AAPC-CPPM Certified Physician Practice Manager - Set 2 - Part 1

Correct Answer: Conducting the action

If the Government elects not to proceed, the statute gives the person who initiated the action the right to conduct the action. The court may still permit the Government to intervene later for good cause. Option b is incorrect because choosing an alternate remedy, such as an administrative civil money penalty proceeding, is an election the statute gives to the Government, not to the relator. Option c is incorrect because the Government, not the person who initiated the action, may obtain a stay of discovery, and only after an in camera showing of interference. Option d is incorrect because later intervention is something the court may permit the Government to do on a showing of good cause, so it is not a relator right.

Correct Answer: Concealing an event affecting the right to payment

The statute covers a person who knows of an event affecting an initial or continued right to a benefit or payment and conceals or fails to disclose it, intending fraudulently to secure a greater amount or an unauthorized payment. Option a is incorrect because this offense concerns presenting a claim for a physician's service when the person who furnished it was known not to be licensed as a physician. Option b is incorrect because conversion applies to someone who applied for a benefit for another person's use, received it, and knowingly and willfully diverted it to a different use. Option c is incorrect because this offense involves knowingly and willfully assisting, for a fee, with disposing of assets so the individual qualifies for medical assistance under a State plan.

Correct Answer: Compliance officer

Under Element 3, training and education, the compliance officer develops an annual training plan that lists the topics to be delivered and the target audience for each topic, with support from the Compliance Committee. Option b is incorrect because board members are among those who receive training and who exercise oversight, so the guidance does not assign them the drafting of the plan. Option c is incorrect because human resources is named as a function that helps decide on consequences for noncompliance under Element 5, not as the developer of training plans. Option d is incorrect because the CEO's described role is to demonstrate commitment, for example through a signed introduction in the code of conduct, not to build the training plan.

Correct Answer: The exposure determination

The Bloodborne Pathogens standard requires the written Exposure Control Plan to contain at least the exposure determination, the schedule and method of implementation for the listed paragraphs, and the procedure for evaluating exposure incidents. Option a is incorrect because naming employees who maintain equipment to control ignition sources belongs to the fire prevention plan, not to the plan that addresses bloodborne pathogen exposure. Option b is incorrect because that review duty is stated for the emergency action plan, while the Exposure Control Plan rules call for access to a copy and annual updating. Option d is incorrect because that list is a minimum element of a fire prevention plan, a separate written plan, and the Exposure Control Plan has no such requirement.

Correct Answer: Report the withdrawal despite lack of awareness

A voluntary withdrawal of a renewal application while under investigation for possible professional incompetence must be reported to the NPDB. The practitioner's awareness of the investigation is not a requirement for filing the report. Option a is incorrect because withdrawal of a renewal application while under investigation falls within the reportable events; only withdrawal of an initial application before a final action generally goes unreported. Option b is incorrect because the reporting duty arises from the withdrawal itself while under investigation, so no final professional review action has to be completed before the report is filed. Option c is incorrect because the guidance states that a practitioner's awareness of an investigation is not a requirement for filing a report with the NPDB.

Correct Answer: QAPI

QAPI is the merger of Quality Assurance and Performance Improvement. It is a data-driven, proactive approach whose activities involve members at all levels of the organization. Option a is incorrect because a PIP is a concentrated effort on one particular problem, in one area or facility wide, not a merger of two approaches. Option b is incorrect because PI is the other half of the merger; alone it studies processes proactively, but it does not combine two approaches. Option d is incorrect because it is only one of the two merged approaches, and it is a reactive, retrospective effort that examines why standards were missed.

