100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
2025 AHIP - Fraud, Waste, and Abuse Questions and Answers (Verified by Expert)2025/2026 $12.99   Add to cart

Exam (elaborations)

2025 AHIP - Fraud, Waste, and Abuse Questions and Answers (Verified by Expert)2025/2026

 5 views  0 purchase
  • Course
  • AHIP 2025
  • Institution
  • AHIP 2025

2025 AHIP - Fraud, Waste, and Abuse Questions and Answers (Verified by Expert)2025/2026

Preview 1 out of 2  pages

  • November 4, 2024
  • 2
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • ahip 2025
  • AHIP 2025
  • AHIP 2025
avatar-seller
Ashley96
2025 AHIP - Fraud, Waste, and Abuse

1. A individual drops off a prescription for a beneficiary who is a "normal" customer. The
prescription is for a managed substance with a quantity of a hundred and sixty. This
beneficiary commonly receives a quantity of 60, now not one hundred sixty. You
evaluation the prescription and feature concerns about viable forgery. What is your next
step? - ANS-Call the prescriber to verify the quantity
2. Abuse entails charge for gadgets or services while there's no felony entitlement to that
price and the provider has not knowingly or intentionally misrepresented facts to achieve
fee. - ANS-True
3. Any person who knowingly submits false claims to the Government is accountable for 5
instances the Government's damages because of the violator plus a penalty. -
ANS-False
4. Bribes or kickbacks of any type for offerings which might be paid under a Federal fitness
care application (which includes Medicare) constitute fraud by means of the character
making in addition to the man or woman receiving them. - ANS-True
5. Once a corrective action plan is started, the corrective action plan should be monitored
annually to make certain they may be powerful. - ANS-False
6. Some of the legal guidelines governing Medicare Part C and D fraud, waste, and abuse
(FWA) include the Health Insurance Portability and Accountability Act (HIPAA), the Civil
False Claims Act, the Anti-Kickback Statute, and the Criminal Health Care Fraud Statute.
- ANS-True
7. These are examples of issues that have to be suggested to a Compliance Department:
suspected fraud, waste, and abuse (FWA); potential fitness privateness violation,
unethical behavior, and worker misconduct. - ANS-True
8. Waste consists of any misuse of sources, which include the overuse of services or
different practices that without delay or indirectly result in pointless prices to the
Medicare Program. - ANS-True
9. Ways to file ability fraud, waste, and abuse (FWA) consist of: - ANS-All of the above
10. What are some of the penalties for violating fraud, waste, and abuse (FWA) laws? -
ANS-All of the above
11. Which of the following is NOT doubtlessly a penalty for violation of a regulation or law
prohibiting fraud, waste, and abuse (FWA)? - ANS-Deportation
12. Which of the subsequent requires intent to achieve payment and the know-how the
moves are incorrect? - ANS-Fraud
13. You are in charge of paying claims submitted via providers. You be aware a positive
diagnostic provider ("Doe Diagnostics") requested a sizeable payment for a large patient
institution. Many of these claims are for a sure technique. You assessment the same
kind of procedure for different diagnostic carriers and realise Doe Diagnostics' claims far
exceed every other issuer you reviewed. What have to you do? - ANS-Consult with your

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller Ashley96. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $12.99. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

72042 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
$12.99
  • (0)
  Add to cart