CRP: General Fraud Waste and Abuse exam 2023 with verified solutions
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Course
CRP: General Fraud Waste and Abuse
Institution
CRP: General Fraud Waste And Abuse
I work in Radiology and have noticed a specific nurse performs comprehensive exams on patients without documenting them. Despite not documenting the exams, I know patients still get a bill for them What should I do? correct answersReport the situation to my leader or compliance leader; what we bill...
CRP: General Fraud Waste and Abuse
I work in Radiology and have noticed a specific nurse performs comprehensive exams on patients without documenting them. Despite not documenting the exams, I know patients still get a bill for them What should I do? correct answersReport the situation to my leader or compliance leader; what we bill always needs to match documentation.
Recurring payment denials could indicate submission of false claims.
True or False? correct answersTrue
It is important to adequately document that services performed were medically necessary. True or False correct answersTrue.
My coworker is going through a tough time at home, and he's texted me several times within the last month to clock him in when he's running late. I want to help him out, but I don't want to get in trouble. He says it's not a big deal because he stays late and works off the clock. IS this an example of fraud? correct answersYes, it's fraud when an employee clocks-in another employee.
Which of the following situations may indicate a false claim: A: A physician performs a service she is not licensed for and bills the patient;
B: The billing system is programmed to insert diagnosis codes on a claim to pass Medicare claim edits;
C: A doctor applies his name to a claim even though he was not in the office and the nurse practitioner performed the service;
D: A medical coder does not see appropriate documentation for the codes that were chosen by the physician's office, so he reaches out to the physician for documentation clarification;
E: A medical coder is told to always code a physician's service a certain way, even if there is no documentation of the service in the medical record. correct answersA, B, C, E
A non-retaliation policy ensures that an employee who reports suspected violations in good faith will not
be subject to intimidation, threats, or coercion, or any retaliatory action. True or False correct answersTrue
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