Health care fraud - Study guides, Class notes & Summaries

Which piece of legislation mandated the establishment of a joint Health Care Fraud and Abuse Control program? HIPAA When an employee is a provider's office suspects fraudulent activity and uses the Office of Inspector General Hotline to report it, the employee should do which of the following? -Stop filing suspicious bills and claims -Pursue knowledgeable legal counsel -Disengage professionally with the suspected perpetrator. -Report and return overpayments Which of the follo...

Test Bank for Law and Ethics in the Business Environment 9e 9th Edition by Terry Halbert, Elaine Ingulli. Full Chapters test bank included CHAPTER 1 Law, Ethics, & Business: An Introduction Freedom versus Responsibility: A Duty to Rescue? Yania v. Bigan (Pennsylvania, 1959) Justifying the “No Duty to Rescue” Rule ■ John Stuart Mill, “On Liberty” Radical Change? ■ Steven J. Heyman, “The Duty to Rescue: A Liberal-Communitarian Approach” Podias v. Mairs (New Jersey, 200...

D220 Study Guide – If you see a ** by something, then that was seen on a D220 test by SOMEONE. According to some, there are handful of questions on the OA from the PA. Access Levels- User can only see information that they access to. (CNA cannot see everything an RN can) Administrative Safeguards of Electronic Health Information- Restricting access of all authorized users of the EHR according to their position within the healthcare system Admission-Transfer-Discharge (ADT) System - Classi...

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? Report the incident to the compliance department (via compliance hotline or other mechanism) You are performing a regular inventory of the contr...

The dental assistant is solely responsible for any acts or procedures performed in the dental office: True or False? (Ans- False A dental assistant's registration may be revoked for all EXCEPT the following: A. Violation of the rules of the SBDE B. Violation of the Texas Dental Practice Act C. Other applicable rules or statuses affecting radiological procedures in Texas D. Violations do not apply to dental assistants (Ans- D. Violations do not apply to dental assistants Which of t...

HIPPA Health Insurance Portability and Accountability Act of 1996 and the Healthcare Fraud and abuse control program. Far-reaching program to combat fraud and abuse in healthcare including both public and private health plans. Individuals protected health information Demographic data, name, address, birth date, and SS number. central focus of clinical documentation should be to demonstrate the quality of care provided to the patient with detail and accuracy to facilitate optimum...

Which of the following is an example of the best practice strategy to prevent fraud, waste, and abuse? - Establish procedures for maintaining and distributing medication samples If health care providers accept free drug samples from manufacturers, a best practice strategy to prevent fraud, waste, and abuse entails establishing procedures to prevent providers or employees from using free samples for personal gain. HIPAA mandated that health care entities implement which of the following stra...

Health Insurance Portability and Accountability Act (HIPPA) mandated that health care entities implement which of the following strategies to help reduce the Medicare fee-for-service error rate and prevent payment for potential fraudulent activity? - Answer: electronic health records Rationale: Electronic health records reduce the error of false claims. They are also more likely to be more thorough. Which of the following health care resources or services is most vulnerable to fraud, waste,...

CHAPTER1: ANSWERS AND RATIONALES 1. Which change represents the primary impetus for the end of the era of the female lay healer? 1. Perception of health promotion as an obligation 2. Development of a clinical nurse specialist position statement 3. Foundation of the American Association of Nurse-Midwives 4. Emergence of a medical establishment Page: 4 Feedback 1. . Lay healers traditionally viewed their role as being a function of their community obligations; however, the emerging medical establi...

CPH Exam Practice Test Bank Prep_ Answered_2022. Many people do not attempt to decrease unhealthy behaviors such as overeating or smoking because they lack the confidence that they can successfully change. This is an example of: (A) Perceived susceptibility (B) Perceived severity (C) Perceived self-efficacy (D) Perceived response efficacy The construct of normative beliefs is from which model/theory? (A) Transtheoretical model (B) Theory of reasoned action/planned behavior (C) So...