CPCO Exam Practice (2023/ 2024 New
Update) Questions and Verified Answers
QUESTION
A search warrant, State or federal (or both) allows the agents the right to what?
Answer:
to enter and seize documents
QUESTION
Which office is mainly responsible to investigate health care fraud waste and abuse?
Answer:
Office of Inspector General (OIG)
QUESTION
When drafting audit protocol in an internal investigation it should be carefully worded and tied
to the regulatory scope and applicability research. If an attorney doe snot draft the protocol, one
should review it for language, Why?
Answer:
For attorney client privilege.
QUESTION
CMS relies on a number of program contractors to identify and respond to fraud, abuse, and
improper payments in the Medicare and Medicaid programs. these contractors are charged with
protecting the programs ____________.
Answer:
Integrity
,QUESTION
If an internal audit reveals issues, it's time to do some interviews and document reviews. How
many people should be involved in the interview process of an employee?
Answer:
2+ the attorney
QUESTION
Free statistical software that can be used to select a random sample for audits is called what?
Answer:
RAT-STATS
QUESTION
When is it acceptable to bill an office visit based on time?
Answer:
If over half of the visit is spent counseling the patient.
QUESTION
Incident to rules can be complicated and present additional risks to a practice/organization. If a
provider is available only via paper or telephone, incident-to billing _________________
Answer:
Requirements are not met.
QUESTION
Because it is considered the overarching criteria for determining a level of service, the provider
must ensure that the documentation supports what?
Answer:
Medical Necessity.
,QUESTION
Which screening exam does not require an order, in any setting?
Answer:
Mammogram
QUESTION
In general, the OIG recommends auditing how many medical records per federal payer?
Answer:
5 or more
QUESTION
Accountable care organizations (ACO's) involve different providers, including hospitals and
physicians. Members of the ACO share both the gains and losses for certain Medicare fee-for-
service beneficiaries with high-risk conditions such as heart failure, COPD, and diabetes. What is
this arrangement called?
Answer:
Gain sharing
QUESTION
Which law governs relationships between competitors?
Answer:
Antitrust
QUESTION
Medical practices should be aware of risks identified in the past and then establish policies and
procedures for what?
, Answer:
Continual monitoring
QUESTION
Which of the following is not true regarding how improper payments are categorized?
Answer:
Billed based on time
QUESTION
Can CMS take back monies without reviewing a patient's record?
Answer:
Yes, through the use of data mining.
QUESTION
What department monitors and recertifies MFCU's?
Answer:
OIG
QUESTION
Can providers request an extension for providing records requested by an auditor?
Answer:
Yes, by sending a valid explanation.
QUESTION
Which of the following best describes ZPIC's?
Update) Questions and Verified Answers
QUESTION
A search warrant, State or federal (or both) allows the agents the right to what?
Answer:
to enter and seize documents
QUESTION
Which office is mainly responsible to investigate health care fraud waste and abuse?
Answer:
Office of Inspector General (OIG)
QUESTION
When drafting audit protocol in an internal investigation it should be carefully worded and tied
to the regulatory scope and applicability research. If an attorney doe snot draft the protocol, one
should review it for language, Why?
Answer:
For attorney client privilege.
QUESTION
CMS relies on a number of program contractors to identify and respond to fraud, abuse, and
improper payments in the Medicare and Medicaid programs. these contractors are charged with
protecting the programs ____________.
Answer:
Integrity
,QUESTION
If an internal audit reveals issues, it's time to do some interviews and document reviews. How
many people should be involved in the interview process of an employee?
Answer:
2+ the attorney
QUESTION
Free statistical software that can be used to select a random sample for audits is called what?
Answer:
RAT-STATS
QUESTION
When is it acceptable to bill an office visit based on time?
Answer:
If over half of the visit is spent counseling the patient.
QUESTION
Incident to rules can be complicated and present additional risks to a practice/organization. If a
provider is available only via paper or telephone, incident-to billing _________________
Answer:
Requirements are not met.
QUESTION
Because it is considered the overarching criteria for determining a level of service, the provider
must ensure that the documentation supports what?
Answer:
Medical Necessity.
,QUESTION
Which screening exam does not require an order, in any setting?
Answer:
Mammogram
QUESTION
In general, the OIG recommends auditing how many medical records per federal payer?
Answer:
5 or more
QUESTION
Accountable care organizations (ACO's) involve different providers, including hospitals and
physicians. Members of the ACO share both the gains and losses for certain Medicare fee-for-
service beneficiaries with high-risk conditions such as heart failure, COPD, and diabetes. What is
this arrangement called?
Answer:
Gain sharing
QUESTION
Which law governs relationships between competitors?
Answer:
Antitrust
QUESTION
Medical practices should be aware of risks identified in the past and then establish policies and
procedures for what?
, Answer:
Continual monitoring
QUESTION
Which of the following is not true regarding how improper payments are categorized?
Answer:
Billed based on time
QUESTION
Can CMS take back monies without reviewing a patient's record?
Answer:
Yes, through the use of data mining.
QUESTION
What department monitors and recertifies MFCU's?
Answer:
OIG
QUESTION
Can providers request an extension for providing records requested by an auditor?
Answer:
Yes, by sending a valid explanation.
QUESTION
Which of the following best describes ZPIC's?
