Qui tam - Study guides, Class notes & Summaries

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

What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index - Answer c. Protected Health Information A new radiology company opens in town. The manager calls your practice and offers to pay $20 for every Medicare patient you send to them for radiology services. What does this offer violate? a. Stark Laws b. HIPAA c. Anti-Kickback law d. Qui Tam - Answer c. Anti-Kickback law ...

When non-compliance is identified, what does the OIG recommended? a .Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action, and the follow-up action taken. b. Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action,and the follow-up action taken. c. Immediately terminate employment for the party found in non-complia...

AAPC CPB - Chapter 1 Review | Questions and Correct Answers Latest Update 2024 What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index - Answer - c. Protected Health Information A new radiology company opens in town. The manager calls your practice and offers to pay $20 for every Medicare patient you send to them for radiology services. What does this offer violate? a. Stark Laws ...

AAPC CPB - Chapter 1 Review Question Test 2024. What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index - correct answer c. Protected Health Information A new radiology company opens in town. The manager calls your practice and offers to pay $20 for every Medicare patient you send to them for radiology services. What does this offer violate? a. Stark Laws b. HIPAA c. Anti-Kic...

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

Fraud and Abuse - ANSWERacts of providers that are deemed to have defrauded the government or abused the right to bill for services rendered abuse - ANSWER(are accidents) may directly or indirectly result in unnecessary costs to a program such as medicare or medicaid, improper payment, or payment for services that fail to meet professionally recognized standards of care or that are medically unnecessary fraud - ANSWERdefined as knowingly and willfully executing or attempting to execute a s...

AAPC CPB - Chapter 1 Review | Questions and Correct Answers Latest Update 2024 What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index - Answer - c. Protected Health Information A new radiology company opens in town. The manager calls your practice and offers to pay $20 for every Medicare patient you send to them for radiology services. What does this offer violate? a. Stark Laws ...

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. According t...

True or False: Risk Management aligns with Quality Management in determining measures for risk avoidance and prevention - TRUE Your organization recently completed a contemporaneous audit of laboratory billing practices and found that copays have been written off. Which of the following should be your next step? a. Talk to the billing department to see why this is happening b. Conduct a retrospective audit to see if this occurred in the past c. Self-disclose this issue to limit the chance...