Chc practice s - Study guides, Class notes & Summaries

CHC Auditing & Monitoring (2) 2023 A healthcare provider must repay to Medicare money paid for a specific type of billed claim. What type of audit is the MOST likely one used to identify the amount of repayment? - Answer-Full statistical audit A Physician practice are having a hard time determining which claims have been paid in full, and which claims have not been paid at all. What test would be practical for the group to perform to validate the claims that have been paid or not paid...

CHC Auditing & Monitoring (1) 2023 True or False: Risk Management aligns with Quality Management in determining measures for risk avoidance and prevention - Answer-TRUE Your organization recently completed a contemporaneous audit of laboratory billing practices and found that copays have been written off. Which of the following should be your next step? a. Talk to the billing department to see why this is happening b. Conduct a retrospective audit to see if this occurred in the past ...

CHC Random Study Questions 4 Already Passed You are the new compliance officer for a hospital and see that it is currently under an OIG CIA. What would be the first course of action in your new position? a. Review the current OIG Work Plan and update the audit schedule for the hospital. b. Review the Code of Conduct and Policies and Procedures and update them as appropriate. c. Meet with the Compliance Board and discuss your vision of how compliance will be run in the future. d. Review the a...

CHC exam questions and answers already passed Chapter 8 Federal Sentencing Guidelines (FSG) Guidelines and policy in this section apply to sentencing in federal criminal prosecution when the convicted defendant is an organization FSG- 4 factors that increase ultimate punishment of an organization 1.Involvement in or tolerance of criminal activity 2.Prior history of the organization 3.The violation of an order 4.The obstruction of justice FSG- The two factors that mitigate the ultimate punishme...

HCCA - CHC Study Questions (MASTER FLASHCARDS) 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). Ans- True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) Ans- 1.Protect our programs 2.Protect your patients 3.Protect the Provider #:~:text=Proper%20documentation%2C%20b...

CHC - CCB Practice Test All Answers Correct Rated A+ Organizations receiving more than $5 million in Medicaid funds must provide education on the False Claims Act (FCA) in accordance with the: a. Stark Laws b. Deficit Reduction Act (DRA) c. Anti-Kickback (AKS) Law d. Sherman Antitrust Law Ans- b. Deficit Reduction Act (DRA) An Organization identifies a potential issue when reviewing personal services and management contracts. Which of the following should the compliance professional ...

primary care questions with complete solution latest 2023primary care vs. primary health care primary care vs. primary health care Q: What is the difference between primary care and primary health care? A: Primary care is essentially about care for sick or injured individuals based in the community. It is often based around medical care ('primary medical care') but may also involve allied health, nursing care or alternative therapies. Primary health care is broader in that can also d...

primary care questions and answers 100% correctprimary care vs. primary health care primary care vs. primary health care Q: What is the difference between primary care and primary health care? A: Primary care is essentially about care for sick or injured individuals based in the community. It is often based around medical care ('primary medical care') but may also involve allied health, nursing care or alternative therapies. Primary health care is broader in that can also deals with ...

Health Care Systems Where people go for health care services. Inpatient Settings Admitted to the hospital Stay at least 24 hours Outpatient Settings Only receives treatment for a few hours Does not stay overnight Observation Status Not admitted to the hospital, although is staying overnight More common in inpatient hospitals Ownership - Public Federal Federal Government agencies operate the hospital Department of Veterans Affairs - VA Medical Center ...

Health Care Systems Where people go for health care services. Inpatient Settings Admitted to the hospital Stay at least 24 hours 00:01 01:31 Outpatient Settings Only receives treatment for a few hours Does not stay overnight Observation Status Not admitted to the hospital, although is staying overnight More common in inpatient hospitals Ownership - Public Federal Federal Government agencies operate the hospital Department of Veterans Affairs - VA Me...