AAPC-CPPM Certified Physician Practice Manager - Set 4 - Part 2

Correct Answer: word-of-mouth

Buzz marketing, or viral marketing, is intense word-of-mouth marketing. Information passes between individuals, and it creates buzz when interactions are so intense that everyone is talking about the topic. Option a is incorrect because product publicity covers publicizing specific products or services, a public relations function that does not describe interactions spreading among individuals. Option c is incorrect because lobbying means influencing legislators and government officials on legislation and regulation, so it targets lawmakers rather than customers talking among themselves. Option d is incorrect because press relations is a public relations function that places positive, newsworthy information in the news media, which is a different activity from person-to-person buzz.

Correct Answer: Competitor's customers

Competitor's customers buy a competitor's product most or all of the time. Sales promotion goals for this group are to break loyalty and persuade them to switch, using sweepstakes, contests or premiums. Option b is incorrect because brand switchers buy a variety of products in the category, and the goal is persuading them to buy the brand more often. Option c is incorrect because loyal customers already buy the marketer's product most or all of the time, so the promotion goal is to reinforce behavior and increase consumption. Option d is incorrect because price buyers consistently choose the least expensive brand, so promotions appeal with low prices or added value that makes price less important.

Correct Answer: Outsourcing

Outsourcing means obtaining items or functions from an outside source instead of handling them internally. Payroll tasks such as recording hours, managing benefits and wage rates, and issuing paychecks are a long-standing example of work given to third-party providers. Option a is incorrect because the make-or-buy decision is the choice itself between producing inputs internally or buying them externally, not the name for the resulting arrangement with an outside provider. Option c is incorrect because resource planning specifies which materials, parts and components are needed and when, forecasting quantities and drawing up a bill of material; it does not describe handing a function to a third party. Option d is incorrect because supply chain management concerns moving goods efficiently from producers to ultimate users while minimizing inventory, so it does not describe assigning payroll to an outside firm.

Correct Answer: Supply chain management

Supply chain management helps increase the efficiency of logistics service by minimizing inventory and moving goods efficiently from producers to the ultimate users. That matches the practice manager's goal of lowering stock while keeping supplies flowing. Option a is incorrect because it is one facet of distribution, listed alongside location and hours, rather than a method for minimizing inventory and moving goods. Option b is incorrect because it names the series of marketing entities products pass through on the way to end users, not the management approach that improves logistics efficiency. Option c is incorrect because it is the last element of the marketing mix, made up of six parts such as advertising and personal selling, and does not move goods.

Correct Answer: Review for anti-kickback and self-referral compliance

OIG guidance states that physician contracts and agreements with parties in a position to influence Federal health care program business should be reviewed to avoid violating the anti-kickback statute, the self-referral law, and other relevant laws. Option a is incorrect because guidance presents that comparison as a way to improve documentation quality, so it does not test whether a referral-source arrangement violates fraud and abuse laws. Option b is incorrect because those internal guidelines cover record content such as the reason for the encounter and plan of care, and say nothing about leases with referral sources. Option d is incorrect because guidance ties code review to events like a new CEO being hired, not to evaluating an arrangement with an entity receiving referrals.

Correct Answer: The person who controls the process controls the pen

The rule of thumb "the person who controls the process controls the pen" means the person who actually carries out a step is the one who maps it. The medical assistant therefore describes the medical assistant's own steps. Option b is incorrect because a workflow map must capture what is actually happening, and the ideal process is a separate view showing what the process could be. Option c is incorrect because the guidance gives the mapping of each step to the person who carries it out, while the facilitator brings skill, time and vantage point. Option d is incorrect because the guidance warns against relying on a single person unless that person controls and executes every step of the process being mapped.

Correct Answer: Reality process

The reality process is obtained when group members validate the perceived map through direct observation. Correcting the map against what is seen at the front desk shows what the process actually is. Option a is incorrect because workflows show how work actually gets done, not the established protocols, and protocol is not among the three processes the QI team considers. Option b is incorrect because it reflects the workflow the improvement group aspires to and wants to implement, not what direct observation shows is happening now. Option c is incorrect because it is the group's initial map of what members believe is happening, which comes before the observation step that validates it.

