Employee fraud - Study guides, Class notes & Summaries

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). - Answer- True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer- 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the Medicare Part A or Part B appeals process is the app...

Rules of Construction Help to identify and establish the intent of the parties to the contract Utmost good faith Each party is entitled to rely on the representation of the other, and each party should have a reasonable expectation that the other is acting in good faith without attempts to conceal or deceive. Aleatory Contract A contract under which one party's performance is contingent on an uncertain event. property and casualty agent has the power to bind the insurer...

MAN 320F Exam 1 Aroian (Oct 18) Study Guide with Complete Solutions Organizational Behavior - Answer️️ -The systematic study of the actions and attitudes that people exhibit within organizations. Goals of Organizational Behavior - Answer️️ --Explain -Predict -Influence/control Fundamental laws of business - Answer️️ -1) It always takes longer than you scheduled! 2) It always costs more than you budgeted! 3) When placed in difficult situation, people will take the path of le...

ERISA - Answer- Employee Retirement Income Security Act 1974 SOC Reports - Answer- Service Organization Controls: for external vendors SOC 1 - Answer- Internal Controls & Financial reports; used by auditors SOC 2 - Answer- Security, availability, processing integrity, confidentiality and privacy controls;used by management, regulators, and others under an NDA SOC3 - Answer- Same as SOC2, but available for public use. Tribble V Edison - Answer- Landmark court case re fiduciary resp...

Iowa dental board exam: jurisprudence questions and answers What are statutes? - Correct Answer️️ -Laws written by federal and state legislators Where is the dental practice act of Iowa located? - Correct Answer️️ -Iowa code chapter 153 What is the statute of limitations for malpractice related claims for adults in Iowa? - Correct Answer️️ -6 years Tort - Correct Answer️️ -A civil wrong or injury Malpractice - Correct Answer️️ -Failure to exercise reasonable care that...

In New Jersey, and insurer must provide at least______ advance notice for cancellation of property coverages for nonpayment of premium - Answer- 10 days The employment of another producer by a producer is subject to all of the following requirements, except a. the employer shall examine the credentials of the kinds of business described in the contract. b. the employer shall be responsible for the insurance related conduct of the employee c. the employee producer will conduct business und...

1. Principles are a. laws and regulations that guide behavior in the world of business. b. mores, values, and customs that guide behavior in general. c. specific and pervasive boundaries for behavior that are universal and absolute. d. the obligations businesses assume to maximize their positive impact and minimize their negative impact on stakeholders. e. the mores, values, and customs that parents teach their children. ANSWER: POINTS: DIFFICULTY: REFERENCES: LEARNING OBJECTIVES: NATIO...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...

What is the 1st offense penalty for engaging in the practice of residential building without a license? - Answer Not less than $5K and not more than $25K and/or 1 year What is the penalty for engaging in the practice of residential building, resulting in a death? - Answer Not less than $5K and not more than $50K and/or 4 years On your individual builder's license application, what should you write as your "business address"? - Answer Your personal address What is the cost of the indi...

AUI2601 Assignment 2 Semester 1 2023 () 100% TRUSTED workings, explanations and solutions. For assistance call or whatsapp us on +25479 811 9845 . QUESTION 1 39 marks The International Professional Practices Framework (IPPF) is the conceptual framework that organises authoritative guidance promulgated by the Institute of Internal Auditors (IIA). Some elements of the IPPF are mandatory and essential for internal auditors, meaning internal auditors are required to conform to these elements. MARKS...