CPOA Professional Issues 3 — Questions and Answers
Question 1: A patient becomes angry about their bill and raises their voice in the reception area. The CPOA should:
- Ask them to leave the practice immediately
- Match their tone to show assertiveness
- Invite them to a private area and listen calmly to their concern (Correct answer)
- Ignore the patient until they calm down on their own
Correct answer: Invite them to a private area and listen calmly to their concern
Moving the patient to a private space and listening calmly de-escalates the situation while protecting other patients' comfort and privacy.
Question 2: Which document outlines the conditions under which a practice may use or disclose a patient's protected health information?
- Assignment of Benefits form
- Notice of Privacy Practices (NPP) (Correct answer)
- Superbill
- Release of Liability waiver
Correct answer: Notice of Privacy Practices (NPP)
The Notice of Privacy Practices (NPP) is a HIPAA-required document explaining how a covered entity handles PHI.
Question 3: In optometric practice, informed consent means the patient has been told:
- Only the cost of the procedure
- The diagnosis, treatment options, risks, and benefits before agreeing to care (Correct answer)
- That the optometrist's recommendation is final
- Which insurance plans the office accepts
Correct answer: The diagnosis, treatment options, risks, and benefits before agreeing to care
Informed consent requires disclosing the diagnosis, proposed treatment, alternatives, and risks so the patient can make a voluntary and educated decision.
Question 4: If a minor patient comes in unaccompanied for an eye exam, the CPOA should generally:
- Proceed with the full exam without question
- Reschedule the appointment for when a parent is present
- Check state law and office policy regarding consent for minors (Correct answer)
- Ask the minor to sign the consent form themselves
Correct answer: Check state law and office policy regarding consent for minors
Consent laws for minors vary by state; the CPOA should follow state law and practice policy before proceeding.
Question 5: A CPOA overhears two staff members joking about a patient's unusual appearance in the break room. This behavior is:
- Acceptable as long as the patient cannot hear
- A violation of professional standards and patient dignity (Correct answer)
- Permitted if the patient is not identified by name
- Only a problem if it occurs in the patient care area
Correct answer: A violation of professional standards and patient dignity
Ridiculing patients violates professional standards of respect and patient dignity regardless of whether it occurs in a private staff area.
Question 6: Upcoding in medical billing refers to:
- Adding a modifier to a procedure code
- Billing for a higher-level service than was actually provided (Correct answer)
- Submitting a claim electronically instead of on paper
- Correcting a rejected claim and resubmitting it
Correct answer: Billing for a higher-level service than was actually provided
Upcoding is billing fraud where a higher-reimbursing code is used for a lesser service actually rendered.
Question 7: Which of the following is an example of maintaining professional boundaries with patients?
- Sharing your personal cell phone number so patients can text any time
- Accepting expensive gifts from a patient to avoid offending them
- Keeping interactions focused on clinical care and office needs (Correct answer)
- Becoming close personal friends with long-term patients
Correct answer: Keeping interactions focused on clinical care and office needs
Professional boundaries are maintained by keeping the patient relationship centered on clinical care and avoiding dual personal relationships.
CPOA Professional Issues 3
A patient becomes angry about their bill and raises their voice in the reception area.
The CPOA should: