Abuse fwa – 2 - Study guides, Class notes & Summaries

Fraud Waste and Abuse (FWA) Training with Complete SolutionsFraud Waste and Abuse (FWA) Training with Complete SolutionsFraud Waste and Abuse (FWA) Training with Complete SolutionsFraud Waste and Abuse (FWA) Training with Complete Solutions How to recognize FWA in the Medicare Program - ANSWER-Knowledge of the law including the Civil False claims Act, Health Care Fraud Statute, and Criminal Fraud, Anti-Kickback Statute, Stark Statute, Exclusion from all Federal healthcare programs, and the He...

2024 Medicare+ Fraud, Waste, and Abuse Already Rated A+ 1. You are tasked with submitting a risk diagnosis to the Centers for Medicare & Medicaid Services (CMS) for payment, and your supervisor tells you to ignore the Sponsor's process and adjust or add risk diagnosis codes for certain individuals. What should you do? - ️ Report the incident to the compliance department (via compliance hotline or other mechanism). 2. You are performing a regular inventory of the controlled substances ...

HCCA CHC Final Exam Practice Questions With Answers (MASTER FLASHCARDS) | 100% Verified. 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 Frist level - redetermination by Medicare contractor Second level - reconsideration by Independent contractor Third appeal...

UHC 2022 Ethics and Compliance Test – Questions and Answers Agent John is planning to conduct a series of events. Some will be strictly educational, others will be formal presentations of specific UnitedHealthcare plans, and others will be informal marketing events where he can generate leads and schedule future in-home marketing appointments. Of the three types of events John plans to conduct, which need to be reported to UnitedHealthcare? Correct Ans - ******* When completing an ...

UHC 2019In terms of events, which of the following is true? - correct answer Agents are required to report all events (marketing/sales and education) to UnitedHealthcare according to Company policy You have a scheduled appointment with a Consumer to discuss DSNPs. The consumer has completed the SOA form. Two days before the appointment, the consumer calls and requests to discuss PDP plans, which you are also certified to sell. What should you tell the consumer? - correct answer Tell the consu...

HCCA - CHC (MASTER FLASHCARDS) Exam Questions With Answers Latest | Graded A+. According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer-1.Protect our programs 2.Protect your patients 3.Protect the Provider #:~:text=Proper%20documentation%2C%20both%20in%20patients,to%20prot ect%20you%20the%20provider. At which level of the Medicare Part A or Part B appeals process is the appeal decision by the Office of Medicare Hearings...

Fraud Waste and Abuse (FWA) Training How to recognize FWA in the Medicare Program - ANS Knowledge of the law including the Civil False claims Act, Health Care Fraud Statute, and Criminal Fraud, Anti-Kickback Statute, Stark Statute, Exclusion from all Federal healthcare programs, and the Health Insurance Portability and Accountability Act. Civil False Claims Act - ANS Makes a person liable to pay damages to the government if 1. He or she knowingly conspires to commit FWA. 2. Carries ...

2022 United HealthCare - Ethics and Compliance 1. In terms of events, which of the following is true? 2. When completing an enrollment application in LEAN, why is an agent prohibited from entering their own email address in a field available for the consumer's email address? 3. Annual Election Period (AEP) is a time when 4. You have scheduled an appointment and obtained a Scope of Appointment (SOA) form to discuss Medicare Advantage Plans with a consumer. When you arrive at the appointment, a f...

UHC Ethics & Compliance 2022 What type of events must an agent report to UnitedHealthcare? While using LEAN to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address. What should Jeff do? Which election period occurs from October 15 to December 7? Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing/sales event? You have scheduled an appointment and obtained a Scope of App...

CHC Random Study Questions With 100% Verified Answers Fill in the blank: The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS- OIG, establish "core elements" for provider and supplier compliance programs within a particular industry or sector. - answerAffordable Care Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter 21, Section 30 of the "Medicare Managed Care Manual": All sponsors are required to a...