Anti kickback - Study guides, Class notes & Summaries

1-day payment window rule - Answer a Medicare requirement similar to the day payment window rule that applies to inpatient poychiatric hosp tals, inpatient rehabilitation facilities, long term care facilities, and chil dren's and cancer hospital. 3-day payment window rule - Answer a Medicare requirement that all diagnostic and clinically related non-diagnostic outpatient services provided with in three days of an inpatient admission must combined the inpa- tient claim when they are provided b...

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...

Anti-Kickback Statute (42 US SS 1320a-7b (b) prohibitions - Prohibits offering, paying, soliciting or reviving anything of value to induce or reward referrals or generate Federal health care program business Anti-Kickback Statute (42 US SS 1320a-7b (b) referrals - Referrals from anyone Anti-Kickback Statute (42 US SS 1320a-7b (b) - Any items or services Anti-Kickback Statute (42 US SS 1320a-7b (b) (Intent) - Intent MUST be proven (knowing and willful) Anti-Kickback Statute (42 US SS 1320a...

AAPC Official CPC Certification Study Guide Notes "hold harmless clause" - ANSWER * found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: - ANSWER * more accurate payment of claims * fewer billing mistakes * improved documentation and more accurate coding * less chance of violati...

Naham Exam Latest Update with Verified Solutions AIDET acknowledge, introduce, duration, explanation, thank you Press Ganey provides patient service satisfaction surveys, used for both public relations & performance improvement KPI Key Performance Indicator KPI Example Preregistration percentage, wait times, accuracy rate, pos collections, productivity HEAT Hear them out, empathize with the customer, apologize, take responsibility for actions PPE personal protective equip...

CALIFORNIA LAW EXAM OPTOMETRY REALWITH 100% CORRECT ANSWERS 2023 COMPLETE SOLUTIONS ALEADY GRADED A Any person holding a license shall notify the issuing board of any changes in mailing address within ____ days after change - Correct answer-30 days It is prohibited to dispense, prescribe of sell eyeglasses not made of shatter-resistant lenses or non-flammable frames to _______ - Correct answer-1. one eyed person 2. law enforcement officer 3. fireman 4. person < 18 years old *not...

HCCA CHC - Stark & Anti Kickback Exam Questions With 100% Verified Answers AntiKickback Statute Highlights - answer1. Criminal/Civil (you go out of business 2. Any federal health program (Medicare, Medicaid, Tri-Care) 3. Requires proof of improper intent (DOJ-Criminal) 4. Applies to any referral source 5. 24 Safe Harbors 6. OIG Advisory Opinions Stark Highlights - answer1. Civil only (no prison time) 2. Medicare only 3. Strict Liability (does not consider knowledge or intent. if X happ...

Stark Definition: Immediate Family Member - Spouse, natural or adoptive parent, children or siblings, step-siblings, in-laws, grandparents/grandchildren. Anti-Kickback Statute (AKS) - Prohibits anyone from purposefully offering, soliciting, or receiving anything f value to generate referrals for items or services payable by any federal health program (Medicare, Medicaid, Tri-Care). 42 states and D.C. have their own AKS. After discovering Stark Law non-compliance... - put a bill-hold immedia...

HCCA CHC - Stark & Anti Kickback Exam Questions With 100% Verified Answers AntiKickback Statute Highlights - answer1. Criminal/Civil (you go out of business 2. Any federal health program (Medicare, Medicaid, Tri-Care) 3. Requires proof of improper intent (DOJ-Criminal) 4. Applies to any referral source 5. 24 Safe Harbors 6. OIG Advisory Opinions Stark Highlights - answer1. Civil only (no prison time) 2. Medicare only 3. Strict Liability (does not consider knowledge or intent. if X happ...

CCEP Glossary of Compliance Terms questions with answers 2023 Anti-Kickback Law Prohibits the solicitation, receiving, offering, or paying of any remuneration directly or indirectly in cash or in kind exchange. Attestation The affirmation by signature, usually on a printed form, that the action outlined has been accomplished by the individual signing; e.g., the individual has read the code of conduct and agreed to adhere to its principles. Attorney-Client Privilege A legally ac...

AHFI Exam Latest Update Graded A+ Anti-Kickback Statute (42 US SS 1320a-7b (b) prohibitions Prohibits offering, paying, soliciting or reviving anything of value to induce or reward referrals or generate Federal health care program business Anti-Kickback Statute (42 US SS 1320a-7b (b) referrals Referrals from anyone Anti-Kickback Statute (42 US SS 1320a-7b (b) Any items or services Anti-Kickback Statute (42 US SS 1320a-7b (b) (Intent) Intent MUST be proven (knowing and willful) ...

HCCA CHC - Stark & Anti Kickback Study Guide with Complete Solutions AntiKickback Statute Highlights - Answer️️ -1. Criminal/Civil (you go out of business 2. Any federal health program (Medicare, Medicaid, Tri-Care) 3. Requires proof of improper intent (DOJ-Criminal) 4. Applies to any referral source 5. 24 Safe Harbors 6. OIG Advisory Opinions Stark Highlights - Answer️️ -1. Civil only (no prison time) 2. Medicare only 3. Strict Liability (does not consider knowledge or intent...