Correct Answer: Replacement of the QI team

Redesigned workflows often require realigning jobs, staff time, roles and responsibilities, which in turn changes policies and procedures, job descriptions, training and accountability/reporting systems. Replacing the QI team is not among them; that team helps lead the redesign. Option a is incorrect because the guidance includes these systems, which ensure tasks are completed, among the items that must be adjusted after a redesign. Option c is incorrect because training is listed among the items requiring change, since staff roles and responsibilities shift under the redesigned workflow. Option d is incorrect because job descriptions are named in the guidance as a document that must change when jobs are realigned to fit the redesigned workflows.

Correct Answer: Realigning jobs and staff time allocation

New workflows often require realigning jobs and changing staff time allocation, roles and responsibilities to fit the redesign. This in turn calls for changes to policies and procedures, job descriptions, training and accountability systems. Option a is incorrect because workflows commonly overlap or depend on other activities, so practices are told to identify and consider these dependencies rather than remove them. Option b is incorrect because the QI team is described as a partner that helps redesign the workflow, and nothing in the guidance calls for replacing it. Option c is incorrect because PDSA is the method for testing changes, helping a practice find unanticipated effects and correct them before taking them to scale.

Correct Answer: Scheduling

Scheduling is the aspect of production control that specifies and controls the time required for each step in the production process. The operations manager prepares timetables showing the most efficient sequence of production. Option a is incorrect because this is a tool that maps the flow from suppliers through the factory to customers and helps identify bottlenecks; it is not itself a control aspect. Option b is incorrect because this is the process of creating quality standards, producing goods that meet them, and measuring finished goods against those standards, not timing steps. Option d is incorrect because routing is the first step of production control and sets out the work flow, the sequence of machines and operations, rather than the time each step requires.

Correct Answer: Receipt of federal financial assistance

Section 504 prohibits disability discrimination in programs or activities that receive federal financial assistance, including health programs and services. Medicare and Medicaid reimbursements can count as that assistance, so receipt of it triggers coverage. Option b is incorrect because mobility disabilities are the focus of the technical assistance guidance on the ADA, but treating such patients does not determine whether Section 504 applies. Option c is incorrect because that describes the entities covered by Title II of the ADA as programs of public entities, which is a separate basis of coverage. Option d is incorrect because that describes how private hospitals and medical offices are covered by Title III of the ADA, not the trigger for Section 504 coverage.

Correct Answer: Examination rooms

The ADA scoping advisory states that not all medical care patient rooms must be accessible, but common use and public use spaces such as recovery rooms, examination rooms, and cafeterias are not exempt and must be accessible. Option a is incorrect because scoping limits how many medical care patient rooms must be accessible, and rooms outside that number are not required to comply. Option c is incorrect because the guidance places doctors' offices outside the hospital outpatient category, since they are not located in hospitals, so that label does not fit. Option d is incorrect because the ADA guidance says structures and equipment directly associated with the actual processes of construction are not required to be accessible.

Correct Answer: Requirements for new construction

Section 202.2 states that each addition to an existing building or facility must comply with the requirements for new construction. The extra provision on primary function areas applies only when an addition affects or could affect access to such an area. Option a is incorrect because equivalent facilitation permits alternative designs, but the guidance states there is no certification process for it outside transit facilities, so no agency review applies. Option b is incorrect because the scoping requirements expressly cover additions to existing buildings, and existing facilities are left out only when they are not altered. Option d is incorrect because that standard applies to alterations where full compliance is technically infeasible, not to an addition, which is held to the full new construction requirements.

