Page | 1
CPCO STUDY GUIDE Questions and Verified
Answers
One of the most important elements of an effective compliance program is to
have a compliance officer or committee who is__________.
Ans: empowered
If an employee, provider or anyone that deals with Federal or State healthcare
dollars has intent to receive payment for services not legitimately rendered this is
considered ______________?
Ans: fraud
Joan, as an employee of a healthcare organization, has _________to report
erroneous conduct, without repercussions, so that it may be corrected
immediately
Ans: duty
person who exposes misconduct, alleged dishonest or illegal activity occurring
in an organization is called a______________?
Ans: relator
The compliance program will flounder if employees of the organization are not
aware of _________?
Ans: laws and regulations that pertain to their specific job descriptions
When physicians (or their staff) make billing mistakes and errors the most
important thing to do is _________?
Ans: Send a refund
Judy is the Compliance Officer for Apple Medical Group. The practice is a small
group of providers. Judy wants to have an open door policy as suggested by the
OIG, thus she will?
Ans: Post notices of up-to-date compliance information on the employee
bulletin board
, Page | 2
Participants in the Federal healthcare programs have an obligation to take
measures, such as instituting a compliance program, to _________________?
Ans: detects and prevent fraudulent, abusive and wasteful activities
Tim, the Compliance Officer for XYZ Community Hospital, should report to
whom?
Ans: CEO or Board
The biller at XYZ Community Hospital wants to win the award every month for
posting the most insurance checks. Instead of giving the claims 30-60 days to
clear, she bills them again at the end of the month. This is an example of?
Ans: double billing
The OIG has described seven basic components of an effective compliance
program for a small physician practice that are based from the _______________?
Ans: Federal Sentencing Guidelines
Kim, Compliance Officer for ABC Provider Group, created a compliance plan
and policy a year ago. While reviewing the groups Baseline Audits it comes to
her attention that many of the staff have decided NOT to follow the compliance
plan. The Non-Compliance has ____________?
Ans: created a big risk of the group and Kim needs to make sure that
everyone knows about the risk of not following the compliance plan
A high-level statement or plan that embraces an organization's general beliefs,
goals, objectives and acceptable procedure for a specified subject area is a
_______________?
Ans: policy
Kim is the Compliance Officer for ABC Provider Group. Kim has read the OIG
Compliance Program Guidance that acknowledges patient care as the first
priority of a physician practice. As the Compliance Officer (CO), Kim should
implement what type of compliance model?
Ans: A "patients first"
It is important to educate employees of the methods they may utilize to directly
notify and communicate issues of suspected areas of non-compliance. What is
considered a best practice method of anonymous reporting?
, Page | 3
Ans: intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine?
Ans: areas of the billing department that might be in compliance
When the term Open Door Policy is used in reference to the Effective
Communication, what is this referring to?
Ans: The Compliance Officer is accessible to all employees via many
methods of communication
When Kim from ABC Provider Group is conducting a risk assessment, one of the
most important and key sources of information that Kim as the Compliance Officer
should utilize is_____________.
Ans: the Office of Inspector General's Annual Work Plan
The mission statement of the healthcare organization and a statement of why they
are in business are also known as _________?
Ans: The Code of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital
update the compliance program and plan?
Ans: As laws and regulations change; and at least annually
After an employee receives their initial training regarding the
practice/organization Compliance Program what is the next step the compliance
officer should take to protect the practice against potential noncompliance
activity?
Ans: Perform a baseline assessment of the employee's competency scores to
determine if additional training is required
ABC Provider Group and Apple Medical Group agree to pool their resources for
the purpose of accomplishing a specific task. This is called _____________.
Ans: Joint ventures
The following is not a level of non-compliance:
Ans: Mistake in billing
, Page | 4
For potential criminal violations, a practice should have immediate discussions
with a criminal attorney who
Ans: Is well versed in Healthcare Fraud and Abuse law
The Compliance Officer's main two responsibilities are to ____________the
practice/organization's compliance program.
Ans: develops and then implement
Judy is the Compliance Officer for Apple Medical Group. The providers of the
group ask Judy to design a new Compliance Plan. Should Judy ask some other
practices in town for a copy of their Compliance Plan? Do all Compliance
Programs have to be the same regardless of the practice size or specialty? Why?
Ans: No, compliance programs need to be tailored to fit the unique needs of
every organization or physician practice
USSC is important as it related to the Federal Sentencing Guidelines and thus
related to the core elements of compliance. What does the USSC acronym stand
for?
Ans: United States Sentencing Commission
Kathy, the Compliance Officer at a small provider office, is notified that a non-
English speaking patient will be arriving today. A LEP person/patient who needs
an interpreter to translate to and from the person's primary language must be
provided.
Ans: at no cost to the patient or insurance carrier
In addition to hospitals, what other type of facility did the OIG provide
supplemental compliance program guidance for?
Ans: Nursing Facilities
What is (are) considered a significant element(s) in fraud?
