Free CMOM Practice Questions

Question 1

Since a practice changed its registration software, a clearinghouse has returned 38 claims with an invalid-subscriber-ID message. None reached the payer for adjudication. Eligibility checks confirm active coverage, and comparison with the insurance cards shows that the claim export dropped a leading zero from each subscriber ID. How should the billing team resolve this batch?

Accepted Answer

Correct the export error and resubmit the rejected claims as initial submissions.

Answer

Appeal the returned claims using the eligibility responses as evidence.

Answer

Submit replacement claims referencing the clearinghouse's original submission numbers.

Answer

Wait for payer remittance notices, then correct the listed denial reasons.

Question 2

The afternoon waiting-room queue grows while two examination rooms remain empty and the physician repeatedly waits for the next patient. Registration is complete before each delay. The rooming assistant is also returning refill-status calls that clinical staff have screened as nonurgent and that can safely wait until later. Keeping staffing, visit volume, and clinic hours unchanged, which adjustment addresses the constraint?

Accepted Answer

Protect uninterrupted rooming time and return routine calls during a separate work period.

Answer

Ask patients to arrive earlier so registration finishes before the rooming assistant needs them.

Answer

Lengthen each appointment slot to allow more time between the physician's visits.

Answer

Double-book selected slots so another patient is available whenever the physician becomes idle.

Question 3

Payroll shows 43 hours worked and 5 hours of paid vacation for a nonexempt referral coordinator in one workweek. The regular hourly rate is $24, and vacation is paid at that rate. Three of the worked hours lacked advance approval, although the supervisor knew the work was being performed. No other compensation or additional state-law premium applies. What gross pay is owed for the week?

Accepted Answer

$1,188

Answer

$1,080

Answer

$1,152

Answer

$1,248

Question 4

The records clerk refuses a treating cardiologist's request for an adult patient's medication list and recent cardiac test reports because no authorization is on file. The requester and treatment relationship are verified, and no additional disclosure restriction applies. The manager explains that:

Accepted Answer

HIPAA permits this treatment disclosure without authorization, using appropriate safeguards.

Answer

HIPAA requires a separate authorization whenever records go to an unrelated practice.

Answer

Only practices sharing an electronic health record may exchange records without authorization.

Answer

The cardiologist needs a business associate agreement before treatment records can be shared.

Question 5

A payer pays a fixed amount per enrolled member each month for all primary care visits; specialist care is carved out. Enrollment and payment rates are unchanged, but primary care visits and the practice's staffing and supply costs rise. There is no visit-based supplement. Which statement correctly assigns the financial risk?

Accepted Answer

Capitation revenue stays constant while costs for the included services increase.

Answer

The payer must reimburse the added primary care costs at contract reconciliation.

Answer

Payments for extra visit claims supplement the fixed monthly capitation amount.

Answer

Specialist charges become the practice's responsibility as primary care utilization increases.

Question 6

For a fully resolved billing cohort, charges total $240,000, contractual adjustments total $80,000, and net cash collections total $144,000. The remaining $16,000 was written off after preventable timely-filing denials. The billing report shows a 100% adjusted collection rate because both contractual adjustments and denial write-offs were subtracted from charges. What percentage of the contractually collectible revenue was actually collected?

Accepted Answer

90.0%

Answer

60.0%

Answer

66.7%

Answer

100.0%

Question 7

At a staff meeting, a scheduler says referral follow-up belongs to the medical assistant once an appointment is booked. The assistant says the scheduler remains responsible until the specialist's report arrives. Both meet their individual productivity targets, but reports are repeatedly missing when patients return. The manager finds that neither job description assigns follow-up ownership. Which intervention addresses the source of the conflict?

Accepted Answer

Define each referral stage's owner and the criteria for transferring responsibility.

Answer

Coach both employees to communicate more frequently when referrals remain open.

Answer

Add overdue-referral counts to both employees' monthly performance evaluations.

Answer

Require both employees to initial a weekly report listing all outstanding referral requests.

Question 8

While clearing a procedure tray, an employee sustains a puncture from a used needle. The employee washes the site and immediately reports the incident. The source patient's infection status is unknown. The employee has completed hepatitis B vaccination and suggests waiting until tomorrow for assessment. Which response meets the employer's immediate obligation?

Accepted Answer

Make confidential post-exposure evaluation and follow-up immediately available at no cost to the employee.

Answer

Obtain the source patient's test results before authorizing an evaluation of the exposed employee.

Answer

Arrange a next-day appointment with the employee's personal physician and use the employee's health insurance.

Answer

Complete workers' compensation authorization before releasing the employee to obtain a medical evaluation.

Question 9

A physician's claims-made policy ends June 30. The replacement policy begins July 1 and excludes all earlier acts. What would protect against a claim first reported in August for care provided during the old policy's covered period?

Accepted Answer

An extended reporting endorsement on the expiring claims-made policy.

Answer

A higher per-claim liability limit on the physician's new policy.

Answer

A reduced deductible for claims reported under the physician's new policy.

Answer

An occurrence policy that covers only care provided beginning July 1.

Question 10

At a routine visit, a 68-year-old patient reports retiring last month. The patient already had Medicare Parts A and B while working and has now elected COBRA continuation under the same employer plan. The former employer has 120 employees. There is no end-stage renal disease or other payer-order exception. How should the next covered office claim be coordinated?

Accepted Answer

Bill Medicare first, then seek any secondary benefits available from the COBRA plan.

Answer

Keep COBRA primary until its continuation coverage ends.

Answer

Keep the employer plan primary because the former employer still has at least 20 employees.

Answer

Follow the patient's insurance-card order when selecting the primary payer.

Free CMOM Practice Questions

Domain 1: Practice Management 21% of exam

Question 1

Question 2

Domain 2: Personnel Management 21% of exam

Question 3

Question 4

Domain 3: Financial 20% of exam

Question 5

Question 6

Domain 4: Compliance 20% of exam

Question 7

Question 8

Domain 5: Managed Care 18% of exam

Question 9

Question 10

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