MEDICARE+ FRAUD, WASTE, AND ABUSE 2024 EXAMS PACKAGE DEAL |DOWNLOAD TO PASS

Your job is to submit a risk diagnosis to the Centers for Medicare & Medicaid Services (CMS) for the purpose of payment. As part of this job, you use a process to verify the data is accurate. Your immediate supervisor tells you to ignore the Sponsor's process and to adjust or add risk diagnosis cod...

Compliance is the responsibility of the compliance officer, compliance committee and upper management only False Ways to report a compliance issue include All of the above What is the policy of non-retaliation Protects employees who, in good faith, report suspected non-compliance ...

abuse misuse of healthcare funds, products and services Anititrust Laws laws that prevent the formation of monopolies appeal To ask a higher court to review the decision and determine if justice was done balance billing collecting the difference between a provider's usual f...

Which piece of legislation mandated the establishment of a joint Health Care Fraud and Abuse Control program? HIPAA When an employee is a provider's office suspects fraudulent activity and uses the Office of Inspector General Hotline to report it, the employee should do which of the followi...

Medicare plan means A MA plan, MA-PD plan or PDP Subcontractor means **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIREC...

What reports are available on Aetna's Producer World? A) Your Medicare book of business B) Month/YTD/Prior year commission report C) Licensing reports D) A and B E) All of the above E) All of the above You will need to successfully complete which requirements to have "ready-to-sell...

Your job is to submit a risk diagnosis to the Centers for Medicare & Medicaid Services (CMS) for the purpose of payment. As part of this job, you use a process to verify the data is accurate. Your immediate supervisor tells you to ignore the Sponsor's process and to adjust or add risk diagnosis cod...

Per CMS guidelines, what document MUST be shown and explained to every prospect when conducting a sales presentation? Coordination of care form True or False. In following with our Code of Conduct, you can call SCAN's EthicsPoint Hotline: or go to to report Fraud, Waste and Abuse to SCAN....

Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. O True O False False Ways to report fraud, waste, and abuse (FWA) include: A. Telephone hotlines B. Mail drops C. In-person reporting to the compliance department/su...

Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. False Ways to report a compliance issue include: a. Telephone hotlines b. Report on the Sponsor's website c. In-person reporting to the compliance department/supervisor d. All of...