Qui tam - Study guides, Class notes & Summaries

©BRAINBARTER 2024/2025 CPMA STUDY QUESTIONS With Verified Answers. WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? - answer1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and health plan request and denial. Exclusion Statute - answer1.Physician is banned from participating in any federal or state healthcare ...

CPCO Exam Prep | 36 Questions and Answers 100% Solved Which Act of 2003 gave momentum to the e-prescribing movement, and was put in place to reduce medication errors due to illegible physician handwriting, etc.? - Medicare Modernization Act (MMA) The CMP Inflation Adjustment increased the maximum penalty amount per false claim to? - 10,781-$21,563, plus the assessment of not more than three times the amount claimed for damages In a qui tam action in which the government intervenes,...

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

CPMA Questions with Correct Answers Graded A+ Under CIA, 50 sampling units are reviewed. What is the sample referred as? A. Discovery Sample B. Initial Sample C. Complete Sample D. Selective Sample A. Discovery Sample (used to determine the net financial error rate) Which may result in false claims act violation? A. A provider routinely waives the copay for MCR beneficiaries B. A provider accepts insurance only payments from MCR beneficiaries C. A provider submits claims to MCR for D...

A practice agrees to pay $250,000.00 to settle a lawsuit alleging that the practice used x-rays of one patient to justify services on multiple other patients' claims. The office manager brought the civil suit. What type of case is this? - Answer Qui Tam In which of the following circumstances may PHI not be disclosed without the patient's authorization or permission? - Answer An office receives a call from the patient's husband asking for information about his wife's recent office vis...

A practice agrees to pay $250,000.00 to settle a lawsuit alleging that the practice used x-rays of one patient to justify services on multiple other patients' claims. The office manager brought the civil suit. What type of case is this? - ️️Qui Tam In which of the following circumstances may PHI not be disclosed without the patient's authorization or permission? - ️️An office receives a call from the patient's husband asking for information about his wife's recent office visit. ...

WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? - ANSWER 1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and health plan request and denial. They can't bill federal or state for any services provided .3 length: host less than five years .4 When exclusionary period has ended dr must apply for reinstatement and rec...

Domain 8 (CCS-P EXAM) QUESTIONS & ANSWERS 2024 A program unveiled by the Office of the Inspector General that expanded and simplified methods for healthcare providers to voluntarily report fraudulent conduct affecting Medicare, Medicaid, and other federal healthcare programs is the: a. Provider Self-Disclosure Protocol b. Federal False Claims Act c. Operation Restore Trust d. Health Insurance Portability and Accountability Act - ANSWER-a. Provider Self-Disclosure Protocol The term us...

WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? - ANSWER 1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and health plan request and denial. They can't bill federal or state for any services provided .3 length: host less than five years .4 When exclusionary period has ended dr must apply for reinstatement and rec...

CPB Final Exam A practice agrees to pay $250,000.00 to settle a lawsuit alleging that the practice used x-rays of one patient to justify services on multiple other patients' claims. The office manager brought the civil suit. What type of case is this? - Qui Tam In which of the following circumstances may PHI not be disclosed without the patient's authorization or permission? - An office receives a call from the patient's husband asking for information about his wife's recent office...