Anti kickback law - Study guides, Class notes & Summaries

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...

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 ...

1-day payment window rule - Answer a Medicare requirement similar to the day payment window rule that applies to inpatient poychiatric hosp tals, inpatient rehabilitation facilities, long term care facilities, and chil dren's and cancer hospital. 3-day payment window rule - Answer a Medicare requirement that all diagnostic and clinically related non-diagnostic outpatient services provided with in three days of an inpatient admission must combined the inpa- tient claim when they are provided ...

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 - ANSWERSd. Physician unique identifier number A physician received office space at a reduced rate for referring patients to the hospital's out- patient physical therapy center. What Law does this vi...

California Law Exam Optometry Exam 2024 Questions and Answers (Graded A)California Law Exam Optometry Exam 2024 Questions and Answers (Graded A)California Law Exam Optometry Exam 2024 Questions and Answers (Graded A)California Law Exam Optometry Exam 2024 Questions and Answers (Graded A) Any person holding a license shall notify the issuing board of any changes in mailing address within ____ days after change - ANSWER-30 days It is prohibited to dispense, prescribe of sell eyeglasses not mad...

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 ...

CALIFORNIA LAW EXAM OPTOMETRY REALWITH 100% CORRECT ANSWERS 2023 COMPLETE SOLUTIONS ALEADY GRADED A Any person holding a license shall notify the issuing board of any changes in mailing address within ____ days after change - Correct answer-30 days It is prohibited to dispense, prescribe of sell eyeglasses not made of shatter-resistant lenses or non-flammable frames to _______ - Correct answer-1. one eyed person 2. law enforcement officer 3. fireman 4. person < 18 years old *not...

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 contr...

CPMA Exam Questions And Answers All Verified CMS Fraud Definition - ANS Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition - ANS An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud - ANS Billing for services and/or supplies that you know were not furnished or provided, altering claim forms and/or receipts to ...

Anti-Kickback Law ️ Prohibits the solicitation, receiving, offering, or paying of any remuneration directly or indirectly in cash or in kind exchange. Attestation ️ The affirmation by signature, usually on a printed form, that the action outlined has been accomplished by the individual signing; e.g., the individual has read the code of conduct and agreed to adhere to its principles. Attorney-Client Privilege ️ A legally accepted policy that communication between a client and attorn...