Exam (elaborations)
Intro Exam #1 Pt. 2 (Fraud, abuse and waste) with 100% correct answers 2024
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Intro Exam #1 Pt. 2 (Fraud, abuse and waste) with 100% correct answers 2024
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IntroExam
#1
Pt.
2
(Fraud,
abuse
and
waste)
with
100%
correct
answers
2024
What
is
the
major
distinction
between
fraud
and
abuse?
Fraud
involves
intentional
deception
or
misrepresentation
while
abuse
does
not
Penalties
under
the
false
claims
act
are:
monetary
penalties
of
between
$5500
and
$11000
per
claim,
plus
3
times
the
damages
sustained
by
the
government
documentation
is
important
for
which
reasons
(3)
-it
serves
as
record
of
pt
care
-it
supports
the
medical
necessity
of
claims
submitted
-it
serves
as
a
communication
vehicle
among
providers
what
could
be
considered
fraud?
(3)
-billing
for
services
not
rendered
-upcoding
services
-using
unqualified
individuals
to
provide
services
T/F
changing
the
contents
of
medical
records
can
escalate
the
matter
from
an
audit
to
a
criminal
act
True
What
is
not
an
acceptable
billing
practice?
Aquatic
therapy
does
not
require
1-on-1
contact
btw
PT/PTA
and
pt
in
order
to
be
billed
as
individual
therapy
A
violation
of
the
Anti-kickback
Statue
could
include:
either
offering
or
receiving
any
form
of
payment
in
exchange
for
referrals
of
medicare
and
medicaid
patients
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