In February 2020, an auditor is asked to review 10 records for date of service
12/1/2019 to make sure the claims were paid correctly. Te claims included
code 33010, which was denied on all the claims. Te denial was for an invalid
code. What should the auditor advise the provider?
A. Code 330...
✓ b. Take disciplinary action and document the date of the incident,
name of the reporting party, name of the person responsible for taking
action, and the follow-up action taken.
✓ According to the OIG, disciplinary action should be taken based on
the severity of the offense. Disciplinary actions could include oral
warnings, written reprimands, probation, demotions, termination, etc.
The incident should be documented with the date of the incident,
name of the reporting party, name of the person responsible for taking
action, and the follow-up action taken.
In a Corporate Integrity Agreement (CIA), does the OIG specify the
Independent Review Organization to be used?
a. Yes; the specific IRO will be named in the CIA.
b. Yes; the CIA will identify five IROs that can be used for the CIA Review.
c. No; the OIG does not have any input on the IRO used under any
circumstance.
d. No; the OIG does not specify the IRO to be used, but does retain the right
to notify the provider if they must select a new IRO.
Master01 | September, 2024/2025 | Latest update
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