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RHIT D3 compliance | Questions And Answers Latest {} A+ Graded | 100% Verified
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RHIT D3 compliance | Questions And Answers Latest {} A+ Graded | 100% Verified
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RHIT D3 compliance | Questions And Answers Latest {2024- 2025} A+ Graded | 100%Verified
OASIS data are used to assess the____ of home health services. - [Outcome]. OASIS is outcomes and
Assessment Information Set. designed to gather data about outcomes for Medicare patient who receive
service from home health.
A statement or guideline that directs decision making or behavior in organization is called a: - [Policy]
What is three risk areas that are vitally important to the accuracy of the claims submission process.
Which is a fraudulent billing practices represent a major compliance risk for health care organizations. -
[Coding and billing, documentation, and medical necessity for tests and procedures]
Which areas within high risk of compliance that including in billing practices. - [Billing for non-covered
services, altered claim forms, duplicate billing, misrepresentation of facts on a claim form, failing to
return overpayments, unbundling, billing for medically unnecessary services, overcoding and upcoding,
billing for items or services not rendered, and false cost reports]
What is healthcare fraud? - [false representation of fact, failure to disclose a material fact, or damage to
another party that reasonably relied on misrepresentation]
Corporate compliance programs become common/blueprint for an effective compliance program for
healthcare organization after adoption of__________ - [The US federal Sentencing Guidelines], they
outline seven steps as the hallmark of an effective program to prevent and detect violation of law.
There are a number of legal issues facing the EHR. State laws vary as to what is and is not acceptable in a
court of law regarding EHRs. What is a legal concern regarding the EHR? - [Ability to subpoena audit
trails]. Healthcare providers frequently receive subpoenas requesting the production of the medical
record.
The act of granting approval to healthcare organization based on whether the organization has met a set
of voluntary standards of accreditation agency is called: - [Accreditation]. for example The Joint
Commission is an accreditation agency
, Who is outlined elements of compliance program? - [The OIG (office of inspector general)] outlined
seven elements as the minimum necessary for a comprehensive compliance program.
List of elements for an Effective Compliance
Program. - They are:1)Implementing written policies, procedures and standards of conduct;
2)Designating a compliance officer and compliance committee 3) Conducting effective training and
education 4)Developing effective lines of communication 5) Enforcing standards through well publicized
disciplinary guidelines 6) Conducting internal monitoring and auditing 7) Responding promptly to
detected offenses and developing corrective action.
A group practice has hired an HIT as its chief compliance officer. The current compliance program
includes written standards of conduct and policies and procedures that address specific areas of
potential fraud. It also has audits in place to monitor compliance. What else compliance officer should
also ensure are in place? - [Establishment of a hotline to receive complaints and adoption of procedures
to protect whistleblowers from retaliation]. this is one of the seven elements that OIG has outlined
which is conducting internal monitoring and auditing this is a maintenance of a process.
In developing a coding compliance program, who would be ordinarily included as participants in coding
compliance education? - [Current coding personnel, Medical staff, Newly hired coding personnel] HIM
manager should provide education, training related to complete and accurate coding, documentation
and billing on an ANNUAL basis. Annually require by compliance for coding staff should be updated the
compliance.
The Healthcare Cost and Utilization Project (HCUP) is a major initiative of which organization within the
federal government? - [Agency for Healthcare Research and Quality (AHRQ) ] sponsor HCUP. This
organization most involved in health services research, they looks at issues related to the efficiency and
effectiveness of the healthcare delivery system, disease protocols, and guidelines for improved disease
outcomes.
Who issues compliance program guidance? - [HHS ( Health and Human service) office of Inspector
General (OIG)] OIG issue compliance program guidance since 1998 for various types of healthcare
organization. Which most healthcare organization need guidance to develop fraud and abuse
compliance plans or program.
What is data security? - Data security is to insure [workstation are protected] from unauthorized access
and if workstation is inactive for a period of time it should log itself off automatically to prevent
unauthorized person from accessing ePHI.
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