What is healthcare fraud - Study guides, Class notes & Summaries
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WGU D333 (Latest 2023/ 2024 Update) Ethics in Technology Exam| Questions and Verified Answers| 100% Correct| Grade A
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WGU D333 (Latest 2023/ 2024 Update) Ethics in Technology Exam| Questions and Verified Answers| 100% Correct| Grade A 
 
Q: What is industrial espionage? 
 
Answer: 
 Acquiring competitors' sensitive information for promotion decisions. 
 
 
Q: What is a benefit of open source code? 
 
Answer: 
 Open source code allows many programmers to read, redistribute, and modify the code so that it improves. 
 
 
Q: What is clinical decision support (CDS)? 
 
Answer: 
 Process and tools to enhance health-r...
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Test Bank for Principles of Healthcare Reimbursement 5th Edition
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Questions 
1. What is the name of your state’s insurance commission? 
Name depends upon the state of the student’s residence. 
2. What is the mission of your state’s insurance commission? 
Mission depends upon the insurance commission of the state of the student’s residence. 
3. List three consumer-related topics on the insurance commission’s website. 
Additional topics depend upon the insurance commission of the state of the student’s 
residence. However, common topics include frau...
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UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS |A+ GRADE
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UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS |A+ GRADE 
 
Q: Agent Jacob learns that Emily, the consumer with whom he is meeting, is the authorized legal representative for her father. What must Jacob explain to Emily when completing an Enrollment Application for her father? 
 
 
Answer: 
Jacob must explain that Emily will sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indic...
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CSPR - Certified Specialist Payment Rep (HFMA) Exam 2023 with Complete Solutions
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Steps used to control costs of managed care include: - ANSWER-Bundled codes 
Capitation 
Payer and Provider to agree on reasonable payment 
 
DRG is used to classify - ANSWER-Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred 
 
Identify the various types of private health plan coverage - ANSWER-HMO 
Conventional 
PPO and POS 
HDHP/SO plans - high-deductible health plans with a savings...
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CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023
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CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 
Steps used to control costs of managed care include: 
Bundled codes 
Capitation 
Payer and Provider to agree on reasonable payment 
 
 
 
DRG is used to classify 
Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred 
 
 
 
Identify the various types of private health plan coverage 
HMO 
Conventional 
PPO and POS 
H...
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CPCO EXAM REVIEW QUESTIONS AND ANSWERS, 100% ACCURATE. VERIFIED.
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CPCO EXAM REVIEW QUESTIONS AND ANSWERS, 100% 
ACCURATE. VERIFIED. 
The OIG consists of 6 departments: - -1.Immediate OIG — responsible for the overall 
fulfillment of the OIG's mission and for promoting effective management and quality of the 
agency's processes and products. 
2.Office of Audit Services — performs independent audits of HHS programs and/or HHS 
grantees and contractors to examine their performance. 
3.Office of Evaluation and Inspections — conducts national evaluations...
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UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS Version 2 |A+ GRADE
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UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS Version 2 |A+ GRADE 
 
 
Q: John has Power of Attorney to act on behalf of his mother. What does that mean when it comes to his mother enrolling in a Medicare Advantage Plan? 
 
 
Answer: 
John may sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indicates his authority under state law to enroll his mother. 
 
 
 
Q: In which of the...
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CPMA(2023-2024 Latest Update)Correct 100%
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When auditing operative notes, the auditor will expect to see documentation from all of the following except: - ANSWER Surgical assistants. 
 
According to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), an outside auditor must sign which of the following agreements prior to reviewing and auditing any medical records? - ANSWER Business Associate Agreement 
 
When auditing an ENT practice, you discover the practice uses an EMR. Which of the following options would you loo...
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HCCA - CHC Study Questions and Answers (Graded A)
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True or False: 
The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - Answer- True 
 
ref. ACA section 6102 
 
According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer- 1.Protect our programs 
2.Protect your patients 
3.Protect the Provider 
 

 
At which level of the Medicare Part A or Part B appeals process is the app...
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UVA Theological Bioethics (RELG 2650) Midterm IDs Questions With Complete Solutions
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bioethics correct answer: The study of ethics related to issues that arise in health care. 
 
ethics correct answer: sustained and intentional reflection on morality and the moral life with analysis, discontent, reasoning, and arguments 
 
moral rules or principles of behavior that should guide members of a profession or organization and make them deal honestly and fairly with each other and with their custom 
 
utilitarianism correct answer: 1 fundamental moral good-to maximize outcomes of ...
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ADJUSTER PRO EXAM WITH REVISED ANSWERS (2023)
- Exam (elaborations) • 16 pages • 2023
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ADJUSTER PRO EXAM WITH REVISED 
ANSWERS (2023) 
Stu has a collection of rare comic books. He wants to purchase theft insurance for his 
collection, separate from his home and other property. What term most accurately 
describes the type of policy Stu would purchase? - CORRECT ANSWER-Monoline 
Policy 
Which of the following statements does NOT apply to the Standard Fire Policy? - 
CORRECT ANSWER-It automatically covers wind and vandalism. 
Which of the following refers to being restored to the ...
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