Medicare fraud abuse - Study guides, Class notes & Summaries

AEtna Sample Exam Questions with Answers Latest Grade A+ 2023/2024. Broker Services - Reports What report(s) are available on Aetna Producer World? a. Your Medicare book of business b. Monthly Commission Report (Two years of monthly data is available) c. License reports d. A and B e. All of the above - correct answer E. all of the above Ready To Sell - Agent RTS Requirements You will need to successfully complete which requirements to be Ready to Sell (RTS) with Aetna Medicare? a. Pass...

AHIP TRAINING Medicare Fraud, Waste, and Abuse Training Practice Questions and Answers 100% Pass Medicare plan means - Correct Answer ️️ -A MA plan, MA-PD plan or PDP Subcontractor means - Correct Answer ️️ -**An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as an agent who has a contract wit...

AHIP 2025 Exam Prep| Qs & As| 100% Correct| Grade A (Verified Answers) Q: At a minimum, an effective compliance program includes four core requirements. Answer: False Q: What are some of the consequences for non-compliance, fraudulent, or unethical behavior? Answer: All of the above Q: Correcting non-compliance________. Answer: Protects enrollees, avoids recurrence of same non-compliance, and promotes efficiency Q: What is the policy of non-retaliation...

Medicare Fraud, Waste, & Abuse (2022/2023) (Certified Answers) Your job is to submit a risk diagnosis to the Centers for Medicare & Medicaid Services (CMS) for the purpose of payment. As part of this job, you use a process to verify the data is accurate. Your immediate supervisor tells you to ignore the Sponsor's process and to adjust or add risk diagnosis codes for certain individuals. What should you do? a.Do what your immediate supervisor asked you to do and adjust or add risk diagnosis co...

AHIP TRAINING Medicare Fraud, Waste, and Abuse Training 2024 with complete solution

AHIP TRAINING Medicare Fraud, Waste, and Abuse Training Practice Questions and Answers 100% Pass Medicare plan means - Correct Answer ️️ -A MA plan, MA-PD plan or PDP Subcontractor means - Correct Answer ️️ -**An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as an agent who has a contract wit...

AHIP TRAINING Medicare Fraud, Waste, and Abuse Training Practice Questions and Answers 100% Pass Medicare plan means - Correct Answer ️️ -A MA plan, MA-PD plan or PDP Subcontractor means - Correct Answer ️️ -**An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as an agent who has a contract wit...

Medicare plan means Correct Answer: A MA plan, MA-PD plan or PDP Subcontractor means Correct Answer: **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as an agent who has a contract with an agency or filed marketing organization that contract with a Medicare plan. FWA Training: A compliance prog...

AHIP TRAINING Medicare Fraud, Waste, and Abuse Training Questions and Answers 100% Solved Medicare plan means A MA plan, MA-PD plan or PDP Subcontractor means **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as an agent who has a contract with an agency or filed marketing organization that contr...

An Example of Health Plan Employee abuse - Maria Adams works for a Medicare plan. She uses the plan's email to send out information to enrollees of the plan promoting her husband's sports memorabilia business. (This activity would also be in violation of HIPPA privacy rules) AUDIT - **A methodical examination and review of data or processes with the purpose of verifying the data's accuracy or whether established processes are in place or are properly followed. Civil Monetary Penalties - ...