Anti kickback statute - Study guides, Class notes & Summaries

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 codes for certain individuals. What should you do? Report the incident to the compliance department (via compliance hotline or other mechanism) You are performing a regular inventory of the contro...

Naham Exam Latest Update with Verified Solutions AIDET acknowledge, introduce, duration, explanation, thank you Press Ganey provides patient service satisfaction surveys, used for both public relations & performance improvement KPI Key Performance Indicator KPI Example Preregistration percentage, wait times, accuracy rate, pos collections, productivity HEAT Hear them out, empathize with the customer, apologize, take responsibility for actions PPE personal protective equip...

Anti-Kickback Statute (42 US SS 1320a-7b (b) prohibitions - Prohibits offering, paying, soliciting or reviving anything of value to induce or reward referrals or generate Federal health care program business Anti-Kickback Statute (42 US SS 1320a-7b (b) referrals - Referrals from anyone Anti-Kickback Statute (42 US SS 1320a-7b (b) - Any items or services Anti-Kickback Statute (42 US SS 1320a-7b (b) (Intent) - Intent MUST be proven (knowing and willful) Anti-Kickback Statute (42 US SS 1320a...

AHFI Exam Latest Update Graded A+ Anti-Kickback Statute (42 US SS 1320a-7b (b) prohibitions Prohibits offering, paying, soliciting or reviving anything of value to induce or reward referrals or generate Federal health care program business Anti-Kickback Statute (42 US SS 1320a-7b (b) referrals Referrals from anyone Anti-Kickback Statute (42 US SS 1320a-7b (b) Any items or services Anti-Kickback Statute (42 US SS 1320a-7b (b) (Intent) Intent MUST be proven (knowing and willful) ...

HealthcareComplianceExamQuestionsandCorrect Answers. anti-kickback statute - Correct Answer The Social Security amendments of 1972 included the original anti-kickback legislation the legislation stated the statute was to prevent fraud and abuse from federal healthcare programs. A criminal statute that provides exchange of anything of value in an effort to induce or reward the referral of federal healthcare program business. If fined up to $25,000 and imprisonment up to five years Safe har...

Anti-Kickback Statute (42 US SS 1320a-7b (b) prohibitions - Answer-Prohibits offering, paying, soliciting or reviving anything of value to induce or reward referrals or generate Federal health care program business Anti-Kickback Statute (42 US SS 1320a-7b (b) referrals - Answer-Referrals from anyone Anti-Kickback Statute (42 US SS 1320a-7b (b) - Answer-Any items or services Anti-Kickback Statute (42 US SS 1320a-7b (b) (Intent) - Answer-Intent MUST be proven (knowing and willful) Anti...

AAPC CPB Chapter 1-5/ 477 Q&A/ Already Graded A+/ . Terms like: Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - Answer: d. Physician unique identifier number A physician received office space at a reduced rate for referring patients to the hosp...

CMS Fraud Definition Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud Billing for services and/or supplies that you know were not furnished or provided, altering claim forms and/or receipts to receive a higher payment amount, billing a Medicare patient abov...

Anti-Kickback Statute (42 US SS 1320a-7b (b) prohibitions - Prohibits offering, paying, soliciting or reviving anything of value to induce or reward referrals or generate Federal health care program business Anti-Kickback Statute (42 US SS 1320a-7b (b) referrals - Referrals from anyone Anti-Kickback Statute (42 US SS 1320a-7b (b) - Any items or services Anti-Kickback Statute (42 US SS 1320a-7b (b) (Intent) - Intent MUST be proven (knowing and willful) Anti-Kickback Statute (42 US SS ...

NCCT REVIEW LAW AND ETHICS EXAM QUESTIONS AND ANSWERS 1. Which of the following activities is an example of abuse rather than fraud? A. upcoding B. misrepresenting the diagnosis C. inadvertent coding errors D. billing for services not rendered - Answer-inadvertent coding errors Rationale Abuse is an unintentional mistake. Fraud is an intentional misrepresentation for gain. Upcoding, misrepresenting the diagnosis, and billing for services not rendered are examples of fraud. Inadvertent ...