Kickback - 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...

Who develops a solicitation? - ANSThe government, and the buyer Who prepares an offer? - ANSThe contractor, and the seller During the post award phase while the contract is being performed, who has responsibility for quality? - ANSThe seller Acquisition - ANSFAR 2.101 tells us Acquisition means the acquiring by contract with appropriated funds of supplies or services (including construction) by and for the use of the Federal Government through purchase or lease, whether the supplies...

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...

California Optometry Law and Regulations Exam | Latest 2024/2025 Update | Questions and Verified Answers| 100% Correct| Grade A Q: It is prohibited to dispense, prescribe, or sell eyeglasses which are not made of shatter-resistant lenses or non-flammable frames to whom? Answer: Monocular pts Law enforcement Firefighters <18 yo Q: T/F. Polycarbonate lenses are required for monocular pts, law enforcement, firefighters, and kids. Answer: False- No specific requirement fo...

HCCA CHC - Stark & Anti-Kickback Questions and Answers 100% Correct | New Update 2024

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...

CFCI Study Guide 2024 with Complete Solutions Fraud - Answer- "Any illegal acts characterized by deceit, concealment, or violation of trust. These acts are not dependent upon the perpetrated by individuals and organizations to obtain money, property, or services; to avoid payment or loss of services; or to secure personal or business ad-vantage." Main types of fraud - Answer- Internal Fraud and External Fraud Internal Fraud - Answer- Activities that may be criminal, committed within an ...

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...

Gold Coast FINAL EXAM STUDY SET for 4/11 Gold Coast FINAL EXAM STUDY SET (Questions and Answers, 100% Verified) what are the the areas a realtor should be an expert in? Marketing Valuation & Market Conditions Property Transfer "MVP" Does one need to be a resident of the state or a citizen of the U.S. to get a FL real estate license? to get a FL real estate license, you don't need to be a citizen What must an applicant for a real estate license do if he has been convicted of a cri...

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...

M100 Community Association Management Exam (Latest 2023/ 2024) Questions and Verified Answers with Rationales| A+ Grade QUESTION True or false. The role of the professional community association manager is to make all decisions for the association and to delegate information-gath- ering and fact-finding support to the board of directors. Answer: False The professional community association manager is charged with assisting the board of directors' decision making process by me...

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...