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Manager CPPM Ultimate Exam
Question 1. Which provider type is authorized to prescribe Schedule II controlled substances in most states? A) Nurse Practitioner B) Physician Assistant C) Medical Doctor D) Licensed Practical Nurse Answer: C Explanation: MDs have full prescriptive authority for Schedule II drugs, whereas NPs and PAs may have limited authority depending on state law. Question 2. In the patient-visit workflow, what is the primary purpose of the “clinical intake” step? A) Verify insurance eligibility B) Collect chief complaint and history C) Schedule follow-up appointments D) Process payment Answer: B Explanation: Clinical intake gathers the patient’s symptoms and medical history to guide the encounter. Question 3. Which communication technique is most effective for de-escalating a conflict with a staff member? A) Ignoring the issue B) Using “you-statements” C) Active listening and summarizing D) Raising your voice Answer: C Explanation: Active listening shows respect and clarifies concerns, reducing tension. Question 4. A bottleneck in a practice’s checkout process is most likely caused by:
Manager CPPM Ultimate Exam
A) Excessive exam room size B) Slow insurance verification C) Delayed claim submission D) Long patient wait times before the visit Answer: C Explanation: Delays in submitting claims postpone revenue, creating a checkout bottleneck. Question 5. The HITECH Act primarily incentivized providers to: A) Reduce staff numbers B) Adopt electronic health records (EHR) C) Increase patient co-pays D) Expand physical office space Answer: B Explanation: HITECH provided financial incentives for meaningful EHR use. Question 6. Under the ACA, which of the following is a “shared savings” mechanism? A) Fee-for-service reimbursement B) Capitation payment C) Accountable Care Organization (ACO) model D) Out-of-pocket maximum Answer: C Explanation: ACOs share savings when they meet quality and cost targets. Question 7. The Anti-Kickback Statute prohibits: A. Billing for services not rendered B. Offering anything of value to induce referrals C. Submitting false claims to Medicare
Manager CPPM Ultimate Exam
Question 11. In a balance sheet, “accounts payable” is classified as: A) Asset B) Liability C) Equity D) Revenue Answer: B Explanation: Accounts payable represent amounts owed to vendors. Question 12. Which accounting method records revenue when cash is actually received? A) Accrual B) Cash basis C) Modified accrual D) Hybrid Answer: B Explanation: Cash basis accounting recognizes revenue upon receipt of cash. Question 13. The primary purpose of a chart of accounts in a physician’s office is to: A) List patient diagnoses B) Organize financial transactions by category C) Schedule staff shifts D) Track inventory of medical supplies Answer: B Explanation: It provides a systematic structure for recording financial data. Question 14. Under a fee-for-service model, a practice’s revenue is most directly tied to: A) Number of patients seen
Manager CPPM Ultimate Exam
B) Population health outcomes C) Fixed monthly payments D) Global capitation rates Answer: A Explanation: Each service rendered generates a separate payment. Question 15. Which CPT coding component determines the level of E/M service? A) Number of diagnoses coded B) Time spent with the patient and complexity C) Length of the operative report D) Type of anesthesia used Answer: B Explanation: E/M levels are based on history, exam, medical decision-making, and time. Question 16. The “front-end” of the revenue cycle includes: A) Claim denial analysis B) Payment posting C) Eligibility verification and pre-authorization D) Bad-debt write-off Answer: C Explanation: Front-end activities ensure patients are covered before services. Question 17. A common cause of claim denial for a new patient visit is: A) Use of outdated CPT codes B) Missing primary diagnosis code C) Submitting the claim after the 90-day limit D) Billing under a capitation contract Answer: B
Manager CPPM Ultimate Exam
A) A physician shares PHI with a third-party service provider B) Two physicians collaborate on research C) A patient signs a consent form D) The practice purchases office furniture Answer: A Explanation: BAAs govern how a business associate handles protected health information. Question 22. Meaningful Use Stage 2 primarily emphasized: A) Paper charting reduction B) Patient portal usage and e-prescribing C) Telehealth reimbursement D) Clinical decision support for imaging Answer: B Explanation: Stage 2 added criteria for patient engagement and e-prescribing. Question 23. Which of the following best describes a Health Information Exchange (HIE)? A) A shared EHR platform owned by a single hospital B) A network that enables secure sharing of patient data across organizations C) A patient-controlled health record app D) A billing software integration tool Answer: B Explanation: HIEs facilitate interoperable data exchange among disparate entities. Question 24. In disaster recovery planning, “RTO” stands for: A) Recovery Time Objective B) Remote Telehealth Operations C) Regulatory Treatment Order
Manager CPPM Ultimate Exam
D) Risk Tolerance Overview Answer: A Explanation: RTO defines the target time to restore services after disruption. Question 25. Which of the following is a key element of EMTALA compliance? A) Providing a free flu shot to every patient B) Stabilizing emergency patients regardless of ability to pay C) Requiring prior authorization for all ED visits D) Limiting ED capacity to 20 patients per shift Answer: B Explanation: EMTALA mandates emergency stabilization irrespective of payment. Question 26. A practice that uses “lean” methodology to improve workflow is primarily trying to: A) Increase staff salaries B) Eliminate waste and improve efficiency C) Expand office square footage D) Reduce patient satisfaction scores Answer: B Explanation: Lean focuses on waste reduction and process optimization. Question 27. The Stark Law prohibits: A) Billing for services not rendered B) Referring patients to an entity with which the physician has a financial relationship, unless an exception applies C) Accepting gifts from pharmaceutical companies D) Providing free health screenings Answer: B Explanation: Stark restricts self-referral for designated health services.
