1. What document is referenced to when looking for potential
problem areas identified by the government indicating scrutiny
of the services within the coming year?
A) OIG Compliance Plan Guidance
B) OIG Security Summary
C) OIG Work Plan
D) OIG Investigation Plan - ANS -C (Rationale: Twice a year, the
OIG releases a Work Plan outlining its priorities for the fiscal
year ahead. Within the Work Plan, potential problem areas
with claims submissions are listed and will be targeted with
special scrutiny.)
,2. What form is provided to a patient to indicate a service may not
be covered by Medicare and the patient may be responsible for
the charges?
A) LCD
B) CMS-1500
C) UB-04
D) ABN - ANS -D (Rationale: An Advanced Beneficiary Notice
(ABN) is used when a Medicare beneficiary requests or
agrees to receive a procedure or service that Medicare may
not cover. This form notifies the patient of potential out of
pocket costs for the patient.)
3. Under HIPAA, what would be a policy requirement for
"minimum necessary"? "
A) Only individuals whose job requires it may have access to
protected health information.
, B) Only the patient has access to his or her own protected
health information.
C) Only the treating provider has access to protected health
information.
D) Anyone within the provider's office can have access to
protected health information. - ANS -A (Rationale: It is the
responsibility of a covered entity to develop and implement
policies, best suited to its particular circumstances to meet
HIPAA requirements. As a policy requirement, only those
individuals whose job requires it may have access to
protected health information.)
4. Which statement describes a medically necessary service? :
A) Performing a procedure/service based on cost to eliminate
wasteful services.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller DoctorKen. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
