Stark legislation - Study guides, Class notes & Summaries

CHC Practice Test 2024 Questions and Answers At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified independent contractor? a. first level appeal b. second level appeal c. third level appeal d. fourth level appeal -Answer-b. second level appeal There are five levels of appeal. First level entails a redetermination of claim; second level involves reconsideration by a qualified independent contractor; third level includes a hearing overseen by...

Stark or Physician Self-Referral Law - ️️The Omnibus Budget Reconciliation Act bans physicians from referring patients to receive "designated health services" to any entity with which the physician has a financial relationship. Designated health services include lab testing, imaging services, physical or occupational therapy, etc. (civil only, medicare/medicaid only, strict liability) Anti-Kickback Statute (AKS) - ️️Prohibits the solicitation, receiving, offering, or paying any remu...

CHC Practice Test Questions And Answers 100% Verified. At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified independent contractor? a. first level appeal b. second level appeal c. third level appeal d. fourth level appeal - correct answer. b. second level appeal There are five levels of appeal. First level entails a redetermination of claim; second level involves reconsideration by a qualified independent contractor; third lev...

CCS-P EXAM QUESTIONS & ANSWERS 2024 HIPAA - ANSWER-What Act provides for criminal penalties for healthcare professional who "knowingly and willingly" attempt to defraud any health program What information is necessary to assign the correct Evaluation and Management (E/M) code for preventive medicine services? - ANSWER-Preventive medicine services category codes are assigned based on the age of the patient Which of the following data elements is needed to accurately assign a CPT prev...

CPMSM StudyWhen developing clinical privileges the following are important to evaluate? - correct answer Established standards of practice such as, specialty board recommendations. What is the main reason for periodically assessing appropriateness of clinical privileges for each specialty? - correct answer To protect patient safety by ensuring current competeny, revelance to the facility and accepted standards of trade. Which is the most likely speciality to perform a PTCA? - correct answe...

CHC Practice Test 2024 Questions and Answers At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified independent contractor? a. first level appeal b. second level appeal c. third level appeal d. fourth level appeal -Answer-b. second level appeal There are five levels of appeal. First level entails a redetermination of claim; second level involves reconsideration by a qualified independent contractor; third level includes a hearing overseen by...

Who determines the PMHNP scope of practice/ NP role and actions? - ANS The STATE legislation Who determines the Standard of Practice ("Quality" of Practice)? High quality of care consistent with standards / minimum levels of acceptable performance - ANS ANA HIPAA and psychotherapy notes: - ANS No disclosure without authorization What should you remember about your pt with dual dx? - ANS separate ROI for chemical dependency and psych. info Ex...

CPMSM Study Questions with solutions 2024 When developing clinical privileges the following are important to evaluate? Established standards of practice such as, specialty board recommendations. What is the main reason for periodically assessing appropriateness of clinical privileges for each specialty? To protect patient safety by ensuring current competeny, revelance to the facility and accepted standards of trade. Which is the most likely speciality to perform a PTCA? Inte...

At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified independent contractor? a. first level appeal b. second level appeal c. third level appeal d. fourth level appeal - ACCURATE ANSWERS b. second level appeal There are five levels of appeal. First level entails a redetermination of claim; second level involves reconsideration by a qualified independent contractor; third level includes a hearing overseen by admin law judge; fourth level is a...

CCS-P EXAM QUESTIONS & ANSWERS 2023/2024 HIPAA - ANSWER-What Act provides for criminal penalties for healthcare professional who "knowingly and willingly" attempt to defraud any health program What information is necessary to assign the correct Evaluation and Management (E/M) code for preventive medicine services? - ANSWER-Preventive medicine services category codes are assigned based on the age of the patient Which of the following data elements is needed to accurately assign a CPT p...