Ans: Knowingly and Intent
Department of Labor requires compliance with employee and employer laws
including:
Ans: FLSA, OSHA, CRA, ERISA
CPCO STUDY GUIDE Questions and Verified
Answers
One of the most important elements of an effective compliance program is to
have a compliance officer or committee who is__________.
Ans: empowered
If an employee, provider or anyone that deals with Federal or State healthcare
dollars has intent to receive payment for services not legitimately rendered this is
considered ______________?
Ans: fraud
Joan, as an employee of a healthcare organization, has _________to report
erroneous conduct, without repercussions, so that it may be corrected
immediately
Ans: duty
person who exposes misconduct, alleged dishonest or illegal activity occurring
in an organization is called a______________?
Ans: relator
The compliance program will flounder if employees of the organization are not
aware of _________?
Ans: laws and regulations that pertain to their specific job descriptions
When physicians (or their staff) make billing mistakes and errors the most
important thing to do is _________?
Ans: Send a refund
Judy is the Compliance Officer for Apple Medical Group. The practice is a small
group of providers. Judy wants to have an open door policy as suggested by the
OIG, thus she will?
Ans: Post notices of up-to-date compliance information on the employee
bulletin board
, Page | 2
Participants in the Federal healthcare programs have an obligation to take
measures, such as instituting a compliance program, to _________________?
Ans: detects and prevent fraudulent, abusive and wasteful activities
Tim, the Compliance Officer for XYZ Community Hospital, should report to
whom?
Ans: CEO or Board
The biller at XYZ Community Hospital wants to win the award every month for
posting the most insurance checks. Instead of giving the claims 30-60 days to
clear, she bills them again at the end of the month. This is an example of?
Ans: double billing
The OIG has described seven basic components of an effective compliance
program for a small physician practice that are based from the _______________?
Ans: Federal Sentencing Guidelines
Kim, Compliance Officer for ABC Provider Group, created a compliance plan
and policy a year ago. While reviewing the groups Baseline Audits it comes to
her attention that many of the staff have decided NOT to follow the compliance
plan. The Non-Compliance has ____________?
Ans: created a big risk of the group and Kim needs to make sure that
everyone knows about the risk of not following the compliance plan
A high-level statement or plan that embraces an organization's general beliefs,
goals, objectives and acceptable procedure for a specified subject area is a
_______________?
Ans: policy
Kim is the Compliance Officer for ABC Provider Group. Kim has read the OIG
Compliance Program Guidance that acknowledges patient care as the first
priority of a physician practice. As the Compliance Officer (CO), Kim should
implement what type of compliance model?
Ans: A "patients first"
It is important to educate employees of the methods they may utilize to directly
notify and communicate issues of suspected areas of non-compliance. What is
considered a best practice method of anonymous reporting?
, Page | 3
Ans: intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine?
Ans: areas of the billing department that might be in compliance
When the term Open Door Policy is used in reference to the Effective
Communication, what is this referring to?
Ans: The Compliance Officer is accessible to all employees via many
methods of communication
When Kim from ABC Provider Group is conducting a risk assessment, one of the
most important and key sources of information that Kim as the Compliance Officer
should utilize is_____________.
Ans: the Office of Inspector General's Annual Work Plan
The mission statement of the healthcare organization and a statement of why they
are in business are also known as _________?
Ans: The Code of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital
update the compliance program and plan?
Ans: As laws and regulations change; and at least annually
After an employee receives their initial training regarding the
practice/organization Compliance Program what is the next step the compliance
officer should take to protect the practice against potential noncompliance
activity?
Ans: Perform a baseline assessment of the employee's competency scores to
determine if additional training is required
ABC Provider Group and Apple Medical Group agree to pool their resources for
the purpose of accomplishing a specific task. This is called _____________.
Ans: Joint ventures
The following is not a level of non-compliance:
Ans: Mistake in billing
, Page | 4
For potential criminal violations, a practice should have immediate discussions
with a criminal attorney who
Ans: Is well versed in Healthcare Fraud and Abuse law
The Compliance Officer's main two responsibilities are to ____________the
practice/organization's compliance program.
Ans: develops and then implement
Judy is the Compliance Officer for Apple Medical Group. The providers of the
group ask Judy to design a new Compliance Plan. Should Judy ask some other
practices in town for a copy of their Compliance Plan? Do all Compliance
Programs have to be the same regardless of the practice size or specialty? Why?
Ans: No, compliance programs need to be tailored to fit the unique needs of
every organization or physician practice
USSC is important as it related to the Federal Sentencing Guidelines and thus
related to the core elements of compliance. What does the USSC acronym stand
for?
Ans: United States Sentencing Commission
Kathy, the Compliance Officer at a small provider office, is notified that a non-
English speaking patient will be arriving today. A LEP person/patient who needs
an interpreter to translate to and from the person's primary language must be
provided.
Ans: at no cost to the patient or insurance carrier
In addition to hospitals, what other type of facility did the OIG provide
supplemental compliance program guidance for?
Ans: Nursing Facilities
What is (are) considered a significant element(s) in fraud?
Ans: Knowingly and Intent
Department of Labor requires compliance with employee and employer laws
including:
Ans: FLSA, OSHA, CRA, ERISA
