According to the oig Study guides, Class notes & Summaries

CPCS/CPMSM Sample Questions Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to the Joint Commission, who may amend the medical staff bylaws? - Governing Body Failure to meet the established qualifications and criteria for appointment should be reported to whom? - The applicant NCQA requires the MCO to obtain a minimum of ???? years of work history? - 5 years According to NCQA what policy must an organiza...

AAPC ICD10 Physician Coding for CPC Preparation (All Exams QUESTIONS AND ANSWERS GRADED A LATEST VERSIONS) with rationale Review Test Submissio n: Chapter 1 Quiz • Question 1 10 out of 10 points What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services within the coming year? Selected Answer: Correct Answer: Response Feedback: c. OIG Work Plan c. OIG Work Plan Rationale: Twice a year, the O...

What anatomical or compartment contains all the thoracic viscera except the lungs? - Mediastinum Who is responsible for enforcing the HIPAA security rule - Office of Civil Rights (OCR) ABN - Advance Beneficiary Notice According to the OIG, internal monitoring and auditing should be performed by what means? - Periodic audits What does the abbreviation MAC stand for? - Medicare Administrative Contractor How many lobes make up the RIGHT lung? - the right has 3 lobes the left has 2 lobes

What anatomical or compartment contains all the thoracic viscera except the lungs? - correct answer Mediastinum Who is responsible for enforcing the HIPAA security rule - correct answer Office of Civil Rights (OCR) ABN - correct answer Advance Beneficiary Notice According to the OIG, internal monitoring and auditing should be performed by what means? - correct answer Periodic audits What does the abbreviation MAC stand for? - correct answer Medicare Administrative Contracto...

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). True According to HHS-OIG - what are three important reasons for proper documentation in Compliance? 1.Protect our ___________________ 2.Protect your ___________________ 3.Protect the ___________________ 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the ...

CPMA Exam Questions with All Correct Answers The Joint Commission (JC) requires the Factors that Affect Learning must be assessed for a hospital or hospital owned physician practice as well as other health care facilities. When assessing this element what does this include? A. The patient's ability to read, method of learning and understanding. B. Any language or physical disabilities. C. Cultural beliefs. D. All the above - Answer-D. All the above Report copies and printouts, f...

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...

CPCO prep exam questions & answers 2023/2024 Does Medicare pay for all tests ordered by Providers? - ANSWER-No, they need to determine if it's covered and medically necessary. For larger physician practices, how often does the OIG suggest reporting compliance activities to the board of directors? - ANSWER-Regularly According to the OIG, medically unnecessary services can be billed to Medicare for what purpose? - ANSWER-To receive a denial so a claim can be submitted to a secondary pa...

CPMA Exam Questions with All Correct Answers The Joint Commission (JC) requires the Factors that Affect Learning must be assessed for a hospital or hospital owned physician practice as well as other health care facilities. When assessing this element what does this include? A. The patient's ability to read, method of learning and understanding. B. Any language or physical disabilities. C. Cultural beliefs. D. All the above - Answer-D. All the above Report copies and printouts, ...

CPC FINAL EXAM PREP • Question 1 10 out of 10 points What form is provided to a patient to indicate a service may not be covered by Medicare and the patient may be responsible for the charges? Selected Answer: Correct Answer: Response Feedback: d. ABN d. ABN Rationale: An Advanced Beneficiary Notice (ABN) is used when a Medicare beneficiary requests or agrees to receive a procedure or service that Medicare may not cover. This form notifies the patient of potential ou...