CPCO Exam Questions with Revised
Answers () 100% Guarantee Pass.
Question 1
Under Public Law 104-191, the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
what is the name of the national program designed to coordinate Federal, State and local law
enforcement activities with respect to health care fraud and abuse? - CORRECT ANSWERS
Health Care Fraud and Abuse Control Program (HCFAC)
Question 2
According to the Federal Sentencing Guidelines, "To have an effective compliance and ethics program...,
an organization shall exercise due diligence to prevent and detect criminal conduct." The FSGs also state
organizations shall: - CORRECT ANSWERS Promote an organizational culture that encourages
ethical conduct and a commitment to compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice must: - CORRECT
ANSWERS Tailor those materials to the physician practice where they will be applied.
Question 4
As the compliance contact for your physician practice, you are charged with developing the policies and
procedures related to coding and billing. When developing these policies and procedures, which of the
following statements should be included? - CORRECT ANSWERS For any services billed,
documentation must be present in the patient's medical record to support the services.
Question 5
City Orthopedics, a large physician group practice employs several physician assistants and nurse
practitioners. There have been several questions by the physicians on how incident to services should be
billed. The compliance officer has called the Medicare Administrative Contractor for the practice and
was given some information on how incident to services should be billed. Because the practice will be
relying on the information received from the Medicare Administrative Contractor, what steps should the
compliance officer take at the conclusion of the call according to the OIG Compliance Guidance for
Individual and Small Group Physician Practices? - CORRECT ANSWERS Document the
conversation and retain the records.
Question 6
Developing effective compliance policies and procedures is an important part of any compliance
program. To help your practice mitigate compliance risk, policies and procedures should: - CORRECT
ANSWERS Be sure any time frames or requirements listed can be accomplished given the
practice's resources.
Question 7
Select the best phrase from the list below to complete the following policy statement: Centennial
Medical Associates is committed to following Federal, State, and Local laws, rules, guidelines, and
regulations. To promote this effort, Centennial Medical Associates will perform claims audits at least on
an annual basis to ____________________. - CORRECT ANSWERS Verify accuracy of coding
and reimbursement for the services performed.
, Question 8
You have just been identified as the compliance officer at your practice. The OIG Compliance Guidance
for Individual and Small Group Physician Practices suggests six specific duties that may be assigned to
you. What is one of those duties? - CORRECT ANSWERS Reviewing reports to see that new
employees and vendors have been checked against the OIG's list of excluded individuals and entities.
Question 9
For larger physician practices, how frequently does the OIG recommend reporting compliance activities
to the Board of Directors and CEO? - CORRECT ANSWERS Regularly
Question 10
When conducting compliance training within a physician practice, what is one of the goals that the
practice should strive for in this compliance training? - CORRECT ANSWERS All employees will
receive training on how to perform their jobs in compliance with the standards of the practice and any
applicable regulations.
Question 11
What is the goal of ongoing auditing and monitoring in a physician's practice? - CORRECT ANSWERS
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.
Question 12
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? - CORRECT ANSWERS Well-publicized disciplinary actions for retaliation
Question 13
What does the HHS OIG suggest as possible warning signs that non-compliance may exist? - CORRECT
ANSWERS Significant change in the number or type of claim rejections.
Question 14
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 the response/prevention element? - CORRECT ANSWERS Create a
response team, consisting of representatives from compliance, audit, and any other relevant functional
department.
Question 15
A physician office laboratory is authorized to perform urinalysis testing, including the microscopic
analysis under their PPMP certification. It has been the physician's experience that many of his patients
that have urinalysis testing done also require 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? - CORRECT ANSWERS Yes. Performing the microscopic test on all patients
when the results of the urinalysis are negative could be considered medically unnecessary.
Question 16
Answers () 100% Guarantee Pass.
Question 1
Under Public Law 104-191, the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
what is the name of the national program designed to coordinate Federal, State and local law
enforcement activities with respect to health care fraud and abuse? - CORRECT ANSWERS
Health Care Fraud and Abuse Control Program (HCFAC)
Question 2
According to the Federal Sentencing Guidelines, "To have an effective compliance and ethics program...,
an organization shall exercise due diligence to prevent and detect criminal conduct." The FSGs also state
organizations shall: - CORRECT ANSWERS Promote an organizational culture that encourages
ethical conduct and a commitment to compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice must: - CORRECT
ANSWERS Tailor those materials to the physician practice where they will be applied.
Question 4
As the compliance contact for your physician practice, you are charged with developing the policies and
procedures related to coding and billing. When developing these policies and procedures, which of the
following statements should be included? - CORRECT ANSWERS For any services billed,
documentation must be present in the patient's medical record to support the services.
Question 5
City Orthopedics, a large physician group practice employs several physician assistants and nurse
practitioners. There have been several questions by the physicians on how incident to services should be
billed. The compliance officer has called the Medicare Administrative Contractor for the practice and
was given some information on how incident to services should be billed. Because the practice will be
relying on the information received from the Medicare Administrative Contractor, what steps should the
compliance officer take at the conclusion of the call according to the OIG Compliance Guidance for
Individual and Small Group Physician Practices? - CORRECT ANSWERS Document the
conversation and retain the records.
Question 6
Developing effective compliance policies and procedures is an important part of any compliance
program. To help your practice mitigate compliance risk, policies and procedures should: - CORRECT
ANSWERS Be sure any time frames or requirements listed can be accomplished given the
practice's resources.
Question 7
Select the best phrase from the list below to complete the following policy statement: Centennial
Medical Associates is committed to following Federal, State, and Local laws, rules, guidelines, and
regulations. To promote this effort, Centennial Medical Associates will perform claims audits at least on
an annual basis to ____________________. - CORRECT ANSWERS Verify accuracy of coding
and reimbursement for the services performed.
, Question 8
You have just been identified as the compliance officer at your practice. The OIG Compliance Guidance
for Individual and Small Group Physician Practices suggests six specific duties that may be assigned to
you. What is one of those duties? - CORRECT ANSWERS Reviewing reports to see that new
employees and vendors have been checked against the OIG's list of excluded individuals and entities.
Question 9
For larger physician practices, how frequently does the OIG recommend reporting compliance activities
to the Board of Directors and CEO? - CORRECT ANSWERS Regularly
Question 10
When conducting compliance training within a physician practice, what is one of the goals that the
practice should strive for in this compliance training? - CORRECT ANSWERS All employees will
receive training on how to perform their jobs in compliance with the standards of the practice and any
applicable regulations.
Question 11
What is the goal of ongoing auditing and monitoring in a physician's practice? - CORRECT ANSWERS
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.
Question 12
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? - CORRECT ANSWERS Well-publicized disciplinary actions for retaliation
Question 13
What does the HHS OIG suggest as possible warning signs that non-compliance may exist? - CORRECT
ANSWERS Significant change in the number or type of claim rejections.
Question 14
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 the response/prevention element? - CORRECT ANSWERS Create a
response team, consisting of representatives from compliance, audit, and any other relevant functional
department.
Question 15
A physician office laboratory is authorized to perform urinalysis testing, including the microscopic
analysis under their PPMP certification. It has been the physician's experience that many of his patients
that have urinalysis testing done also require 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? - CORRECT ANSWERS Yes. Performing the microscopic test on all patients
when the results of the urinalysis are negative could be considered medically unnecessary.
Question 16
