1
CPCO
CPCO Certification Exam Questions with
Correct Verified Answers, Already
Passed! (Complete & Accurate)
What is the goal of ongoing auditing and monitoring in a physician's
practice?
A. Ongoing auditing and monitoring will prevent fraud
B. Ongoing auditing and monitoring will enhance revenues by
detecting instances of under coding.
C. 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.
D. Ongoing auditing and monitoring will improve the quality of
patient care. - ANS ✓C. 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.
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?
A. A clearly defined chain of command for reporting potentially
fraudulent conduct
B. Guaranteed anonymity
CPCO Certification
, 2
CPCO
C. Well-publicized disciplinary actions for retaliation
D. A policy that encourages reporting directly to the OIG - ANS ✓C.
Well-publicized disciplinary actions for retaliation
What does the HHS OIG suggest as possible warning signs that non-
compliance may exist?
A. Significant change in the number or type of claim rejections.
B. Getting carrier newsletters pertaining to the types of service that
your practice bills.
C. Consistent use of certain codes.
D. Receipt of carrier requests for documentation. - ANS ✓A. Significant
change in the number or type of claim rejections.
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 step that can be taken to
establish compliance effectiveness for responding to and/or
preventing compliance issues?
A. Create a response team, consisting of representatives from the
compliance and audit department.
B. Create a response team, consisting of representatives from
compliance, audit, and any other relevant functional department.
C. Create an investigation team, consisting of representatives from
compliance, audit, and any other relevant functional department.
D. Create a prevention team, consisting of representatives from
compliance, audit, and any other relevant functional department. -
ANS ✓B. Create a response team, consisting of representatives from
compliance, audit, and any other relevant functional department.
CPCO Certification
, 3
CPCO
A physician office laboratory is authorized to perform urinalysis
testing, including the microscopic analysis under their Provider-
Performed Microscopy Procedures (PPMP) certification. It has been
the physician's experience that many of his patients that have
urinalysis testing done also requires the microscopic exam. Because
of this and to be able to provide better treatment, he has established
an office policy that for all urinalysis testing performed in his office,
the lab should also perform the microscopic test. Is this a
compliance risk?
A. Yes. Performing the microscopic test on all patients when the
results of the urinalysis are negative could be considered medically
unnecessary.
B. Yes. The physician must always order the code for the urinalysis
test with the microscopic exam to avoid unbundling.
C. No. Because the physician is providing quality patient care, there is
no compliance risk.
D. No. The physici - ANS ✓A. Yes. Performing the microscopic test on all
patients when the results of the urinalysis are negative could be considered
medically unnecessary.
Billing companies should have written policies and procedures that
reflect and reinforce Federal and State statutes. These policies must
create a mechanism for the billing or reimbursement staff to
communicate effectively and accurately with the health care provider.
Which of the following policies and procedures should a billing office
have in place to meet these needs?
A. Conclude that claims may be submitted when note has been started
but not yet finalized by the physician as long as a signed affidavit is in
CPCO Certification
CPCO
CPCO Certification Exam Questions with
Correct Verified Answers, Already
Passed! (Complete & Accurate)
What is the goal of ongoing auditing and monitoring in a physician's
practice?
A. Ongoing auditing and monitoring will prevent fraud
B. Ongoing auditing and monitoring will enhance revenues by
detecting instances of under coding.
C. 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.
D. Ongoing auditing and monitoring will improve the quality of
patient care. - ANS ✓C. 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.
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?
A. A clearly defined chain of command for reporting potentially
fraudulent conduct
B. Guaranteed anonymity
CPCO Certification
, 2
CPCO
C. Well-publicized disciplinary actions for retaliation
D. A policy that encourages reporting directly to the OIG - ANS ✓C.
Well-publicized disciplinary actions for retaliation
What does the HHS OIG suggest as possible warning signs that non-
compliance may exist?
A. Significant change in the number or type of claim rejections.
B. Getting carrier newsletters pertaining to the types of service that
your practice bills.
C. Consistent use of certain codes.
D. Receipt of carrier requests for documentation. - ANS ✓A. Significant
change in the number or type of claim rejections.
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 step that can be taken to
establish compliance effectiveness for responding to and/or
preventing compliance issues?
A. Create a response team, consisting of representatives from the
compliance and audit department.
B. Create a response team, consisting of representatives from
compliance, audit, and any other relevant functional department.
C. Create an investigation team, consisting of representatives from
compliance, audit, and any other relevant functional department.
D. Create a prevention team, consisting of representatives from
compliance, audit, and any other relevant functional department. -
ANS ✓B. Create a response team, consisting of representatives from
compliance, audit, and any other relevant functional department.
CPCO Certification
, 3
CPCO
A physician office laboratory is authorized to perform urinalysis
testing, including the microscopic analysis under their Provider-
Performed Microscopy Procedures (PPMP) certification. It has been
the physician's experience that many of his patients that have
urinalysis testing done also requires the microscopic exam. Because
of this and to be able to provide better treatment, he has established
an office policy that for all urinalysis testing performed in his office,
the lab should also perform the microscopic test. Is this a
compliance risk?
A. Yes. Performing the microscopic test on all patients when the
results of the urinalysis are negative could be considered medically
unnecessary.
B. Yes. The physician must always order the code for the urinalysis
test with the microscopic exam to avoid unbundling.
C. No. Because the physician is providing quality patient care, there is
no compliance risk.
D. No. The physici - ANS ✓A. Yes. Performing the microscopic test on all
patients when the results of the urinalysis are negative could be considered
medically unnecessary.
Billing companies should have written policies and procedures that
reflect and reinforce Federal and State statutes. These policies must
create a mechanism for the billing or reimbursement staff to
communicate effectively and accurately with the health care provider.
Which of the following policies and procedures should a billing office
have in place to meet these needs?
A. Conclude that claims may be submitted when note has been started
but not yet finalized by the physician as long as a signed affidavit is in
CPCO Certification
