HCA Certification Training Exam Questions & Answers(SCORED A+)

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.Protect the Provider At which level of the Medicare Part A or Part B appeals process is the appeal decision by the Office of Medicare Hearings and Appeals (OMHA)? a. first level of appeal b. second level of appeal c. third level of appeal d. fourth level of appeal - ANSWER_c. third level of appeal What should CCO be able to do? (What skills should this person have?) Choose all that apply: a. Leadership skills. b. Oversee the coding department. c. Skills to design and implement a compliance program. d. Be able to anticipate new risk areas. e. Practical experience with documenting medical necessity. - ANSWER_a. Leadership skills, c. Skills to design and implement a compliance program, and d. Be able to anticipate new risk areas. What is the appeals process is the appeal decision by the Office of Medicare Hearings and Appeals (OMHA)? Frist level - _________________________ Second level - _________________________ Third appeal - _________________________ Fourth appeal - _________________________ Fifth appeal - _________________________ - ANSWER_Frist level - redetermination by Medicare contractor Second level - reconsideration by Independent contractor