CPCO Compliance Officer study plan

Map the seven elements of an effective compliance program to at least two concrete artifacts (policy, training log, audit report) you could produce in a real job

Define the roles of the compliance officer, compliance committee, and governing body, and write a one-paragraph distinction between each

Build a personal glossary of 25 coding terms (CPT, HCPCS Level II, ICD-10-CM/PCS, modifiers, NCCI edits) with a one-sentence definition each

Explain how the OIG Work Plan and corporate integrity agreements shape an organization's compliance priorities, using one hypothetical example

Compare the False Claims Act, Anti-Kickback Statute, Stark Law, and Civil Monetary Penalties Law on intent standard, penalties, and who enforces them

Identify the elements of a compliance risk assessment and draft a five-row risk register for a mid-size physician group

Describe the audit process end to end: scoping, sampling, data request, fieldwork, findings, corrective action plan, and follow-up

Distinguish internal from external audits and list three triggers that prompt each

Calculate error rates and confidence intervals for a sample of 30 claims given a set of seeded errors

Design a statistically valid sample for a 12-month claims audit, stating population, sampling method, and sample size rationale

Trace a claim from encounter through charge capture, coding, claim scrub, submission, remittance, and denial, noting where each control sits

Interpret an EOB and a remittance advice, and classify five denial reasons by root cause (coding, eligibility, authorization, medical necessity, timely filing)

Apply ICD-10-CM conventions (laterality, combination codes, sequela, unspecified codes) to 20 coding scenarios and justify each choice

Assign correct CPT and HCPCS Level II codes, including modifiers for bilateral, multiple procedures, and distinct services, to 15 operative or procedure notes

Explain the difference between coding for reimbursement and coding for quality reporting, and identify one place where they diverge

Reconcile a charge master entry against a code set to find at least three common mismatches

Draft a compliance training plan that names audience, frequency, content, and method of documenting completion

Build a corrective action plan for a seeded audit finding, including root cause, interim controls, owner, and target date

Describe how to handle a detected overpayment, including identification, quantification, reporting timeline, and refund process

Outline an investigation protocol for a reported compliance concern, from intake through resolution and non-retaliation safeguards

Perform a focused chart audit of 15 records against documentation guidelines, scoring each element and writing a finding for every miss

Identify documentation gaps that create coding risk (unsupported diagnosis, missing specificity, cloned notes) and rank them by financial exposure

Explain the purpose and structure of an internal coding audit, including how to give feedback to a coder without creating a punitive culture

Apply NCCI edits and modifier rules to five claim pairs and decide which should be bundled

Explain the components of the Medicare Physician Fee Schedule, including relative value units, geographic adjustment, and the conversion factor

Distinguish prospective payment, fee-for-service, and value-based reimbursement models and state one compliance risk unique to each

Describe the requirements for a compliant billing arrangement, including written agreement, fair market value, and commercially reasonable terms

Identify three billing practices that commonly draw enforcement attention and explain the compliance control that prevents each

Complete a full-length timed practice exam under test conditions and record your score by domain

Review every missed question and write the underlying rule or concept in your own words

Re-drill your three weakest subtopics until you can explain each without notes

Assemble a one-page pre-exam reference sheet of formulas, statutes, and code conventions you tend to forget