CPCO STUDY GUIDE Test Exam Practice
Exam (Latest ) Tested Questions
with Revised Answers, (A+ Guarantee)
One of the most important elements of an effective compliance program is to have a compliance officer
or committee who is__________. - CORRECT ANSWERS 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 ______________? - CORRECT
ANSWERS fraud
Joan, as an employee of a healthcare organization, has _________to report erroneous conduct, without
repercussions, so that it may be corrected immediately - CORRECT ANSWERS duty
person who exposes misconduct, alleged dishonest or illegal activity occurring in an organization is
called a______________? - CORRECT ANSWERS relator
The compliance program will flounder if employees of the organization are not aware of _________? -
CORRECT ANSWERS 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
_________? - CORRECT ANSWERS 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? - CORRECT ANSWERS
Post notices of up-to-date compliance information on the employee bulletin board
Participants in the Federal healthcare programs have an obligation to take measures, such as instituting
a compliance program, to _________________? - CORRECT ANSWERS detects and prevent
fraudulent, abusive and wasteful activities
,Tim, the Compliance Officer for XYZ Community Hospital, should report to whom? - CORRECT ANSWERS
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? - CORRECT ANSWERS double billing
The OIG has described seven basic components of an effective compliance program for a small physician
practice that are based from the _______________? - CORRECT ANSWERS 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 ____________? - CORRECT ANSWERS
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 _______________? - CORRECT ANSWERS
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? - CORRECT ANSWERS 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? - CORRECT ANSWERS intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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_____________. - CORRECT
ANSWERS 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 _________? - CORRECT ANSWERS The Code of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital update the compliance
program and plan? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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 _____________. - CORRECT ANSWERS Joint
ventures
The following is not a level of non-compliance: - CORRECT ANSWERS Mistake in billing
For potential criminal violations, a practice should have immediate discussions with a criminal attorney
who - CORRECT ANSWERS Is well versed in Healthcare Fraud and Abuse law
The Compliance Officer's main two responsibilities are to ____________the practice/organization's
compliance program. - CORRECT ANSWERS 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?
- CORRECT ANSWERS 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? - CORRECT ANSWERS 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. - CORRECT ANSWERS 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? - CORRECT ANSWERS Nursing Facilities
What is (are) considered a significant element(s) in fraud? - CORRECT ANSWERS Knowingly and
Intent
Department of Labor requires compliance with employee and employer laws including: - CORRECT
ANSWERS FLSA, OSHA, CRA, ERISA
Which government branch was created to fight waste, fraud and abuse in all federal health care
programs especially Medicare, Medicaid? - CORRECT ANSWERS Office of Inspector General
(OIG)
Dr. X is a very through provider. He always runs a full blood panel on each patient every year for their
physical. This is an example of: - CORRECT ANSWERS Waste
Exam (Latest ) Tested Questions
with Revised Answers, (A+ Guarantee)
One of the most important elements of an effective compliance program is to have a compliance officer
or committee who is__________. - CORRECT ANSWERS 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 ______________? - CORRECT
ANSWERS fraud
Joan, as an employee of a healthcare organization, has _________to report erroneous conduct, without
repercussions, so that it may be corrected immediately - CORRECT ANSWERS duty
person who exposes misconduct, alleged dishonest or illegal activity occurring in an organization is
called a______________? - CORRECT ANSWERS relator
The compliance program will flounder if employees of the organization are not aware of _________? -
CORRECT ANSWERS 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
_________? - CORRECT ANSWERS 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? - CORRECT ANSWERS
Post notices of up-to-date compliance information on the employee bulletin board
Participants in the Federal healthcare programs have an obligation to take measures, such as instituting
a compliance program, to _________________? - CORRECT ANSWERS detects and prevent
fraudulent, abusive and wasteful activities
,Tim, the Compliance Officer for XYZ Community Hospital, should report to whom? - CORRECT ANSWERS
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? - CORRECT ANSWERS double billing
The OIG has described seven basic components of an effective compliance program for a small physician
practice that are based from the _______________? - CORRECT ANSWERS 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 ____________? - CORRECT ANSWERS
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 _______________? - CORRECT ANSWERS
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? - CORRECT ANSWERS 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? - CORRECT ANSWERS intra-office or USPS mail
Tim at XYZ wants to conduct a baseline audit to help determine? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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_____________. - CORRECT
ANSWERS 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 _________? - CORRECT ANSWERS The Code of conduct
How often should the Tim, Compliance Officer for XYZ Community Hospital update the compliance
program and plan? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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 _____________. - CORRECT ANSWERS Joint
ventures
The following is not a level of non-compliance: - CORRECT ANSWERS Mistake in billing
For potential criminal violations, a practice should have immediate discussions with a criminal attorney
who - CORRECT ANSWERS Is well versed in Healthcare Fraud and Abuse law
The Compliance Officer's main two responsibilities are to ____________the practice/organization's
compliance program. - CORRECT ANSWERS 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?
- CORRECT ANSWERS 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? - CORRECT ANSWERS 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. - CORRECT ANSWERS 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? - CORRECT ANSWERS Nursing Facilities
What is (are) considered a significant element(s) in fraud? - CORRECT ANSWERS Knowingly and
Intent
Department of Labor requires compliance with employee and employer laws including: - CORRECT
ANSWERS FLSA, OSHA, CRA, ERISA
Which government branch was created to fight waste, fraud and abuse in all federal health care
programs especially Medicare, Medicaid? - CORRECT ANSWERS Office of Inspector General
(OIG)
Dr. X is a very through provider. He always runs a full blood panel on each patient every year for their
physical. This is an example of: - CORRECT ANSWERS Waste
