Qui tam - Study guides, Class notes & Summaries

CPMA Exam Questions & Answers CMS Fraud Definition - Answer ️️ Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition - Answer ️️ An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud - Answer ️️ Billing for services and/or supplies that you know were not furnished or provided, altering claim forms and/or receipts...

CMS Fraud Definition - answer=Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition - answer=An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud - answer=Billing for services and/or supplies that you know were not furnished or provided, altering claim forms and/or receipts to receive a higher payment amount, billing a Medi...

What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index Answer c. Protected Health Information A new radiology company opens in town. The manager calls your practice and offers to pay $20 for every Medicare patient you send to them for radiology services. What does this offer violate? a. Stark Laws b. HIPAA c. Anti-Kickback law d. Qui Tam Answer c. Anti-Kickback law Which ...

CPMA Exam Complete Questions And Answers With Latest Quiz CMS Fraud Definition Correct Answer: Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition Correct Answer: An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud Correct Answer: Billing for services and/or supplies that you know were not furnished or provided, alter...

1. The biller at a medical practice has identified $575 in Medicare overpayments. After verification, they are presented to the office manager, who tells the biller not to write the refund check. The medical practice is going to put the money in their general account instead. What act does this action violate? A.Truth in Lending Act B.Health Insurance Portability and Accountability Act C.Administrative Simplification Rule D.False Claims Act - correct answer 1.Answer: D. False Claims Act ...

HIPPA REGULATION: Privacy Overview - There are three major areas addressed in the Privacy Regulation: 1. Use and disclosure of PHI, 2. Patient rights 3. Security administrative and physical Business Associates - can be held directly accountable by federal or state authority for failure to comply with HIPAA statutory or regulations. ex. IT techs, Janitors, Cleaning Services, Vendors, Collection agencies, Consultants and Billing Services. Entities - ex. doctors, hospitals, pharmacy Breach - ...

What is the importance of audit in a practice? - Answer- 1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and health plan request and denial. Exclusion Statute - Answer- 1.Physician is banned from participating in any federal or state healthcare program by OIG 2. They can't bill federal or state for any services ...

CMS defines ___________ as billing for a lower level of care than is supported in documentation, making false statements to obtain undeserved benefits or payment from a federal healthcare program, or billing for services that were not performed. a. Fraud b. Abuse c. a Stark violation d. an Anti-kickback - Answer-a. Fraud A patient is seen in your clinic. Her husband calls later in the day to ask for information about the visit. The practice pulls the patient's privacy authorization to s...

CPMA Exam Questions and Answers All Correct CMS Fraud Definition - Answer-Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition - Answer-An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud - Answer-Billing for services and/or supplies that you know were not furnished or provided, altering claim forms and/or receipts to r...

©BRAINBARTER 2024/2025 CPMA STUDY QUESTIONS With Verified Answers. WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? - answer1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation and health plan request and denial. Exclusion Statute - answer1.Physician is banned from participating in any federal or state healthcare ...