Doe diagnostics - Study guides, Class notes & Summaries

Your job is to submit a risk diagnosis to the Centers for Medicare & Medicaid Services (CMS) for the purpose of payment. As part of this job, you use a process to verify the data is accurate. Your immediate supervisor tells you to ignore the Sponsor's process and to adjust or add risk diagnosis codes for certain individuals. What should you do? Report the incident to the compliance department (via compliance hotline or other mechanism) You are performing a regular inventory of the contro...

AHIP fraud waste & abuse questions and answers already passed Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? Fraud Which of the following is not potentially a penalty for violation of the law or regulation prohibiting fraud, waste and abuse (fwa)? Deportation A person comes into your pharmacy to drop off a prescription for a beneficiary who is a regular customer. The prescription is for a controlled substance with a quantity of 160. This...

Medicare Fraud, Waste, & Abuse (2022/2023) (Certified Answers) Your job is to submit a risk diagnosis to the Centers for Medicare & Medicaid Services (CMS) for the purpose of payment. As part of this job, you use a process to verify the data is accurate. Your immediate supervisor tells you to ignore the Sponsor's process and to adjust or add risk diagnosis codes for certain individuals. What should you do? a.Do what your immediate supervisor asked you to do and adjust or add risk diagnosis co...

NUR202 Geriatric Nursing: Management Concepts for Elder Care. Mrs. H, a 65-year-old woman with a history of hypertension, presents to the clinician with a continued complaint of a cough. She has been to the office 3 times over the last 6 months with the same troublesome cough. She has had 2 chest infections, 1 of which resulted in an admission to the hospital. She reports that she has been feeling increasingly fatigued and breathless on exertion over the past few weeks. She had a hysterecto...

Your job is to submit a risk diagnosis to the Centers for Medicare & Medicaid Services (CMS) for the purpose of payment. As part of this job, you use a process to verify the data is accurate. Your immediate supervisor tells you to ignore the Sponsor's process and to adjust or add risk diagnosis codes for certain individuals. What should you do? CORRECT ANSWER Report the incident to the compliance department (via compliance hotline or other mechanism) You are performing a regular inventory of...

AHIP Fraud Waste and Abuse Questions With Verified Answers Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? - ANSWER Fraud Which of the following is NOT potentially a penalty for violation of a law or regulation prohibiting Fraud, Waste, and Abuse (FWA)? - ANSWER Deportation A person comes to your pharmacy to drop off a prescription for a beneficiary who is a "regular" customer. The prescription is for a controlled substance...

AHIP Fraud Waste and Abuse Questions With Verified Answers Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? - ANSWER Fraud Which of the following is NOT potentially a penalty for violation of a law or regulation prohibiting Fraud, Waste, and Abuse (FWA)? - ANSWER Deportation A person comes to your pharmacy to drop off a prescription for a beneficiary who is a "regular" customer. The prescription is for a controlled substance...

AHIP Fraud Waste and Abuse Questions With Verified Answers Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? - ANSWER Fraud Which of the following is NOT potentially a penalty for violation of a law or regulation prohibiting Fraud, Waste, and Abuse (FWA)? - ANSWER Deportation A person comes to your pharmacy to drop off a prescription for a beneficiary who is a "regular" customer. The prescription is for a controlled substance...

A person comes into your pharmacy to drop off a prescription for a beneficiary who is a regular customer. The prescription is for a controlled substance with a quantity of 160. This beneficiary normally receives a quantity of 60, not 160. You review the prescription and have concerns about the possible forgery. What is your next step? - Answer-Call the prescriber to verify the quantity Which of the following is not potentially a penalty for violation of the law or regulation prohibiting frau...

Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? Correct Answer: Fraud Which of the following is not potentially a penalty for violation of the law or regulation prohibiting fraud, waste and abuse (fwa)? Correct Answer: Deportation A person comes into your pharmacy to drop off a prescription for a beneficiary who is a regular customer. The prescription is for a controlled substance with a quantity of 160. This beneficiary normally...