medicare Part B performance threshold and payment adjustment
statutorily increase each year until the maximums are reached in performance year
____________________.
2021
, The MIPS low-volume threshold is based on what measures? (3)
1. The number of covered professional services under the MPFS.
2.. Part B allowed charges for covered professional services.
3. Any one of the above criteria.
Value-based purchasing is a reimbursement model that pays hospitals based on performance around
the following: (3)
1. Patient satisfaction scores
2. Quality of care
3. Efficiency
The state-based insurance exchange for small businesses (SHOP) stands for:
Small Business Health Options Program
The state-based insurance exchange for individuals is called the...
American Health Benefit Exchanges
Under MIPS, payment is based on performance in what year?
2 years prior (e.g. payment in 2023 is based on performance in 2021)
QA is also a management function that deals with _____________________ and running a(n)
_____________________________________________ to ensure the usability of the product.
setting policy; administrative system of controls
___________________ is a technical function that includes activities such as calibrations and analyses
of a sample of items (claims, lab results, data, etc.) to assess the accuracy associated with sample
selection as it relates to the entire population of items.
Quality Control
Converting to _______________ of medications has the potential to greatly reduce medication errors.
computerized provider order entry (CPOE)
CPOE stands for
computerized physician order entry
PDCA stands for:
Plan
Do
Check
Act
The "PLAN" phase of PDCA requires a ____________________ so the team understands the goal for
improvement.
