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Fraud, Waste, and Abuse Exam Practice Questions and Answers (100% Pass)
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Fraud, Waste, and Abuse Exam Practice Questions and Answers (100% Pass)
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©PREP4EXAMS@2024/2025 REAL EXAM DUMPS Monday@ August 5@ 2024 6@07 PMFraud, Waste, and Abuse Exam Practice
Questions and Answers (100% Pass)
What is Fraud?
>Correct Answer-Intentional deception or misrepresentation made by a person with
the knowledge that the deception could result in some unauthorized benefit to
him/herself or some other person
What is Abuse?
>Correct Answer-Provider practices that are inconsistent with sound fiscal,
business, or medical practices, and result in an unnecessary cost to Health
programs, or in reimbursement for services that are not medically necessary or fail
to meet professionally recognized standards for health care.
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What is Waste?
>Correct Answer-The overutilization or inappropriate utilization of services and
misuse of resources
Examples of Potential Fraud, Waste & Abuse by Providers
Medical identity theft
Billing for items or services not rendered or not provided as claimed
Billing for equipment unnecessary supplies and services
Double billing resulting in duplicate payment
Performing services not medically necessary
Knowing misuse of provider identification numbers
Waiver of copayment or deductible
Billing for noncovered services
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