How do you prevent fraud - Study guides, Class notes & Summaries

What is the purpose of HIPAA? -Answer • Protect PHI from unauthorized disclosure/use; • Prevent fraud, waste and abuse (via Administrative Simplification); • Make health insurance portable under ERISA; • Move health care onto a nationally standardized electronic billing platform Ref. More on HIPAA: HIPAA resides in which CFR section? -Answer 45 CFR sections 164.102 through 164.534 What are the subparts of HIPAA part 164? -Answer HIPAA - 45 CFR 164, subparts: ...

HCCA - CHPC Study Guide Questions 2024. What is the purpose of HIPAA? - Answer • Protect PHI from unauthorized disclosure/use; • Prevent fraud, waste and abuse (via Administrative Simplification); • Make health insurance portable under ERISA; • Move health care onto a nationally standardized electronic billing platform Ref. More on HIPAA: HIPAA resides in which CFR section? - Answer 45 CFR sections 164.102 through 164.534 What are the subparts of HIPAA part 164? - Answer...

The Medical Practice Act (MPA) effects only who?** PHYSICIANS*** TELEMEDICINE Providers to Patients IN Texas*** (exempt: armed services, emergency relief/good samaritan/consulting physicians from other states) A podiatrist needs who to co-admit a patient into the hospital?*** A Physician!*** (usually internal medicine doc) Standard License Requirements: - Age - Hours of College - Med school - GME - Licensing Exam - Medical JP Exam - must be 21 years old - 60 hours ...

2023 AHIP Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him? Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to the Medicare system...

NC BLET Crime PreventionDefinition of Crime Prevention - correct answers Strategies and measures that seek to reduce the risk of crimes occurring and their potential harmful effects on individuals and society, including fear of crime, by intervening to influence their multiple causes Things that MAY prevent crime - correct answers -Religion/religious conviction -New technology -Skill set -New laws -Punishment Crime Triangle consists of... - correct answers Skill, Opportunity, Desire/M...

Entire Contract Provision - ANSWER found at the beginning of the policy, saying that the policy cannot refer to any outside documents as being part of the contract and prohibiting the insurer from making any changes to the policy after it has been issued. (can only make good changes not bad) Insuring Clause - ANSWER sets forth the company's basic promise to pay benefits upon the insured's death. Free-Look Provision - ANSWER gives policyowners the right to return the policy for a full pre...

CFE- Investigation Verified Solutions System log System logs record events executed on an operating system, including miscellaneous events and those generated during system startup, like hardware and controller failures. Common types of system events include starting up and shutting down, configuration updates, and system crashes Open questions Open questions are those worded in a way that makes it difficult for the respondent to answer "yes" or "no." Also, the answer to an open qu...

SAS13 midterm 1: Winter 2024 Questions with 100% Correct Answers Robert Koch - Answer--Grandfather of microbiology!! -Created Koch's Postulates to definitively prove that microorganisms caused a disease -Furthered germ theory of disease -Foundational in pure cultures of microbes -Discovered the microbe causing tuberculosis - developed a "cure" based on tuberculin for TB but it was not effective in treating it (could actually kill people bc of the inflammatory response) hedwig koch - ...

WEBCE Test Questions And Answers With Latest Updates 2024 which of the following situations presents a situation of pure risk? -knowing that his family is depending on him, Frank wants to insure his life -wanting to increase his retirement savings, Saul invests his life savings in the stock market -Ralph takes a second mortgage on his house and uses the proceeds to gamble -wanting better job security, Ron cashes in his life insurance to start his own business knowing that his family is...

what are your responsibilities(3) CORRECT ANSWER prevent, detect and report medicare non-compliance as well as possible fraud, waste and abuse 1. comply with all requirements 2. report 3. follow organizations code of conduct how do you prevent fraud CORRECT ANSWER be up to date on laws coordinate with other payers correct/timely data/billing verify information be on lookout for suspicious activity CRIMINAL FRAUD CORRECT ANSWER KNOWING and WILLFULLY (intent) execute scheme or defraud...