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RHIT D3 Compliance Exam With Complete Solutions Latest Update
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RHIT D3 Compliance Exam With CompleteSolutions Latest Update
OASIS data are used to assess the____ of home health services. - ANSWER [Outcome].
OASIS is Outcomes and Assessment Information Set. Designed to gather data about
outcomes for Medicare patient who receive service from home health.
A statement or guideline that directs decision making or behavior in organization is
called a: - ANSWER [Policy]
What are three risk areas that are vitally important to the accuracy of the claims
submission process. Which are fraudulent billing practices a major compliance risk for
health care organizations. - ANSWER [Coding and billing, documentation, and medical
necessity for tests and procedures]
Which of the following are considered to be high risk of compliance within billing
practices? - ANSWER [Billing for non-covered services, altered claim forms, duplicate
billing, misrepresentation of facts on a claim form, failing to return overpayments,
unbundling, billing for medically unnecessary services, overcoding and upcoding,
billing for items or services not rendered, and false cost reports
What is healthcare fraud? - ANSWER [false representation of fact, failure to disclose a
material fact, or damage to another party that reasonably relied on misrepresentation]
Corporate compliance programs become common/blueprint for an effective compliance
program for healthcare organization after adoption of__________ - ANSWER [The US
federal Sentencing Guidelines], they outline seven steps as the hallmark of an effective
program to prevent and detect violation of law.
There are a number of legal issues facing the EHR. State laws vary as to what is and is
not acceptable in a court of law regarding EHRs. What is a legal concern regarding the
EHR? - ANSWER [Ability to subpoena audit trails]. Health care providers frequently
, receive subpoenas requesting the production of the medical record.
Accreditation granted to healthcare organization based on whether the organization
has met a set of voluntary standards of accreditation agency is
called:-ANSWER[Accreditation]. for example The Joint Commission is an accreditation
agency
Who outlined elements of compliance program?- ANSWER[The OIG (office of inspector
general)] outlined seven elements as the minimum necessary for a comprehensive
compliance program.
List of elements for an Effective Compliance
Program. - ANSWER They are:1)Implementing written policies, procedures and
standards of conduct; 2)Designating a compliance officer and compliance committee 3)
Conducting effective training and education 4)Developing effective lines of
communication 5) Enforcing standards through well publicized disciplinary guidelines 6)
Conducting internal monitoring and auditing 7) Responding promptly to detected
offenses and developing corrective action.
A group practice has hired an HIT as its chief compliance officer. Written standards of
conduct, policies and procedures in respect to substantive areas where the business is
particularly vulnerable to fraud are already there in the present compliance program.
Auditing for compliance is also conducted under the present compliance program.
Besides the above, compliance officer should ensure what other following are in place?
- ANSWER [Establishment of a hotline to receive complaints and adoption of procedures
to protect whistleblowers from retaliation]. But this is one of the seven elements OIG
outlined; internal monitoring and auditing is just maintenance of a process.
In developing a coding compliance program, which of the following would ordinarily be
included as participants in coding compliance education? - ANSWER [Current coding
personnel, Medical staff, Newly hired coding personnel] HIM manager should provide
education, training related to complete and accurate coding, documentation and billing
on an ANNUAL basis. Annually require by compliance for coding staff should be
updated the compliance.
HCUP is a major initiative of what organization in the federal government? ANSWER
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