Correct Answer: Six Sigma DMAIC

Six Sigma focuses on measuring defects and systematically eliminating them. Its key process, DMAIC, stands for Define, Measure, Analyze, Improve and Control, and involves employees at all levels in the work. Option a is incorrect because TQM stresses company-wide quality principles and continuous improvement, but its description does not include the Define, Measure, Analyze, Improve, Control sequence aimed at near-zero defects. Option c is incorrect because QA is a reactive, retrospective effort to meet quality standards and often ends once the standard is met, not a defect-elimination cycle. Option d is incorrect because a PIP is a concentrated effort on one particular problem that gathers information systematically and intervenes, without a defined five-phase defect-measurement process.

Correct Answer: Governance and Leadership

Governance and Leadership assigns the governing body the duty to assure adequate resources for QAPI. That includes designating accountable persons, providing training, and ensuring staff time and equipment, while also building a culture of input. Option a is incorrect because it addresses when in-depth analysis is needed and whether the way care is organized or delivered causes problems, which is an analytic task. Option b is incorrect because it concerns monitoring systems that draw on multiple data sources, Performance Indicators, benchmarks, and Adverse Event tracking rather than allocating staff time or training. Option d is incorrect because it requires a program that is ongoing and comprehensive, covering all services and systems and using the best available evidence, not resource assignment.

Correct Answer: Target

QAPI guidance says the team should set targets for performance in each area it monitors, and defines a target as a goal, usually stated as a percentage. Examples include reducing an event by a set percent. Option a is incorrect because a data strategy settles what data to monitor routinely and how to organize it systematically; it does not set the goal itself. Option c is incorrect because the guidance uses a data-use plan to decide who reviews certain data, how often, and the next steps, not to state a performance goal. Option d is incorrect because that wording is how the guidance defines a benchmark, a reference point used to compare performance, which differs from a goal set for each monitored area.

Correct Answer: High risk, high volume, problem-prone areas

After gaps and opportunities are identified, QAPI guidance states that PIPs are expected to be chosen to deal with high risk, high volume, problem-prone areas related to quality of care or quality of life. Option a is incorrect because turnover is one data source reviewed for gaps and patterns, not the stated standard for choosing PIP topics. Option b is incorrect because quick wins are a reasonable way to begin some PIPs, but the guidance does not make ease of solution the expected selection basis. Option c is incorrect because strong performance deserves recognition and celebration, yet it is not what PIPs are expected to target; they address risk, volume and problem-prone areas.

Correct Answer: I, II, and III

Chartering a PIP team means a specific written mission, members positioned to explore the problem, and interval reports to the Steering Committee. Statement IV is wrong because identified problems need attention but do not all require PIPs. Option a is incorrect because leaves out the reporting expectation, which the guidance also ties to chartering, since a chartered team has been entrusted with a mission and reports back at intervals. Option c is incorrect because relies on statement IV, which fails because identified problems all need attention but do not all require PIPs, and it drops the written mission. Option d is incorrect because includes statement IV, which is contradicted by the guidance, and omits the requirement that team members be positioned to explore the problem.

Correct Answer: I and III

RCA is a systematic process that digs deeper, looking for the reasons behind the reasons, and it generally identifies more than one root cause. It examines systems and processes rather than individuals. Option b is incorrect because RCA focuses primarily on systems and processes, not individual performance, so statement II is inaccurate even though statement I is accurate. Option c is incorrect because both statements contradict the guidance: RCA targets systems, and the seemingly obvious reason for an event may not be the real reason. Option d is incorrect because statement III is accurate, but statement IV reverses the purpose of RCA, which is to dig past the most immediate explanation.

Correct Answer: A fail-safe mechanism

The redesign reflection questions ask what happens if the process breaks down and whether the team needs a fail-safe mechanism. This prompt guards against failure, unlike the questions about sequencing, outsourcing or exemplars. Option a is incorrect because doing steps at the same time concerns how the process is sequenced and its efficiency, and does not provide a backup when the process fails. Option b is incorrect because outsourcing is raised only as a question about whether a step could be done externally, which addresses who performs the work, not breakdown. Option d is incorrect because an exemplar is a person who handles the task very well, and studying that workflow is a separate prompt, not a safeguard against breakdown.

