MEDICAL CODING WEEK 1 QUESTIONS
AND ANSWERS WITH SOLUTIONS 2024
Medicare defines fraud as an intentional deception or misrepresentation that an individual knows to be
false or does not believe to be true and makes it knowing that the deception could result in some
unauthorized benefit to himself/herself or some other person. - ANSWER True
Which of the following is NOT an incentive for providers to participate in the Medicare program?
a. Blue Cross Blue Shield
b. Aetna
c. The federal government
d. The states - ANSWER C Federal Government
What may a QIO charge a patient?
a. Amounts over what is allowed by the insurance
b. The adjustment
c. Premiums
d. Deductibles and copays - ANSWER D. deductibles and copays
Accurate billing and coding is only the physician's responsibility. - ANSWER False
Which of the following is FALSE regarding non-QIO providers?
a. Payment goes to the patient when assignment is not accepted
b. Slower processing of claims
c. MSN is sent to the patient
d. Bonuses are offered as incentive - ANSWER D. bonuses are offered as incentive
A Non-QIO has the same fee schedule as a QIO. - ANSWER False
Falsifying statements to justify payment is one of the most common forms of fraud. - ANSWER True
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