Exclusion statute Study guides, Class notes & Summaries

AAPC CPB Chapter 1-5Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - correct answer d. Physician unique identifier number A physician received office space at a reduced rate for referring patients to the hospital's out- patient physical therapy ce...

CON 3900 Exam Questions and Answers 100% Verified Express Actual Authority: - answerAuthority explicitly given to the agent through the principal's written or oral instructions Implied Actual Authority: - answerauthority to do what is usual, customary and necessary to accomplish the action. No express agreement Apparent Authority: - answersomeone reasonably believes an individual has the authority to act on the behalf of the government Delegation of authority: - answerhe FAR and states ...

WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? - Correct ️️ 1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and health plan request and denial. Exclusion Statute - Correct ️️ 1.Physician is banned from participating in any federal or state healthcare program by OIG 2. They can't bill federal or state f...

AAPC CPB Chapter 1-5. Questions and answers, rated A+ Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - -d. Physician unique identifier number A physician received office space at a reduced rate for referring patients to the hospital's out- patient...

AAPC Chapter 1 CPB: Exam Review Questions and answers/ A physician received office space at a reduced rate for referring patients to the hospital's outpatient physical therapy center. What Law does this violate? 1. Anti-kickback Statute 2. Stark Law 3. False Claims Act 4. Truth in Lending Act - -Anti-Kickback Statute Rationale: The anti-kickback Laws states that anyone who knowingly or willing accept or offer any items or services to induce referral is a violation of the law. Feder...

Circular 230 - correct answer Regulations governing the practice of attorneys, certified public accountants, enrolled agents, enrolled actuaries, and appraisers before the IRS. Disclosure - correct answer The release of tax information by an IRS employee. Due Diligence - correct answer Requirements that tax professionals must follow when preparing income tax returns. Noncompliance - correct answer Failure or refusal to comply with the tax code. Privilege - correct answer Protection f...

Idaho Casualty Exam Questions and Answers (Graded A+) another name for insurance agent is: principal producer broker recorder - producer another name for insurer is: principal producer broker policymaker - principal The Broad Form Products Coverage endorsement in commercial auto policies does which of the following? Adds property coverage Removes the defective products exclusion Adds the defective products exclusion Removes property coverage - Removes the defective pr...

Under a long-term care inflation rider, the benefit levels - ANS periodically increase without proof of insurability In order for a health plan to be an "accountable health plan", who has to approve it? - ANS the director Medicare Part A coinsurance payments are covered by - ANS Medicare Supplement Plan A Employees generally receive workers compensation benefits for - ANS lost wages and medical expenses due to occupational accidents What year was the Mental Health Parity an...

5 most important federal fraud and abuse laws: correct answers *False Claims Act (FCA) *Anti - kickback Statute (AKS) *Physician Self-Referral Law (Stark I II III ) *Exclusion Authorities *Civil Monetary Penalties Law (CMPL) The purpose of EMTALA is to prevent: a. Hospitals from rejecting patients in a discriminatory manner by, refusing treatment, or transferring patients to "charity hospitals" or "county hospitals," because they are unable to pay. b. Hospitals from admitting patien...

CON 3900 Exam Questions and Answers 100% Verified Express Actual Authority: - answerAuthority explicitly given to the agent through the principal's written or oral instructions Implied Actual Authority: - answerauthority to do what is usual, customary and necessary to accomplish the action. No express agreement Apparent Authority: - answersomeone reasonably believes an individual has the authority to act on the behalf of the government Delegation of authority: - answerhe FAR and states ...