Exam (elaborations)
AHIP Final Review FWA 3 questions and answers 2015/2016
- Course
- Institution
AHIP Final Review FWA 3 questions and answers 2015/2016 best for exam revision and rated A with guaranteed excellence results
[Show more]
Seller
Follow
PRIMESTUDY
Content preview
AHIP 2024 Final Review FWA 31. A person drops 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
possible forgery. What is your next step? >ANS>Call the prescriber to verify the quantity
2. Which of the following is NOT potentially a penalty for violation of a law or regulation
prohibiting fraud, waste, and abuse (FWA)? >ANS>Deportation
3. Which of the following requires intent to obtain payment and the knowledge the actions
are wrong? >ANS>Fraud
4. You are in charge of paying claims submitted by providers. You notice a certain
diagnostic provider ("Doe Diagnostics") requested a
substantial payment for a large patient group. Many of these claims are for a certain
procedure. You review the same type of procedure
for other diagnostic providers and realize Doe Diagnostics' claims far exceed any other
provider you reviewed. What should you do? >ANS>Consult with your immediate
supervisor for next steps or contact the compliance department (via compliance hotline,
5. Special Investigations Unit [SIU], or other mechanism)
You are performing a regular inventory of the controlled substances in the pharmacy.
You discover a minor inventory discrepancy.
What should you do? >ANS>Follow your pharmacy's procedures.
6. 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? >ANS>Report the
incident to the compliance department (via compliance hotline or other mechanism)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through EFT, credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying this summary from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller PRIMESTUDY. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy this summary for R198,70. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
82956 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy summaries for 14 years now