What is one of the primary functions of ZPICs?

Prepare for the AAPC Certified Professional Compliance Officer (CPCO) Certification Exam. Use quizzes and detailed explanations to enhance your knowledge and boost your confidence. Excel in your exam with structured learning!

The primary function of Zone Program Integrity Contractors (ZPICs) is to investigate potential fraud incidents within the Medicare program. ZPICs are specialized contractors responsible for identifying and preventing fraud, waste, and abuse in federal programs. Their role includes conducting audits, reviewing claims, and analyzing data to detect suspicious patterns or activities that may indicate fraudulent behavior by healthcare providers or suppliers. By investigating these potential fraud incidents, ZPICs help protect program integrity and ensure that funds are used appropriately to provide healthcare services to beneficiaries.

The other options do not align with the principal purpose of ZPICs. Issuing payment authorizations is typically handled by Medicare Administrative Contractors (MACs), managing patient records falls under the responsibility of healthcare providers and organizations, and guaranteeing reimbursement rates is a function that relates more to policy and regulations set forth by Medicare, rather than the specific investigative role of ZPICs.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy