Medicare unlikely edits Study guides, Class notes & Summaries

CPMA Exam Questions and Answers 100% Solved Which option is NOT part of the seven elements that should be included in a compliance plan based on the OIG's recommendations? a. Responding promptly to detected offenses and developing corrective action. b. Conducting effective training and education. c. Identifying employees on the exclusions list. d. Developing effective lines of communication. c. Identifying employees on the exclusions list. The OIG's Compliance Program Guidance for ...

CBCS Exam Study Guide Questions with Complete Rationales Medical Billing & Coding as a Career - ANS: *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Billing & Coding Specialist What are Medical Ethics? - ANS: Standards of conduct based on moral principle. They are generally accepted a...

HCPCS Level II Exam Questions and Answers 100% Pass The HCPCS codes are -Answer-5 digits The first digit is a letter, followed by four numbers. The codes and descriptions are updated each year by CMS. The HCPCS Level II uses several symbols and conventions to alert coders to -Answer- key pieces of information related to code assignment and/or reimbursement. Examples include the -Answer-identification of new, revised, deleted, and reinstated codes and the identification of codes that repr...

Which option is NOT part of the seven elements that should be included in a compliance plan based on the OIG's recommendations? a. Responding promptly to detected offenses and developing corrective action. b. Conducting effective training and education. c. Identifying employees on the exclusions list. d. Developing effective lines of communication. - Answer- c. Identifying employees on the exclusions list. The OIG's Compliance Program Guidance for Individual and Small Physician Group Pr...

CPB AAPC CH 7Local Coverage Determination (LCD) - correct answer Decision made by a fiscal intermediary (FI) or a Medicare carrier about the services and items that are reasonable and necessary. LCD also decides if a particular service should be covered on an intermediary-wide basis, and it makes decisions about the services that is reasonable and necessary for certain diagnoses and procedures codes. Medicare Administrative Contractor (MAC) - correct answer A company under contract with the f...

CPMA Exam Questions and Correct Answers Which option is NOT part of the seven elements that should be included in a compliance plan based on the OIG's recommendations? a. Responding promptly to detected offenses and developing corrective action. b. Conducting effective training and education. c. Identifying employees on the exclusions list. d. Developing effective lines of communication. - Answer-c. Identifying employees on the exclusions list. The OIG's Compliance Program Guidance ...

1 CRCS EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+ HHS Correct Answer: Health and Human Services CMS Correct Answer: Centers for Medicare and Medicaid Services HHS Correct Answer: U.S. Department of Health and Human Services NIH Correct Answer: National Institutes of Health FDA Correct Answer: Food and Drug Administration ACL Correct Answer: Administration for Community Living; one of the HHS Operating Divisions. 2 QIO Correct Answer: Quality Improveme...

Medically Unlikely Edits - Define the maximum units of service that a provider would report, under most circumstances, for a single beneficiary, on a single date of service, for a specific HCPCS/CPT code Purpose of the medically unlikely edits - To help reduce the paid claims error rate for Medicare Part B claims Medicare Modernization Act - Required a 3-year Recovery Audit demonstration, which ran between 2005 and 2008; during the demonstration, Medicare employed Recovery Auditors to i...

CCS Exam Prep Questions and Answers Latest Updated IPPS inpatient prospective payment system OPPS Outpatient Prospective Payment System fee-for-service (FFS) a written fee schedule for each treatment and/or service provided Diagnosis-related groups (DRGs) an episodic care payment system to hospitals for inpatient services based on standards of care for a specific diagnoses grouped by their similar usage of resources for procedures, service, and treatments MS-DRG ...

CPMA Exam Questions and Correct Answers Which option is NOT part of the seven elements that should be included in a compliance plan based on the OIG's recommendations? a. Responding promptly to detected offenses and developing corrective action. b. Conducting effective training and education. c. Identifying employees on the exclusions list. d. Developing effective lines of communication. - Answer-c. Identifying employees on the exclusions list. The OIG's Compliance Program Guidance for ...