Correct Answer: Tenant and landlord both stay responsible, and the lease allocates duties between them

Title III holds any private entity that owns, leases, leases to, or operates a public accommodation responsible. Tenants and landlords are equally responsible, though the lease may allocate accessibility duties between them. Option a is incorrect because Title III reaches any private entity that owns, leases, leases to, or operates the accommodation, so the landlord shares responsibility equally with the tenant. Option b is incorrect because the ADA places responsibility on both parties; a lease can allocate duties only as between landlord and tenant, and it does not remove the tenant's duty. Option c is incorrect because that split is a common lease arrangement, not the legal rule; Title III makes tenants and landlords equally responsible whatever the lease provides.

Correct Answer: It must coincide with or be in the same area

Section 206.3 requires accessible routes to coincide with or be located in the same area as general circulation paths. Where those paths are interior, the required accessible routes must also be interior. Option a is incorrect because the standards place the accessible route in the same area as walks and other pedestrian circulation paths, not apart from them. Option b is incorrect because the advisory warns that accessible vertical interior circulation must sit in the same area as stairs and escalators, not isolated in the back. Option d is incorrect because the standards state that where circulation paths are interior, the required accessible routes shall also be interior, so an exterior route fails that.

Correct Answer: Fire retardant properties of paints or solutions must be maintained

OSHA's rules on maintenance, safeguards, and operational features for exit routes include a paragraph requiring that the fire retardant properties of paints or solutions be maintained, which is the requirement that applies to repainting an exit route. Option a is incorrect because it is the broad opening paragraph of that section, whereas a separate paragraph deals specifically with paints or solutions on the route. Option c is incorrect because it is a separate paragraph of the maintenance and safeguards section, with its own subject of lighting and marking rather than wall coatings. Option d is incorrect because it is listed under the design and construction requirements for exit routes, which concern how a route is built, not upkeep of finishes.

Correct Answer: Ceiling-mounted lifts need no added maneuvering space

When a portable patient lift or stretcher is used, additional clear floor space is needed to maneuver it. Ceiling-mounted lifts do not require that additional maneuvering clear floor space because they are mounted overhead. Option b is incorrect because this reverses the guidance, since the portable lift is the one that calls for additional clear floor space and the overhead mounting removes it. Option c is incorrect because a portable patient lift must be moved around the room, so additional clear floor space is needed to maneuver it, as with a stretcher. Option d is incorrect because only the portable lift needs extra floor space to maneuver; a ceiling-mounted lift is mounted overhead and does not add that requirement.

Correct Answer: Exit discharge

The exit discharge is the part of the exit route that leads directly outside or to a street, walkway, refuge area, public way, or open space with access to the outside. Option a is incorrect because OSHA definitions list it as a possible destination of the exit discharge, not as one of the three parts of an exit route. Option c is incorrect because it is the portion that leads to an exit, such as a corridor, and does not itself reach the outside. Option d is incorrect because the exit is the generally separated, protected way of travel, such as an enclosed stairway, which itself ends at the exit discharge.

Correct Answer: Exit access

An exit route has three parts: the exit access, the exit and the exit discharge. The exit access is the portion that leads to an exit, so a corridor leading to an enclosed stairway is an exit access. Option a is incorrect because the exit is the protected, generally separated portion such as the enclosed stairway itself, not the corridor that leads to it. Option b is incorrect because a refuge area is a place of safety that an exit route may end in, not one of the three parts of the route. Option c is incorrect because the exit discharge is the final part, such as the door at the bottom of the stairway, that leads directly outside.

Correct Answer: Recognized security practices in place for 12 months

The statute on recognition of security practices directs the Secretary to consider whether a covered entity or business associate adequately demonstrated recognized security practices in place for at least the previous 12 months, which may mitigate fines and end audits early. Option a is incorrect because that submission deadline concerns mitigating factors and affirmative defenses after a notice of a possible civil money penalty, not the audit and fine consideration here. Option b is incorrect because workforce sanctions are a Privacy Rule administrative duty of the covered entity; the statute on mitigation of fines does not list them as the factor considered. Option d is incorrect because complaints trigger investigations under the enforcement rule, but the statute names no complaint history as a factor for mitigating fines or shortening an audit.