Audit retrospective - Study guides, Class notes & Summaries

CRC Practice Exam Review questions With 100% Correct Answers Which of the following medications are prescribed to cancer patients to eradicate the cancer or for prophylaxis? I. Tamoxifen II. Anastrozole III. Januvia IV. Crestor - answerI and II The definition of a best medical record for a RADV audit is: A. Documentation validates the CMS requested HCCs, contains all the necessary documentation elements and has an additional HCC not requested by CMS B. Documentation that validates all...

Property and Casualty Insurance Basics Latest 2024 Graded A+ INSURABLE INTEREST an economic interest in a property that must exist at the time of loss (you can insure the equity interest in your own home) UNDERWRITING classifies the applicant based upon the underwriting requirements of the insurer; matches the risk presented with the premium charged by the insurer LOSS RATIO percentage of claims paid in comparison to total premiums collected during a particular period of time R...

Compliance 101 - Glossary of Compliance Terms 2023/2024 questions and answers Anti-Kickback Statute - answer-Prohibits the solicitation, receiving, offering, or paying of any remuneration directly or indirectly in cash or in-kind exchange. Attestation - answer-The affirmation by signature, usually on a printed form, that the action outlined has been accomplished by the individual signing; e.g., the individual has read the code of conduct and agreed to adhere to its principles. Attorney-Cl...

CRC Practice Exam Review questions With 100% Correct Answers Which of the following medications are prescribed to cancer patients to eradicate the cancer or for prophylaxis? I. Tamoxifen II. Anastrozole III. Januvia IV. Crestor - answerI and II The definition of a best medical record for a RADV audit is: A. Documentation validates the CMS requested HCCs, contains all the necessary documentation elements and has an additional HCC not requested by CMS B. Documentation that validates all...

CHC Practice Questions Clearly Solved 2024.A compliance professional has been working with a department director to implement a new policy regarding timely completion of medical records. Which of the following should be completed by the department manager to promote compliance with the new policy? a. Statistically valid sampling audit b. Monitoring c. Discovery Audit d. Retrospective Audit - Answer b. Monitoring For monitoring activities, OIG uses the term regularly to describe the frequ...

A compliance professional has been working with a department director to implement a new policy regarding timely completion of medical records. Which of the following should be completed by the department manager to promote compliance with the new policy? a. Statistically valid sampling audit b. Monitoring c. Discovery Audit d. Retrospective Audit - Answer b. Monitoring For monitoring activities, OIG uses the term regularly to describe the frequency of review. Which factors should an o...

CMCA PRACTICE EXAM 136 Questions with Verified 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 - CORRECT ANSWER D. All the above Report cop...

CHC exam questions and answers 2024 Chapter 8 Federal Sentencing Guidelines (FSG) -Answer-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 -Answer- 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 ult...

Risk Adjustment CRC exam questions With Verified Answers Interactions - answerWhat are extra RA values or factors added when a patient has more than one major significant dx identified in model ? Quality, Promoting Interoperability, Improvement Activity, Cost - answerMIPS Collection Types Categories When are Star Ratings publicly published? - answerOctober of each year HEDIS types of collection - answerSurveys, Medical Chart Reviews, Insurance Claims, Medical Office Visits, Procedures W...

CHC Practice Questions With 100% Verified Answers A compliance professional has been working with a department director to implement a new policy regarding timely completion of medical records. Which of the following should be completed by the department manager to promote compliance with the new policy? a. Statistically valid sampling audit b. Monitoring c. Discovery Audit d. Retrospective Audit - answerb. Monitoring For monitoring activities, OIG uses the term regularly to describe th...