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Here are multiple-choice questions for CPCO medical coding certification exam
What is the primary focus of the Enrollment principle in the Five-Principle strategy?
a) Ensuring timely payment to healthcare providers
b) Scrutinizing individuals and entities prior to their enrollment in healthcare programs
c) Implementing compliance programs for healthcare providers
d) Monitoring programs for evidence of fraud, waste, and abuse
According to the recommendations from the Office of Inspector General (OIG), what screening measures should be implemented for providers and suppliers applying for enrollment in Medicare or Medicaid?
a) Charging application fees only
b) Offering periodic recertification for providers and suppliers
c) Requiring providers to meet accreditation standards and proof of business integrity
d) Providing a provisional period with no enhanced oversight
What is the objective of the Payment principle in the Five-Principle strategy?
a) Assisting healthcare providers in adopting compliance practices
b) Scrutinizing individuals and entities prior to their enrollment in healthcare programs
c) Establishing payment methodologies responsive to marketplace changes
d) Vigilantly monitoring programs for evidence of fraud, waste, and abuse
According to OIG recommendations, what is imperative when considering any payment structure?
a) Identifying and addressing financial incentives and fraud risks
b) Offering incentives to maximize services provided
c) Avoiding fixed prospective payment systems
d) Providing financial incentives to minimize patient care
What is the key purpose of the Compliance principle in the Five-Principle strategy?
a) Establishing payment methodologies
b) Monitoring programs for evidence of fraud
c) Assisting healthcare providers in adopting compliance practices
d) Responding swiftly to detected fraud
According to OIG recommendations, what is an important component of a comprehensive government-industry partnership to promote program integrity?
a) Billing Medicare or Medicaid for unnecessary services
b) Adhering to compliance programs as a condition of participation
c) Avoiding payment suspension in cases of fraud
d) Increasing penalties for healthcare fraud
What is the focus of the Oversight principle in the Five-Principle strategy?
a) Assisting healthcare providers in adopting compliance practices
b) Establishing payment methodologies responsive to marketplace changes
c) Vigilantly monitoring programs for evidence of fraud, waste, and abuse
d) Responding swiftly to detected fraud
What improvements in program oversight are recommended by OIG?
a) Real-time access to data for law enforcement
b) Decreasing data collection and validation time
c) Reducing reporting of data by states and others
d) Inconsistency in data extraction methods
What is the objective of the Response principle in the Five-Principle strategy?
a) Establishing payment methodologies responsive to marketplace changes
b) Assisting healthcare providers in adopting compliance practices
c) Vigilantly monitoring programs for evidence of fraud, waste, and abuse
d) Responding swiftly to detected fraud
According to OIG recommendations, why is an explicit payment suspension authority needed in cases of suspected fraud?
a) To increase the risk of swift detection
b) To keep taxpayer dollars out of the pockets of criminals
c) To prevent Medicare dollars from flowing to criminals under investigation
d) All of the above
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CPCO Free Practice Questions for OIG’s Five-Principle Strategy to Combat Healthcare Fraud, Waste, and Abuse Medical Coding Certification Exam
Here are the multiple-choice questions with answers and rationale Medical Coding CPCO:
What is the primary focus of the Enrollment principle in the Five-Principle strategy?
Correct Answer: b) Scrutinizing individuals and entities prior to their enrollment in healthcare programs
Rationale: The Enrollment principle focuses on scrutinizing individuals and entities that want to participate as providers and suppliers before their enrollment in healthcare programs, as stated in the provided information.
According to the recommendations from the Office of Inspector General (OIG), what screening measures should be implemented for providers and suppliers applying for enrollment in Medicare or Medicaid?
Correct Answer: c) Requiring providers to meet accreditation standards and proof of business integrity
Rationale: The OIG recommendation includes heightened screening measures such as requiring providers to meet accreditation standards, providing proof of business integrity, periodic recertification, and onsite verification of conditions of participation.
What is the objective of the Payment principle in the Five-Principle strategy?
Correct Answer: c) Establishing payment methodologies responsive to marketplace changes
Rationale: The Payment principle aims to establish payment methodologies that are reasonable and responsive to changes in the marketplace, as per the provided information.
According to OIG recommendations, what is imperative when considering any payment structure?
Correct Answer: a) Identifying and addressing financial incentives and fraud risks
Rationale: According to OIG recommendations, it is imperative to identify the incentives and fraud risks associated with any payment structure and implement necessary safeguards to address them.
What is the key purpose of the Compliance principle in the Five-Principle strategy?
Correct Answer: c) Assisting healthcare providers in adopting compliance practices
Rationale: The Compliance principle aims to assist healthcare providers and suppliers in adopting practices that promote compliance with program requirements, including quality and safety standards.
According to OIG recommendations, what is an important component of a comprehensive government-industry partnership to promote program integrity?
Correct Answer: b) Adhering to compliance programs as a condition of participation
Rationale: According to OIG, providers and suppliers should be required to adopt compliance programs as a condition of participating in Medicare and Medicaid programs.
What is the focus of the Oversight principle in the Five-Principle strategy?
Correct Answer: c) Vigilantly monitoring programs for evidence of fraud, waste, and abuse
Rationale: The Oversight principle focuses on vigilantly monitoring programs for evidence of fraud, waste, and abuse, as stated in the provided information.
What improvements in program oversight are recommended by OIG?
Correct Answer: a) Real-time access to data for law enforcement
Rationale: OIG recommends improvements such as real-time access to data for law enforcement, more timely collection and validation of data, and robust reporting of data by states and others.
What is the objective of the Response principle in the Five-Principle strategy?
Correct Answer: d) Responding swiftly to detected fraud
Rationale: The Response principle aims to respond swiftly to detected fraud, impose sufficient punishment to deter others, and promptly remedy program vulnerabilities.
According to OIG recommendations, why is an explicit payment suspension authority needed in cases of suspected fraud?
Correct Answer: d) All of the above
Rationale: An explicit payment suspension authority is needed to increase the risk of swift detection, keep taxpayer dollars out of the pockets of criminals, and prevent Medicare dollars from flowing to criminals under investigation, as per OIG recommendations.
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