Manager CPPM Ultimate Exam
A) Ignore the report to avoid disruption B) Conduct a confidential investigation and document findings C) Immediately fire the staff member D) Publicly discuss the issue with the whole team Answer: B Explanation: Confidential investigations protect the reporter and ensure proper handling. Question 32. In an office budget, the line item “cost of goods sold (COGS)” most likely includes: A) Salary of physicians B) Rent and utilities C) Medical supplies used in patient care D) Marketing expenses Answer: C Explanation: COGS reflects direct costs of delivering clinical services. Question 33. Which of the following best defines “interoperability” in health IT? A) The ability of a single EHR to function without internet B) Seamless exchange and use of health information across different systems C) Encryption of data at rest D) Use of paper records alongside electronic ones Answer: B Explanation: Interoperability enables data sharing among disparate platforms. Question 34. A “no-show” patient most directly impacts which revenue-cycle metric? A) Days in Accounts Receivable (DAR) B) Net collection rate C) Denial rate
Manager CPPM Ultimate Exam
D) Charge capture Answer: B Explanation: No-shows reduce expected revenue, lowering the net collection rate. Question 35. Which OSHA standard is most relevant to a physician’s office? A) Hazard Communication (HAZCOM) B) Bloodborne Pathogen Standard (29 CFR 1910.1030) C) Confined Space Entry D) Respiratory Protection for mining Answer: B Explanation: OSHA’s Bloodborne Pathogen Standard applies to healthcare settings. Question 36. When negotiating a vendor contract for EHR software, which clause protects the practice from unexpected price hikes? A) Termination for convenience B) Fixed-price escalation clause C) Indemnification provision D) Confidentiality agreement Answer: B Explanation: An escalation clause caps or defines permissible price increases. Question 37. Telemedicine encounters must comply with which of the following to be reimbursable under most payer policies? A) In-person follow-up within 24 hours B) Use of a non-secure video platform C) Documented patient consent and location at time of service D) Billing under inpatient codes only Answer: C Explanation: Consent and location documentation are required for telehealth billing.
Manager CPPM Ultimate Exam
Question 41. Which of the following is an example of a “hard” cost in practice budgeting? A) Staff morale B) Physician reputation C) Lease payments for office space D) Patient satisfaction scores Answer: C Explanation: Hard costs are tangible, fixed expenses like rent. Question 42. A “global period” in CPT coding refers to: A) The time frame during which postoperative services are included in the original procedure payment B) The calendar year for claim submission C) The number of patients seen per day D) The duration of a patient’s insurance eligibility Answer: A Explanation: Global periods bundle related postoperative care with the primary service. Question 43. Which of the following best describes “value-based purchasing” (VBP) in Medicare? A) Paying providers solely based on volume of services B) Adjusting payments based on quality and cost performance metrics C) Offering unlimited services for a flat fee D) Reimbursing only for inpatient stays Answer: B Explanation: VBP ties reimbursement to quality outcomes and cost efficiency. Question 44. The “clean-room” concept in a laboratory setting is primarily intended to:
Manager CPPM Ultimate Exam
A) Reduce patient wait times B) Prevent contamination of specimens and ensure accurate test results C) Increase staff comfort D) Store office supplies Answer: B Explanation: Clean rooms maintain sterility for reliable laboratory testing. Question 45. Which of the following is a key indicator of efficient accounts receivable management? A) High number of unpaid invoices over 90 days B) Low days sales outstanding (DSO) C) Frequent claim denials for missing modifiers D) Large inventory of medical equipment Answer: B Explanation: Low DSO indicates rapid collection of receivables. Question 46. When a practice hires a new medical assistant, the most important step to ensure compliance with labor laws is to: A) Offer a higher salary than market average B) Complete Form I-9 and verify eligibility to work in the U.S. C) Provide a company car D) Require a personal loan for training costs Answer: B Explanation: Form I-9 verification satisfies federal employment eligibility requirements. Question 47. In a “bundled payment” arrangement, the provider is reimbursed: A) Separately for each individual service rendered B) A single, predetermined amount for all services related to an episode of care C) Only after patient satisfaction surveys are completed
Manager CPPM Ultimate Exam
