CPMA Medical Auditor study plan

Map the seven elements of a compliance program to a fictitious multi-site practice, writing one concrete control per element

Distinguish false-claims exposure, anti-kickback, Stark, and civil-monetary-penalty risk in 15 short scenarios

Identify the required components of a medical record (authentication, timeliness, legibility, amendments) and flag deficiencies in 10 sample chart excerpts you write yourself

Define the auditor's independence and confidentiality obligations, and list five situations requiring escalation to compliance

Apply E/M leveling rules (history, exam, and medical decision making) to 20 self-authored encounter vignettes

Select correct CPT and ICD-10-CM codes for surgical, radiology, laboratory, and medicine section services in 25 short case stems

Justify the use of modifiers 25, 26, 59, and 59-alternatives in 10 operative-note summaries

Link every assigned diagnosis code to documented medical necessity and document the linkage

Design a coding-review worksheet that captures encounter date, provider, codes billed, codes supported, error category, and financial impact

Draft a written audit plan stating scope, objectives, sampling method, sample size rationale, timeline, and reporting lines

Differentiate prospective, retrospective, internal, and external audits and select the right type for three stated business problems

Construct a random and a targeted sample from a self-built 200-encounter data set and defend the choice

Execute the audit plan by reviewing 20 self-authored encounters and scoring each against the worksheet

Calculate error rate, coding accuracy rate, and financial impact, and compare results to a stated benchmark

Perform root-cause analysis on the five highest-frequency error types and assign each a corrective action

Document audit workpapers so a second auditor could reproduce your results

Trace a claim from encounter documentation through charge capture, coding, claim scrub, and payment, labeling each handoff and failure point

Apply NCCI edit and modifier rules to resolve 15 bundling and unbundling scenarios

Classify 15 denial scenarios by root cause (eligibility, authorization, coding, medical necessity, timely filing) and prescribe a prevention step for each

Explain the revenue-cycle impact of documentation improvement and compute the effect of a 2% coding error rate on a stated annual claim volume

Write audit findings in plain language that separates observation, criteria, cause, effect, and recommendation

Draft a corrective action plan with owners, deadlines, and measurable success indicators

Build a one-page audit dashboard showing error rate by provider, error category trend, and dollars at risk

Select the correct distribution list and reporting channel for three scenarios involving provider-specific and executive-level findings

Deliver a 10-minute findings presentation and script answers to five likely pushback questions from a defensive provider

Adapt the same findings into three formats: executive brief, provider letter, and compliance committee memo

Design a follow-up audit schedule that verifies corrective action effectiveness at 30, 60, and 90 days

Review your week 2-6 workpapers and rewrite the three weakest rationales for clarity and defensibility

Complete two full-length timed practice exams under test-day conditions and score each by domain

Convert every missed question into an error-log entry citing the rule or concept missed and the corrected reasoning

Re-drill the three lowest-scoring domain subtopics until each reaches 85% on a fresh set of questions

Consolidate all eight weeks of deliverables into one indexed study binder for final review