Stark legislation - Study guides, Class notes & Summaries

Medical Billing And Coding Exam Questions With Verified Solutions 100% 2024

CPMA Compliance and Regulatory Guidelines (Ch 1) Questions and Answers Scored A+ Operation Restore Trust (ORT) * Two year partnership of federal and state agencies working together to protect the healthcare trust fund through shared intelligence and coordinated enforcement * Three agencies involved: The Office of the Inspector General (OIG), the Health Care Financing Administration (now CMS), and the Administration on Aging (AoA). * Program is now called Senior Medicare Patrol (CMP) with the...

HIPAA - Answer What Act provides for criminal penalties for healthcare professional who "knowingly and willingly" attempt to defraud any health program What information is necessary to assign the correct Evaluation and Management (E/M) code for preventive medicine services? - Answer Preventive medicine services category codes are assigned based on the age of the patient Which of the following data elements is needed to accurately assign a CPT preventive medicine code? - Answer The age of...

At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified independent contractor? a. first level appeal b. second level appeal c. third level appeal d. fourth level appeal b. second level appeal There are five levels of appeal. First level entails a redetermination of claim; second level involves reconsideration by a qualified independent contractor; third level includes a hearing overseen by admin law judge; fourth level is a review of Medicar...

You have students from local psychiatric nurse practitioner programs follow you in your clinical practice to show them what you do as a Psychiatric Nurse Practitioner. This is called being a: a. Preceptor b. Mentor c. Professor d. Teacher A A Psychiatric Mental Health Nurse Practitioner providing psychiatric consultation makes a home visit after the police found an 86-year-old widow wandering the streets at 4AM after emergency call from her daughter. The woman has been living with he...

Role of nurse practitioner pmhnp Question with complete solution 2023Unlawful detention without a due process. Habeas Corpus Harmless mentally ill patients cannot be confined against their will if they can survive outside. Mental illness alone cannot justify involuntary hospitalization O'Connor versus Donaldson Right to refuse any treatment and use an appeal process Rennie versus Klein Patient has a right to refuse treatment, but a guardian may authorize their treatment ...

What is the current state of the healthcare industry? correct answer: We grade it by four different criteria, health, quality, cost, and access What is the health of the U.S. like? correct answer: we have shorter life expectancies, higher rates of disease burden, and higher mortality rates than other high income countries. There is disparity of life expectancy across racial, ethnic groups, health statues, income levels, genders and age, but that may not be the healthcare system's fault. We...

Which of the following is an example of a best practice strategy to prevent fraud, waste, and abuse? - Establish procedures for maintaining and distributing medication samples. Which of the following pieces of legislation mandated the establishment of a Join Health Care Fraud and Abuse Control (HCFAC) program? - Health Insurance Portability and Accountability Act (HIPAA) A nurse overhears a provider refer a client who has Medicare to a durable medical equipment company owned by the provider...

CHC Random Study Questions 1 Already Passed Compliance means (Compliance Program) Adherence to laws and regulations, as well as principles of ethical conduct OIG urges the ____________ to assist in the implementation of the compliance program and serves as advisors. A. Board B. CEO C. Compliance Committee D. Quality Committee C. Compliance Committee A compliance professional is reviewing the policies and procedures for exclusion verifications. The policy does not state frequency of exclusio...

When developing clinical privileges the following are important to evaluate? Established standards of practice such as, specialty board recommendations. What is the main reason for periodically assessing appropriateness of clinical privileges for each specialty? To protect patient safety by ensuring current competeny, revelance to the facility and accepted standards of trade. Which is the most likely speciality to perform a PTCA? Interventional Cardiologist TJC hospital s...