Docsity
Log inSign up
Docsity
Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity

Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan

Guidelines and tips
Guidelines and tips
Sell on Docsity
Sell on Docsity
Log inSign up

Prepare for your exams

Study with the several resources on Docsity

Find documents

Prepare for your exams with the study notes shared by other students like you on Docsity

Search Store documents

The best documents sold by students who completed their studies

Search through all study resources
Docsity AINEW

Summarize your documents, ask them questions, convert them into quizzes and concept maps

Explore questions

Clear up your doubts by reading the answers to questions asked by your fellow students

Earn points to download

Earn points by helping other students or get them with a premium plan

Share documents
download point icon20 Points

For each uploaded document

Answer questions
download point icon5 Points

For each given answer (max 1 per day)

All the ways to get free points
Get points immediately

Choose a premium plan with all the points you need

Study Opportunities

Choose your next study program

Get in touch with the best universities in the world. Search through thousands of universities and official partners

Community

Ask the community

Ask the community for help and clear up your study doubts

University Rankings

Discover the best universities in your country according to Docsity users

Free resources

Our save-the-student-ebooks!

Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors

From our blog

Exams and Study
Go to the blog

CPMA Practice Test C with accurate detailed answers, Exams of Auditing

Texas A & M University - Corpus ChristiAuditing

CPMA Practice Test C with accurate detailed answers

Typology: Exams

2024/2025

Available from 07/05/2025

smart-scores
smart-scores 🇺🇸

5

(2)

7K documents

1 / 5

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
CPMA |! Practice |! Test |! C |! with |! accurate |!
detailed |! answers
When |! auditing |! operative |! notes, |! the |! auditor |! will |! expect |! to |! see |!
documentation |! from |! all |! of |! the |! following |! except |! - |! Correct |! answer |! ✔Surgical |!
assistants
According |! to |! the |! Health |! Insurance |! Portability |! and |! Accountability |! Act |! of |!
1996 |! (HIPAA), |! an |! outside |! auditor |! must |! sign |! which |! of |! the |! following |!
agreements |! prior |! to |! reviewing |! and |! auditing |! any |! medical |! records? |! - |! Correct |!
answer |! ✔Business |! Associate |! Agreement
The |! HIPAA |! Privacy |! Rule |! defines |! "minimum |! necessary" |! as |! typically |!
requiring |! healthcare |! employees |! to |! - |! Correct |! answer |! ✔Follow |! policies |! and |!
procedures |! developed |! by |! the |! covered |! entity |! which |! limit |! use |! and |! disclosure
of |! PHI |! to |! that |! which |! is |! needed |! to |! accomplish |! the |! intended |! purpose |! to |!
perform |! the |! duties |! of |! their |! job
When |! auditing |! an |! ENT |! practice, |! you |! discover |! the |! practice |! uses |! an |! EMR. |!
Which |! of |! the |! following |! options |! would |! you |! look |! for |! when |! reviewing |!
documents |! created |! in |! the |! electronic |! medical |! record |! or |! notes |! created |! using |!
templates |! that |! may |! be |! indicators |! of |! misuse? |! - |! Correct |! answer |! ✔Complete |!
medical |! histories |! on |! each |! visit, |! diagnosis |! driven |! by |! clinical |! picture, |!
repetitious |! notes |! not |! relevant |! to |! presenting |! problem
pf3
pf4
pf5

Partial preview of the text

Download CPMA Practice Test C with accurate detailed answers and more Exams Auditing in PDF only on Docsity!

CPMA |! Practice |! Test |! C |! with |! accurate |!

detailed |! answers

When |! auditing |! operative |! notes, |! the |! auditor |! will |! expect |! to |! see |! documentation |! from |! all |! of |! the |! following |! except |! - |! Correct |! answer |! ✔Surgical |! assistants According |! to |! the |! Health |! Insurance |! Portability |! and |! Accountability |! Act |! of |! 1996 |! (HIPAA), |! an |! outside |! auditor |! must |! sign |! which |! of |! the |! following |! agreements |! prior |! to |! reviewing |! and |! auditing |! any |! medical |! records? |! - |! Correct |! answer |! ✔Business |! Associate |! Agreement The |! HIPAA |! Privacy |! Rule |! defines |! "minimum |! necessary" |! as |! typically |! requiring |! healthcare |! employees |! to |! - |! Correct |! answer |! ✔Follow |! policies |! and |! procedures |! developed |! by |! the |! covered |! entity |! which |! limit |! use |! and |! disclosure of |! PHI |! to |! that |! which |! is |! needed |! to |! accomplish |! the |! intended |! purpose |! to |! perform |! the |! duties |! of |! their |! job When |! auditing |! an |! ENT |! practice, |! you |! discover |! the |! practice |! uses |! an |! EMR. |! Which |! of |! the |! following |! options |! would |! you |! look |! for |! when |! reviewing |! documents |! created |! in |! the |! electronic |! medical |! record |! or |! notes |! created |! using |! templates |! that |! may |! be |! indicators |! of |! misuse? |! - |! Correct |! answer |! ✔Complete |! medical |! histories |! on |! each |! visit, |! diagnosis |! driven |! by |! clinical |! picture, |! repetitious |! notes |! not |! relevant |! to |! presenting |! problem

