Ans qui tam - Study guides, Class notes & Summaries

CCEP Certified Compliance and Ethics Professional 101 Exam Questions and Answers Latest (2024 / 2025) (Verified Answers by Expert) compliance program ANS prevention, detection, collaboration, and enforcement 2. Effective compliance program ANS must be an ongoing process and commitmentto an ethical way of conducting business 3. Office of Inspector General and Justice Department ANS is responsible for enforc-ing the rules and regulations under the Medicare and Medicaid laws outline as partof...

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 ...

AAPC CPB Final Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: ANS: covered entity Which of the following is not a covered entity in the Privacy Rule ANS: healthcare consulting firm A request for medical records is received for a specific date of service from patient's insurance company with regards to a submitted claim. No authorization for release of information is provided. What action should be taken? ANS...

HCCA - CHC Study Questions (MASTER FLASHCARDS) 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). - ANS True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - ANS 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which l...

CHC exam Questions and Answers 2023 Chapter 8 Federal Sentencing Guidelines (FSG) Ans- Guidelines and policy in this section apply to sentencing in federal criminal prosecution when the convicted defendant is an organization FSG- 4 factors that increase ultimate punishment of an organization Ans- 1.Involvement in or tolerance of criminal activity 2.Prior history of the organization 3.The violation of an order 4.The obstruction of justice FSG- The two factors that mitigate the ultimat...

CPB Final Exam Questions & Answers 2023 ( A+ GRADED 100% VERIFIED)

CPB PRACTICE EXAM QUESTIONS AND ANSWERS LATEST 2022 WHO IS COVERED BY CHAMPVA? A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES B) ACTIVE DUTY MILITARY AND THEIR FAMILIES C) RETIRED MILITARY AND THEIR FAMILIES D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 - ANS- A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY ...

CHC Practice Test 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 - ANS 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; fou...

HCDS Final Questions HCDS Final n a cross-cultural patient encounter, where the patient does not speak the same language as the provider, the clinician should do which of the following? - ANS Use a professional interpreter or interpreter service What is the coding system for procedures? - ANS CPT Which of the following is TRUE regarding employer-based health care coverage? - ANS If the employee becomes unemployed, he/she loses the health care cove...

Stark or Physician Self-Referral Law - CORRECT ANS 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) - CORRECT ANS Prohibits the solicitation, receiving, offering...