Fraud management program - Study guides, Class notes & Summaries

CPCO EXAM 2024 WITH 100% 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 submit...

The fraud risk management program should include the formal procedures management takes in response to a fraud, such as punishing the perpetrator, remediating the control weaknesses that allowed the fraud to occur, and rebuilding stakeholders' confidence in the organization. - Answer- True Which of the following parties is responsible for directing employees to carry out business activities and managing their performance of those tasks? - Answer- Management To be considered a profession, ...

BA 342 Comprehensive Exam 1 (2024) – With Questions & Answers (Rated A+) BA 342 Comprehensive Exam 1 (2024) – With Questions & Answers (Rated A+) 6Elements of an Ethics and Compliance Program - ANSWER - - How can you trust that your workers will do the right thing? - 2013, 41% of US workers said that they observed illegal or unethical practices in the workplace ○ 6Elements of an Ethics and Compliance Program ■ Written standards of ethical workplace conduct ■ Training on stand...

NAVTA Exam 2 Chapter 1 and 2 Questions and Answers Already Passed NAVTA National Association of Veterinary Technicians in America VTNE Veterinary Technician National Exam three 30 day windows to complete 150 multiple choice must have graduated from avma or cvma accredited program covers the 9 domains of veterinary technology Salaries for Veterinarian Technicians level of experience, location of work, and field of interest have a significant impact on income Animal Welfare Act...

CGFM Exam 1 doctrine of separation of powers provides a foundation for correct answergovernment financial management govt entity can be classed as correct answergeneral or special purpose US constitution written correct answer1787 Most school district in US correct answerIndependent District Role of federal CFO correct answercodified in the Chief Financial Officer act of 1990 telework correct answerworking from home or other remote location Anti-fraud policies correct answera formal code...

CPH Exam Practice Test Bank Prep_ Answered_2022. Many people do not attempt to decrease unhealthy behaviors such as overeating or smoking because they lack the confidence that they can successfully change. This is an example of: (A) Perceived susceptibility (B) Perceived severity (C) Perceived self-efficacy (D) Perceived response efficacy The construct of normative beliefs is from which model/theory? (A) Transtheoretical model (B) Theory of reasoned action/planned behavior (C) So...

HCA Certification Training Exam 2024 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 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? 1.Protect our ___________________ 2.Protect your ___________________ 3.Protect the ___________________ -Answer-1.Protect our programs 2.Protect your patients 3.Prot...

CPCO Test Prep | 36 Questions with 100% Correct Answers | Latest Update 2024 | Rated A+ 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...

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...

Indirect Loss - Answer- A secondary loss that follows from a direct loss to insured property from a covered peril. Ex. Hotel expenses incurred by the insured while a fire-damaged home is repaired is an indirect loss that follows the direct loss of the home. Exclusive Agency System - Answer- An insurance distribution system in which producers (agents) represent a single company. Ex. In the exclusive agency system, insurers use independent contractors (exclusive agents) that represent only on...