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Free CMM Practice Questions

10 free, exam-style Certified Medical Manager (CMM) practice questions with answers and explanations. No signup required. Work through them below, then take the full free CMM practice test to study every exam domain.

Question 1

A Medicare patient with recurring low back pain is scheduled for a repeat lumbar MRI. The treating physician suspects Medicare may deny the claim because an identical MRI was performed six months earlier with no significant clinical change. When must the Advance Beneficiary Notice (ABN) be provided to the patient?

  1. Immediately after the MRI is performed, before submitting the claim to Medicare
  2. Before the MRI is performed, so the patient can make an informed financial decision
  3. Within 30 days of receiving Medicare's Explanation of Medicare Benefits
  4. Only after Medicare formally issues a written denial for the claim
Show answer & explanation

Correct answer: B - Before the MRI is performed, so the patient can make an informed financial decision

Question 2

A cardiologist refers her Medicare patients to a cardiac imaging center where her husband holds a 15% ownership interest. No payments change hands between the physician and the imaging center for these referrals. This arrangement is MOST directly implicated by:

  1. The Stark Law, because a financial relationship exists through an immediate family member
  2. The Anti-Kickback Statute, because the referrals financially benefit the physician's household
  3. The False Claims Act, because Medicare claims are submitted for the referred services
  4. No federal law, because no direct payment is exchanged for the referrals
Show answer & explanation

Correct answer: A - The Stark Law, because a financial relationship exists through an immediate family member

Question 3

An employee at a 75-physician group practice has worked for the organization for 14 months and logged 1,100 hours over the past 12 months. She requests FMLA leave to care for her mother following a serious hospitalization. The practice manager should:

  1. Approve the leave, as the employee has been employed for more than 12 months
  2. Approve the leave, as caring for a parent is a qualifying reason under FMLA
  3. Deny the leave, as the employee has not met the 1,250-hour eligibility requirement
  4. Deny the leave, as FMLA does not apply to leave taken to care for a parent
Show answer & explanation

Correct answer: C - Deny the leave, as the employee has not met the 1,250-hour eligibility requirement

Question 4

A practice promotes its senior billing coordinator to 'Billing Director,' raises her salary to $750 per week, stops tracking her hours, and classifies her as exempt from overtime. Under the FLSA, which factor is MOST critical in validating this exemption?

  1. Whether her primary duties meet the FLSA's applicable duties test
  2. Whether her new title qualifies as managerial under Department of Labor standards
  3. Whether her $750 weekly salary clears the federal overtime exemption threshold
  4. Whether she agreed to the exempt classification in her employment agreement
Show answer & explanation

Correct answer: A - Whether her primary duties meet the FLSA's applicable duties test

Question 5

A receptionist accidentally sends an appointment reminder to the wrong email address. The email contains the patient's name and the name of their treating physician - a psychiatrist. The error was unintentional and was immediately self-reported. Under the HIPAA Breach Notification Rule, this event is BEST classified as:

  1. Not a breach, because the disclosure was unintentional by an authorized workforce member
  2. Not a breach, because appointment reminders do not contain clinical diagnoses or treatment records
  3. A breach requiring HHS notification only, since no medical records were transmitted
  4. A reportable breach requiring notification to the affected individual
Show answer & explanation

Correct answer: D - A reportable breach requiring notification to the affected individual

Question 6

A practice collected $680,000 last year. Total gross charges were $1,200,000 and contractual adjustments totaled $400,000. What is the practice's net collection ratio, and what does it indicate?

  1. 56.7% - the practice is collecting most of what it bills to payers
  2. 85% - the practice is not meeting the industry performance benchmark
  3. 56.7% - significant collectible revenue is not being recovered
  4. 85% - the practice is performing at or above the expected standard
Show answer & explanation

Correct answer: B - 85% - the practice is not meeting the industry performance benchmark

Question 7

A practice manager checks the OIG LEIE before hiring all new employees. A medical biller hired four months ago passed that screen. The manager then discovers the biller was added to the LEIE six weeks after her start date. Which statement BEST reflects the practice's compliance exposure?

  1. No exposure exists, as the employee was not on the LEIE at the time of hire
  2. Potential civil monetary penalties may apply to claims submitted after the exclusion date
  3. Liability arose only at the point the practice manager became aware of the exclusion
  4. The documented pre-hire LEIE screen insulates the practice from subsequent liability
Show answer & explanation

Correct answer: B - Potential civil monetary penalties may apply to claims submitted after the exclusion date

Question 8

A managed care contract states: 'The physician agrees not to seek payment from plan enrollees for any covered service in an amount exceeding the fees specified in this agreement, regardless of the physician's standard charges.' This clause is BEST described as a:

  1. Risk withhold provision
  2. Clean claim requirement
  3. Most-favored-nation clause
  4. Hold-harmless/anti-balance-billing clause
Show answer & explanation

Correct answer: D - Hold-harmless/anti-balance-billing clause

Question 9

A solo internist has $88,000 in Medicare Part B allowed charges, 190 Medicare patients, and 215 covered professional services for the performance year. Which statement BEST describes her MIPS reporting obligations?

  1. She is excluded, as both her charges and beneficiary count fall below their thresholds
  2. She is excluded, as all three low-volume criteria fall below their respective thresholds
  3. She is required to report, as her professional services exceed the 200-service threshold
  4. She is required to report, as solo practitioners are ineligible for the low-volume exclusion
Show answer & explanation

Correct answer: C - She is required to report, as her professional services exceed the 200-service threshold

Question 10

A practice manager completes all required data entry for a new physician's Medicare enrollment in PECOS and attempts to submit the application - but the system blocks the submission because she has been assigned a Surrogate End User role. What is the correct next step?

  1. Submit the enrollment using the paper CMS-855I form and mail it to the Medicare Administrative Contractor
  2. Contact the CMS Provider Enrollment help desk to request a temporary submission override
  3. Have the Authorized Official or Delegated Official log in and submit the application
  4. Ask the physician to create a personal PECOS account and self-submit the enrollment
Show answer & explanation

Correct answer: C - Have the Authorized Official or Delegated Official log in and submit the application

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