Question 51. Which of the following is a permissible “gift” under the OIG safe-harbor for a physician? A) $150 cash payment for a referral B) Free meals provided at a federally-sponsored educational event with a reasonable value C) Direct discounts on services for a specific patient D) A personal vacation paid by a pharma company Answer: B Explanation: The OIG safe-harbor allows modest meals at bona-fide educational events. Question 52. The primary purpose of a “utilization review” is to: A) Increase marketing spend B) Assess the appropriateness and efficiency of health services provided C) Train new medical assistants D) Expand office parking spaces Answer: B Explanation: Utilization review evaluates whether care is necessary and efficient. Question 53. Which of the following best describes “patient-centered medical home” (PCMH)? A) A large hospital network B) A primary-care model emphasizing comprehensive, coordinated, accessible care C) A telemedicine-only practice D) An urgent-care walk-in clinic Answer: B Explanation: PCMH focuses on coordinated, continuous primary care.
Manager CPPM Ultimate Exam
Question 54. When performing a “charge capture” audit, the reviewer is looking for: A) Missed or incorrectly coded services that were provided but not billed B) Employee satisfaction scores C) Length of time patients spend in the waiting room D) Number of parking spaces available Answer: A Explanation: Charge capture ensures all billable services are recorded. Question 55. Under the HIPAA Security Rule, which safeguard is considered “administrative”? A) Encryption of data at rest B) Facility access controls C) Workforce training on security policies D) Use of firewalls Answer: C Explanation: Administrative safeguards include policies, procedures, and training. Question 56. Which of the following best defines “patient satisfaction” as a quality metric? A) Number of procedures performed per day B) Percentage of patients rating their experience as “excellent” or “very good” C) Total revenue generated per month D) Average length of physician’s workday Answer: B Explanation: Satisfaction surveys capture patients’ perceived quality of care. Question 57. A “closed-loop” medication reconciliation process ensures that: A) All prescribed drugs are entered into the EHR and verified at each transition of care
Manager CPPM Ultimate Exam
D) Use of outdated CPT codes Answer: C Explanation: Payments or benefits tied to referrals violate the statute. Question 61. Which of the following best describes “risk adjustment” in value-based contracts? A) Increasing premiums for all patients B) Modifying payments based on patient health status and comorbidities C) Ignoring patient demographics in payment calculations D) Standardizing fees across all services Answer: B Explanation: Risk adjustment accounts for the relative health risk of patient populations. Question 62. A practice’s “net revenue” is calculated by: Gross charges minus contractual allowances, discounts, and adjustments Answer: Net revenue = Gross charges – contractual allowances – discounts – adjustments Explanation: Net revenue reflects the amount actually expected to be collected. Question 63. Which of the following is an example of “non-clinical staff turnover” that can affect practice operations? A) A physician leaving for retirement B) A medical assistant resigning after 2 years C) A radiology technician moving to another hospital D) A patient switching to a different provider Answer: B Explanation: Non-clinical turnover includes administrative or support staff leaving.
Manager CPPM Ultimate Exam
Question 64. In the ACA, “essential health benefits” do NOT include which of the following? A) Emergency services B) Dental care for adults C) Prescription drugs D) Mental health services Answer: B Explanation: Adult dental coverage is not a mandated essential health benefit. Question 65. The “Office of the Inspector General” (OIG) primarily conducts: A) Clinical trials B) Audits and investigations of fraud, waste, and abuse in federal health programs C) Licensing of physicians D) Development of medical devices Answer: B Explanation: OIG enforces compliance and investigates fraud in Medicare/Medicaid. Question 66. Which of the following best characterizes a “physician-owned distributorship” (POD) under Stark Law? A) A pharmacy wholly owned by a physician that dispenses drugs to his/her patients B) A medical equipment vendor unrelated to the physician C) A laboratory that provides tests to external physicians only D) A software company selling EHR licenses Answer: A Explanation: PODs are a Stark exception if certain conditions are met. Question 67. A “point-of-service” (POS) collection strategy aims to: A) Delay payment until after insurance processing B) Collect patient responsibility at the time of care to improve cash flow
