1. 1. You see a patient for a routine medication visit. At the end of the session, the patient asks questions and the session ends up 50 minutes in length.You normally charge for the 30-minute appointment, but instead you charge for the 1-hour appointment. The 1-hour appointment includes a full bod...
ANCC IQ domain 5
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1. 1. You see a patient for a routine medication health and
visit. At the end of the session, the patient substance use
asks questions and the session ends up 50 disorder benefits
minutes in length.You normally charge for the are no lower than
30-minute appointment, but instead you any such dollar
charge for the limits for medical
1-hour appointment. The 1-hour
appointment includes a full body
assessment that you did not perform. This
violation is known as:
- Over-coding
- Super-coding
- Down-coding
- Up-coding
2. 1. During a session, your patient asks to be
able to contact you via your Facebook page
on the internet. You reply:
- I cannot do that because I have a
concealed Facebook identity; and I cannot
reveal that to my patients
- I would be happy to communicate with you.
It makes it easier for me to reach you this
way.
- I would be happy to use Facebook but you
will have to use a private message so that you
can be anonymous
- I cannot do that because Facebook does
not protect your Private Health Information
3. 1. The Mental Health Parity and Addiction
Equi- ty Act of 2008 (MHPAEA) insures which
of the following?
- Small employers who insure 50 or fewer
cov- ered lives are exempt from the
provisions of this MHPAEA law.
- Annual or lifetime dollar limits on mental
1/
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Up-coding
Rationale: Up-coding is a fraudulent practice
in which the provider ser- vices are billed at
high- er procedure codes than were actually
performed, resulting in a higher pay- ment by
Medicare or oth- er third-party payers.
- I cannot do that because Facebook does not
pro- tect your Private Health Information
Rationale: Using Face- book breaks pa-
tient-provider confiden- tiality, in addition to
blur- ring ethical boundaries of the therapeutic
relation- ship. Facebook does not protect
private health in- formation. Information on
the site is available for anyone to see or hack
into even if private messaged.
- Annual or lifetime dol- lar limits on mental
health and substance use disor- der benefits
are no lower than any such dollar lim- its for
medical and surgi- cal benefits offered by a
group health plan.
Rationale: The Mental
2/
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and surgical benefits offered by a group Health Parity and
health plan. Addic- tion Equity Act
- Mental health and substance use disorder of 2008 (MHPAEA)
benefits must be available through both in- provides fed- eral
net- work providers and out-of-network legislation that re-
providers by a group health plan. quires any annual or
- Group health plans may obtain an exemption life- time limits on
medical and surgical
benefits be the
if they can demonstrate expected cost increase same for mental
health
resulting from implementation of the parity and substance use dis-
pro- visions greater than a 5% increase in the order benefits. Small
cost under existing plan. em- ployers who insure
2 to 50 employees can
apply for an "opt-out"
waiver, but they are
not automatical- ly
exempt from the MH-
PAEA requirements.
The group health plan
will
be required to provide
in-network and out-of-
net- work mental
health and substance
use disorder benefits
only if it pro- vides
both in-network and
out-of-network med-
ical and surgical
bene- fits. The group
health plan my obtain
an exemption or
waiver if the first year
of implementation
results in 2% increase
in group health plan
costs over pri- or year
3/
, ANCC IQ domain 5
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that https://quizlet.com/_a1pxcr
covers the fol- lowing
year, and if imple-
mentation results in 1% increase in group
health plan costs in subsequent years. A
section on ac- tuarial determination of
4/
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