According to the oig - Study guides, Class notes & Summaries

CPCO prep Questions with Correct Answers Does Medicare pay for all tests ordered by Providers? - Correct Answer No, they need to determine if it's covered and medically necessary. For larger physician practices, how often does the OIG suggest reporting compliance activities to the board of directors? - Correct Answer Regularly According to the OIG, medically unnecessary services can be billed to Medicare for what purpose? - Correct Answer To receive a denial so a claim can be submitted t...

CPCO Test Prep | 36 Questions and Answers 100% Solved Does Medicare pay for all tests ordered by Providers? - No, they need to determine if it's covered and medically necessary. For larger physician practices, how often does the OIG suggest reporting compliance activities to the board of directors? - Regularly According to the OIG, medically unnecessary services can be billed to Medicare for what purpose? - To receive a denial so a claim can be submitted to a secondary payer. Whi...

The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - Precise Answer True According to HHS-OIG - what are three important reasons for proper documentation in Compliance? 1.Protect our ___________________ 2.Protect your ___________________ 3.Protect the ___________________ - Precise Answer 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which lev...

AAPC CPC Exam Questions and Answers 2023 What type of provider goes through approximately 26 1/2 months of education and is licensed to practice medicine with the oversight of a physician? Physician Assistant (PA) The ____ describes whether specific medical items, services, treatment procedures, or technologies are considered medically necessary under Medicare National Coverage Determinations LCD's only have jurisdiction in their ____ area. Regional ABN stands for Adva...

Does Medicare pay for all tests ordered by Providers? - No, they need to determine if it's covered and medically necessary. For larger physician practices, how often does the OIG suggest reporting compliance activities to the board of directors? - Regularly According to the OIG, medically unnecessary services can be billed to Medicare for what purpose? - To receive a denial so a claim can be submitted to a secondary payer. Which component of the OIG has a duty of operating the OIG hotline...

The Joint Commission (JC) requires the Factors that Affect Learning must be assessed for a hospital or hospital owned physician practice as well as other health care facilities. When assessing this element what does this include? A. The patient's ability to read, method of learning and understanding. B. Any language or physical disabilities. C. Cultural beliefs. D. All the above - Answer- D. All the above Report copies and printouts, films, scans, and other radio logic service im...

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - Answer-True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer-1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the Medicare Part A or Part B appeals process is the appea...

Does Medicare pay for all tests ordered by Providers? - No, they need to determine if it's covered and medically necessary. For larger physician practices, how often does the OIG suggest reporting compliance activities to the board of directors? - Regularly According to the OIG, medically unnecessary services can be billed to Medicare for what purpose? - To receive a denial so a claim can be submitted to a secondary payer. Which component of the OIG has a duty of operating the OIG hotline...

AAPC ICD10 Physician Coding for CPC Preparation (All Exams QUESTIONS AND ANSWERS GRADED A LATEST VERSIONS) with rationale Review Test Submissio n: Chapter 1 Quiz • Question 1 10 out of 10 points What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services within the coming year? Selected Answer: Correct Answer: Response Feedback: c. OIG Work Plan c. OIG Work Plan Rationale: Twice a year, the O...

CPCS/CPMSM Sample Questions Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to the Joint Commission, who may amend the medical staff bylaws? - Governing Body Failure to meet the established qualifications and criteria for appointment should be reported to whom? - The applicant NCQA requires the MCO to obtain a minimum of ???? years of work history? - 5 years According to NCQA what policy must an organiza...