Correct Answer: Collecting, recording, classifying, summarizing, reporting, and analyzing

Accounting is defined as the process of collecting, recording, classifying, summarizing, reporting, and analyzing financial activities. The process results in reports that describe the financial condition of an organization. Option a is incorrect because the definition of accounting includes recording and analyzing, so dropping them for budgeting and forecasting produces a list that does not match it. Option c is incorrect because this list looks close, yet it has no collecting step, which the definition places first among the activities of accounting. Option d is incorrect because auditing and forecasting appear nowhere in the definition of accounting, which names classifying and reporting in those two positions instead.

Correct Answer: Department managers

Department managers work inside the organization and use internal reports from managerial accounting. External reports from financial accounting are used primarily by outsiders such as lenders, suppliers, investors and government agencies. Option a is incorrect because investors are included in the guidance among the outsiders who use these reports, so they are genuine users of external reporting. Option b is incorrect because suppliers are listed as outside parties with an interest in the business who rely on external reports to judge financial strength. Option c is incorrect because lenders are named among the outsiders who use external financial reports to assess the financial strength of a business.

Correct Answer: Obtain IRS approval

Once an accounting method is set up, the taxpayer must generally get IRS approval before changing to another method. This applies to an overall system change and to a change in the treatment of any material item. Option a is incorrect because payers have no role in approving an accounting method; the guidance gives that approval step to the IRS. Option b is incorrect because nothing in the guidance calls for separate returns; a taxpayer figures taxable income under one method that must match the books. Option d is incorrect because the guidance ties a change of method to prior approval, not to an audit; an audit is not a step that permits a switch.

Correct Answer: Cash-method income requires cash-method expenses

Under the hybrid method restrictions, a taxpayer who uses the cash method for reporting income must also use the cash method for reporting expenses, so cash income with accrual expenses is not permitted. Option b is incorrect because the guidance permits combinations only if they clearly reflect income and are used consistently, and it lists specific restrictions that apply to mixed methods. Option c is incorrect because the guidance links expenses to the income method, and an accrual method for expenses is tied to accrual income, not imposed on every taxpayer. Option d is incorrect because separate and distinct books and records matter when a taxpayer runs two or more businesses with different methods, not for mixing methods inside one business.

Correct Answer: Journal

A journal is the book in which each business transaction shown on the supporting documents is recorded, and separate journals may be kept for transactions that occur frequently. Ledgers then receive the journal totals. Option a is incorrect because it documents a small payment from the petty cash fund and is attached to a receipt as proof, not kept as a book. Option b is incorrect because it holds the totals from all of the journals, organized into accounts, rather than receiving each individual transaction from the supporting documents. Option d is incorrect because it summarizes the ledger totals for each account to confirm accuracy, and it is not where individual transactions are first recorded.

Correct Answer: Ledger

A ledger is a book that contains the totals from all of the journals and is organized into different accounts. Journal entries are posted to it, and it shows increases and decreases in specific accounts. Option a is incorrect because a trial balance summarizes the ledger totals for each account to confirm accuracy; it is not the book that holds the journal totals. Option b is incorrect because a petty cash slip is attached to a receipt as proof of a small payment from the petty cash fund. Option c is incorrect because an income statement is a profit or loss report on which the single-entry system is based, not a book organized into accounts.

Correct Answer: Trial balance

In the accounting cycle, ledger totals for each account are summarized in a trial balance, which is used to confirm the accuracy of the figures before financial statements and management reports are prepared. Option b is incorrect because a journal lists financial transactions in chronological order; it is the step before ledgers and does not summarize account totals. Option c is incorrect because this first step reviews documents for completeness before anything is recorded, so no ledger totals exist yet to summarize. Option d is incorrect because statements are prepared from the values the trial balance confirms, so they use the verified figures rather than checking them.