State |! law |! will |! take |! precedence |! over |! HIPAA |! under |! which |! of |! the |! following |! circumstances |! - |! Correct |! answer |! ✔If |! HIPAA |! is |! less |! restrictive |! than |! state |! law When |! providing |! a |! prescription |! for |! a |! patient, |! the |! education |! of |! the |! patient |! (including |! side |! effects |! and |! supporting documentation) |! in |! the |! medical |! record |! that |! the |! information |! was |! reviewed |! is |! based |! on |! which |! of |! the |! following |! standards? |! - |! Correct |! answer |! ✔Joint |! Commission |! standards A |! deliberate |! misrepresentation |! of |! facts |! to |! gain |! unauthorized |! benefits |! is |! the |! definition |! of |! - |! Correct |! answer |! ✔Fraud What |! is |! an |! action |! resulting |! in |! unnecessary |! costs, |! whether |! directly |! or |! indirectly, |! to |! a |! federal |! healthcare |! plan |! considered? |! - |! Correct |! answer |! ✔Abuse When |! responding |! to |! a |! subpoena |! for |! medical |! records, |! which |! of |! the |! following |! documents |! would |! likely |! NOT |! be |! required |! to |! be |! copied |! and |! submitted: |! - |! Correct |! answer |! ✔Signed |! authorization |! for |! release |! of |! information Dr. |! Black |! receives |! a |! demand |! letter |! from |! the |! OIG |! stating |! the |! sanctions |! are |! sought |! under |! CMP |! for |! claims |! submitted |! by |! Dr. |! Black. |! He |! asks |! you, |! his |! auditor, |! to |! review |! the |! letter |! and |! the |! claims |! that |! are |! under |! scrutiny. |! It |! is |! determined |! that |! Dr. |! Black |! should |! not |! agree |! with |! the |! demand |! letter. |! You |! recommend |! that |! Dr. |! Black: |! - |! Correct |! answer |! ✔Request |! a |! hearing |! before |! an |! HHS |! administrative |! court |! judge

joined |! the |! practice |! six |! months |! ago. |! This |! would |! be |! considered |! what |! type |! of |! audit? |! - |! Correct |! answer |! ✔Baseline |! audit Sandra |! Keller |! works |! for |! an |! internal |! medicine |! practice. |! As |! part |! of |! the |! practice's |! compliance |! plan, |! she |! has |! been |! given |! the |! responsibility |! to |! perform |! an |! audit |! of |! the |! top |! five |! surgeries |! performed |! by |! the |! group |! at |! Hill |! Dale |! Hospital |! in |! the |! past |! year. |! How |! will |! Ms. |! Keller |! determine |! what |! types |! of |! services |! to |! review |! for |! this |! physician |! group? |! - |! Correct |! answer |! ✔Run |! a |! utilization |! report |! of |! all |! surgeries |! performed |! by |! the |! group's |! physicians |! during |! the |! past |! year |! at |! Hill |! Dale |! Hospital. To |! identify |! patterns |! of |! undercoding |! and |! upcoding |! among |! physicians |! in |! a |! practice |! as |! compared |! to |! another |! practice |! of |! the |! same |! specialty |! would |! best |! be |! identified |! through |! which |! type |! of |! analysis? |! - |! Correct |! answer |! ✔Aggregate |! analysis The |! practice |! manager |! has |! requested |! an |! audit |! of |! all |! E/M |! services |! for |! all |! the |! providers. |! The |! practice |! manager |! has |! determined |! the: |! - |! Correct |! answer |! ✔Scope As |! an |! auditor, |! you |! identify |! that |! Dr. |! Jones |! consistently |! codes |! 99212 |! more |! than |! the |! other |! providers |! in |! his |! group |! practice. |! This |! was |! determined |! by |! reviewing |! Dr. |! Jones' |! - |! Correct |! answer |! ✔Utilization |! pattern You |! are |! preparing |! to |! perform |! a |! surgical |! chart |! audit. |! Which |! of |! the |! following |! resources |! would |! you |! need |! in |! order |! to |! accurately |! conduct |! the |! audit? |! - |! Correct |! answer |! ✔ICD-10-CM, |! CPT®, |! HCPCS |! Level |! II |! code |! books,

|! NCCI |! edits, |! medical |! terminology |! book, |! global |! days, |! surgery |! audit |! tool, |! rules |! of |! insurance |! carriers Karen |! has |! reviewed |! denials |! from |! payers. |! Out |! of |! the |! 25 |! denials |! reviewed, |! 23 |! of |! them |! were |! found |! to |! be |! denied |! in |! error |! based |! on |! NCCI |! guidelines. |! Karen |! is |! preparing |! her |! appeal |! for |! the |! erroneous |! denials. |! In |! addition |! to |! her |! appeal |! letter, |! what |! should |! she |! include |! in |! the |! appeal |! package |! - |! Correct |! answer |! ✔Original |! claim |! forms, |! copies |! of |! documentation, |! NCCI |! guidelines |! for |! the |! procedures |! reported, |! and |! copies |! of |! EOBs Under |! the |! Office |! of |! the |! Inspector |! General |! CIA, |! an |! Independent |! Review |! Organization |! (IRO) |! reports |! audit |! results |! to: |! - |! Correct |! answer |! ✔the |! compliance |! officer |! in |! the |! organization |! under |! the |! CIA Education |! and |! training |! to |! reinforce |! recommendations |! regarding |! a |! physician's |! deficiencies |! and |! problematic |! areas |! is |! best |! addressed |! through: |! - |! Correct |! answer |! ✔Direct |! follow-up |! with |! the |! physician Which |! statement |! is |! NOT |! true |! regarding |! a |! physician |! practice |! compliance |! plan? |! - |! Correct |! answer |! ✔The |! monetary |! loss |! amount |! is |! the |! overriding |! factor |! to |! consider |! when |! determining |! a |! compliance |! violation The |! OIG |! CIA |! agreement |! states |! that |! the |! IRO's |! minimum |! requirement |! to |! perform |! an |! audit |! is: |! - |! Correct |! answer |! ✔Annually