This document is published by the Office of Inspector General (OIG) every year. It details the
OIG's focus for Medicare fraud and abuse investigations for that year. It gives health care
providers an indication of general and specific areas that are targeted for review. It can be found
on the Internet on CMS's website. - answer✔the OIG's Work Plan
There are times when documentation is incomplete or insufficient to support the diagnoses found
in the chart. The most common way of communicating with the physician for answers is by -
answer✔using established physician query protocols.
You want to review one document in your facility that will spell out the documentation
requirements for patient records, designate the time frame for completion by the active medical
staff, and indicate the penalties for failure to comply with these record standards. Your best
resource will be - answer✔medical staff rules and regulations.
The coding supervisor notices that the coders are routinely failing to code all possible diagnoses
and procedures for a patient encounter. This indicates to the supervisor that there is a problem
with - answer✔completeness.
Adrienne, a disgruntled nurse was fired from East Care Hospital after it was discovered that she
accessed a local celebrity's medical record. The celebrity was being treated for communicable
disease at a satellite clinic under East Care's operational umbrella. In this scenario, Adrienne can
best be described as an ________ for East Care Hospital. - answer✔internal security threat
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