Laws governing medicare - 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...

CPMSM QUESTIONS AND ANSWERS FULLY SOLVED HFAP stands for? Healthcare Facilities Accreditation Program (Accrediting organization for AOA. Provides accreditation programs for primarily osteopathic hospitals) The following bodies approves clinical privileges? Governing Body or Board Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:00 Full screen Which NCQA-required committee makes recommendations regarding credentialin...

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...

WGU C426 Healthcare Values and Ethics Rated A+ Normative Ethics Attempt to determine what moral standards should be followed so that human behavior and conduct may be morally right. Consequential Ethics Theory of ethics emphasizes that the morally right action is whatever action leads to the maximum balance of good over evil. - What will be the effects of each course of action? - Will they be positive or negative? - Who will benefit? - What will do the least harm? Utilitarian Ethics The conce...

AHIMA Health Information Management Final Exam with Complete Solutions members of AHIMA are expected to act in a ethical manner and comply with all laws. code of ethics members elect the delegates who serve in the governing bodies of the organizations. Board of Directors The underlying purpose of AHIMA is ____________.to ensure the quality, confidentiality, and availability of health information across diverse organizations, settings, and disciplines. The underlying purpose of AHIM...

WGU C425 Final Exam Questions With 100% Verified Answers | Latest Update 2023/2024. What Is Health? - ANSWER--U.S. health care has followed a medical/biomedical model. - It assumes illness or disease thereby emphasizing clinical diagnosis and medical in the treatment of disease or its symptoms. - It emphasizes • Clinical diagnosis and medical interventions to: - Treat disease or its symptoms. - Have a clinical diagnosis and medical interventions. Largely governed by the medical model/...

code of ethics correct answersmembers of AHIMA are expected to act in a ethical manner and comply with all laws. Board of Directors correct answersmembers elect the delegates who serve in the governing bodies of the organizations. The underlying purpose of AHIMA is ____________. correct answersThe underlying purpose of AHIMA is ____________.to ensure the quality, confidentiality, and availability of health information across diverse organizations, settings, and disciplines. hospital sta...

CPQA - ANSWER-certified professional in quality assurance When did CPHQ begin to advance the profession of quality and when was the first certification administered? - ANSWER-1976; Sept 8 1984 Board of Director's Quality Role - ANSWER-1. set policy 2. financial and strategic direction 3. quality of care 4. goals and objectives 5. establish quality priorities Leadership - ANSWER-ability to influence an individual or group toward achievement of a goal and includes determining the ...

Replacement is not always the best option for the insured because: - ️️a. A new policy could required the applicant to prove insurability b. A new incontestable period will start with the issuance of the new policy. c. The premiums for the new policy could be higher. For an insurance contract to be complete, it must comply with which of the following? - ️️A copy of the contract, all attached riders and a copy of the application must be give to the insured What type of benefits are...

Compliance Program correct answersfollowing rules and regulations Integrity Program correct answersvalues and doing the right thing Current Compliance activities in many organization correct answerso Equal Employment Opportunity Commission (EEOC) o Employee Retirement Income Security Act (ERISA) o Wage and Hour Rule o Occupational Safety and health Administration (OSHA) o Nuclear Regulatory Commission o Joint Commission on Accreditation of Healthcare Organization (JCAHO) o Research ...